[Diagnostic relevance of provocative (evocative) blood enzyme tests in pancreatic disease (author's transl)].

After a review of the literature the author's results of testing pancreatic function in 445 patients with different diseases are reported. The activities of serum amylase and lipase were estimated before and after stimulation with secretin and pancreozymin; at the same time exocrine secretions of the pancreas were collected in the duodenum and analyzed. Serum enzyme activity did not change markedly after stimulation in pronounced pancreatic insufficiency. Measuring the enzyme activity thus helped to make the diagnosis only in a few cases with chronic pancreatitis and pancreatic carcinoma. In all other patients there was no correlation between changes of serum enzyme activities and changes of exocrine pancreatic function. Pathological test results, that means an increase in enzyme activity after stimulation, were found not only in patients with established or suspected pancreatic diseases, but also in many other subjects. Thus the diagnostic relevance of these tests seems to be rather limited, since it does not prove or exclude with sufficient specificity or adequate probability the presence of pancreatic diseases; it therefore cannot be recommended for screening purposes.