Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis:A multicenter study in Japan  

作　　者：Hiroaki Yasuda Keisho Kataoka Yoshifumi Takeyama Kazunori Takeda Tetsuhide Ito Toshihiko Mayumi Shuji Isaji Tetsuya Mine Motoji Kitagawa Seiki Kiriyama Junichi Sakagami Atsushi Masamune Kazuo Inui Kenji Hirano Ryukichi Akashi Masamichi Yokoe Yoshio Sogame Kazuichi Okazaki Chie Morioka Yasuyuki Kihara Shigeyuki Kawa Masao Tanaka Akira Andoh Wataru Kimura Isao Nishimori Junji Furuse Isao Yokota Tooru Shimosegawa 

机构地区：[1]Department of Medicine,Division of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine [2]Department of Surgery, Kindai University Faculty of Medicine [3]Department of Surgery, National Hospital Organization Sendai Medical Center [4]Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University [5]Department of Emergency Medicine, University of Occupational and Environmental Health [6]Department of Hepatobiliary-Pancreatic and Transplant Surgery, Mie University School of Medicine [7]Department of Gastroenterology, Tokai University School of Medicine [8]Department of Nutritional Sciences, Nagoya University of Arts and Sciences [9]Department of Gastroenterology, Ogaki Municipal Hospital [10]Division of Gastroenterology, Tohoku University Graduate School of Medicine [11]Department of Gastroenterology, Fujita Health University Bantane Hospital [12]Department of Gastroenterology, Graduate School of Medicine, University of Tokyo [13]Department of Healthcare Center, Kumamoto Regional Medical Center [14]General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital [15]The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University [16]Third Department of Internal Medicine, Nara Medical University [17]Department of Gastroenterology, Kitakyushu General Hospital [18]Department of Internal Medicine, Matsumoto Dental University [19]Department of Surgery and Oncology, Graduate School of Medical Sciences,Kyushu University [20]Division of Gastroenterology, Department of Internal Medicine, Shiga University of Medical Science [21]Department of Gastroenterological, General, Breast and Thyroid Surgery,Yamagata University Faculty of Medicine [22]Department of Gastroenterology and Hepatology, Kochi Medical School [23]Faculty of Medicine, Department of Medical Oncology, Kyorin University [24]Department of Biostatistics, Hokkaido University

出　　处：《World Journal of Gastroenterology》2019年第1期107-117,共11页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP) concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012. Urinary and serum samples were collected twice, at enrollment and on the following day for measuring target markers. The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT) Grade of the Japanese Ministry of Health, Labour, and Welfare criteria.RESULTS A total of 94 patients were enrolled during the study period. The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%) and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity, 62.5%). The area under the curve(AUC) score of urinary trypsinogen-2 according to prognostic factors was 0.704, which was highest in all parameter. The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692, respectively, which shows higher than other pancreatic enzymes. The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis. Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP) concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012. Urinary and serum samples were collected twice, at enrollment and on the following day for measuring target markers. The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT) Grade of the Japanese Ministry of Health, Labour, and Welfare criteria.RESULTS A total of 94 patients were enrolled during the study period. The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%) and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity, 62.5%). The area under the curve(AUC) score of urinary trypsinogen-2 according to prognostic factors was 0.704, which was highest in all parameter. The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692, respectively, which shows higher than other pancreatic enzymes. The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis. Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.

关 键 词：Acute PANCREATITIS TRYPSINOGEN activation peptide Urinary TRYPSINOGEN-2 DIPSTICK test 

分 类 号：R[医药卫生]