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urinary trypsinogen-2 for diagnosing acute pancreatitis:a meta-analysis

Hepatobiliary & Pancreatic Diseases International 2013年第4期12卷 355-362页

作者： Tao Jin Wei Huang Kun Jiang Jun-Jie Xiong Ping Xue Muhammad A Javed Xiao-Nan Yang Qing Xia Sichuan Provincial Pancreatitis Center Department of Integrated Traditional Chinese and Western Medicine West China Hospital Sichuan University NIHR Liverpool Pancreas Biomedical Research Unit Royal Liverpool University Hospital University of LiverpoolLiverpool L69 3BX UK Department of Hepato-Biliary-Pancreatic Surgery West China Hospital Sichuan University

BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. urinary trypsinogen-2 (UT-2) has been increasingly used but its clinical value for the diagnosis of acute pancreatitis and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has not yet been systematically assessed. DATA SOURCES: A comprehensive search was carried out using PubMed (MEDLINE), Embase, and Web of Science for clinical trials, which studied the usefulness of UT-2 as a diagnostic marker for acute pancreatitis. Sensitivity, specificity and the diagnostic odds ratios (DORs) with 95% confidence interval (CI) were calculated for each study and were compared with serum amylase and lipase. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated. RESULTS: A total of 18 studies were included. The pooled sensitivity and specificity of UT-2 for the diagnosis of acute pancreatitis were 80% and 92%, respectively (AUC=0.96, DOR=65.63, 95% CI: 31.65-139.09). The diagnostic value of UT-2 was comparable to serum amylase but was weaker than serum lipase. The pooled sensitivity and specificity for the diagnosis of post-ERCP pancreatitis were 86% and 94%, respectively (AUC=0.92, DOR=77.68, 95% CI: 24.99-241.48).CONCLUSIONS: UT-2 as a rapid test could be potentially used for the diagnosis of post-ERCP pancreatitis and to an extent, acute pancreatitis. Further studies are warranted to confirm these results.

关键词： urinary trypsinogen-2 acute pancreatitis endoscopic retrograde cholangiopancreatography diagnostic odds ratios meta-analysis

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Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis

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World Journal of Gastroenterology 2005年第46期11卷 7261-7265页

作者： Jesús Sáez Juan Martínez Celia Trigo José Sánchez-Payá Luis Compay Raquel Laveda Pilar Grió Cristina García Miguel Pérez-Mateo Section of Gastroenterology and Department of Internal Medicine Hospital General Universitario de Alicante Alicante Spain Service of Clinical Laboratory Hospital General Universitario de Alicante Alicante Spain Service of Preventive Medicine Hospital General Universitario de Alicante Alicante Spain Section of Gastroenterology and Department of Internal MedicineHospital General Universitario de Alicante AlicanteSpain

AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute ***: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay ***: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (Purinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/***: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. urinary trypsinogen-2 test strip showed a clinical value similar to amylase and *** TAP was not a useful screening test for the diagnosis of acute pancreatitis.

关键词： Acute pancreatitis urinary trypsinogen-2 urinary trypsinogen activation peptide Activation peptide of carboxypeptidase B Acute abdominal pain

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