Forman M A, Marks S L, De Cock H E V, Hergesell E J, Wisner E R, Baker T W, Kass P H, Steiner J M, Williams D A
Veterinary Medical Teaching Hospital, (Forman, Baker) University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
J Vet Intern Med. 2004 Nov-Dec;18(6):807-15. doi: 10.1892/0891-6640(2004)18<807:eosfpl>2.0.co;2.
Serum feline trypsinogen-like immunoreactivity (fTLI) concentrations and abdominal ultrasound have facilitated the noninvasive diagnosis of pancreatitis in cats, but low sensitivities (33% and 20-35%, respectively) have been reported. A radioimmunoassay has been validated to measure feline pancreatic lipase immunoreactivity (fPLI), but the assay's sensitivity and specificity have not been established. In human beings, the sensitivity of computed tomography (CT) is high (75-90%), but in a study of 10 cats, only 2 had CT changes suggestive of pancreatitis. We prospectively evaluated these diagnostic tests in cats with and without pancreatitis. In all cats, serum was obtained for fTLI and fPLI concentrations, and pancreatic ultrasound images and biopsies were acquired. Serum fPLI concentrations (P< .0001) and ultrasound findings (P = .0073) were significantly different between healthy cats and cats with pancreatitis. Serum fTLI concentrations (P = .15) and CT measurements (P = .18) were not significantly different between the groups. The sensitivity of fTLI in cats with moderate to severe pancreatitis was 80%, and the specificity in healthy cats was 75%. Feline PLI concentrations were both sensitive in cats with moderate to severe pancreatitis (100%) and specific in the healthy cats (100%). Abdominal ultrasound was both sensitive in cats with moderate to severe pancreatitis (80%) and specific in healthy cats (88%). The high sensitivities of fPLI and abdominal ultrasound suggest that these tests should play an important role in the noninvasive diagnosis of feline pancreatitis. As suggested by a previous study, pancreatic CT is not a useful diagnostic test for feline pancreatitis.
血清猫胰蛋白酶原样免疫反应性(fTLI)浓度和腹部超声有助于猫胰腺炎的无创诊断,但据报道其敏感性较低(分别为33%和20 - 35%)。一种放射免疫测定法已被验证可用于测量猫胰腺脂肪酶免疫反应性(fPLI),但该测定法的敏感性和特异性尚未确定。在人类中,计算机断层扫描(CT)的敏感性较高(75 - 90%),但在一项对10只猫的研究中,只有2只猫有提示胰腺炎的CT改变。我们对有或无胰腺炎的猫进行了这些诊断测试的前瞻性评估。对所有猫均采集血清以测定fTLI和fPLI浓度,并获取胰腺超声图像和活检样本。健康猫和患胰腺炎的猫之间血清fPLI浓度(P <.0001)和超声检查结果(P =.0073)存在显著差异。两组之间血清fTLI浓度(P =.15)和CT测量值(P =.18)无显著差异。fTLI在中度至重度胰腺炎猫中的敏感性为80%,在健康猫中的特异性为75%。猫PLI浓度在中度至重度胰腺炎猫中既敏感(100%)又在健康猫中具有特异性(100%)。腹部超声在中度至重度胰腺炎猫中既敏感(80%)又在健康猫中具有特异性(88%)。fPLI和腹部超声的高敏感性表明这些测试应在猫胰腺炎的无创诊断中发挥重要作用。如先前一项研究所表明的,胰腺CT对猫胰腺炎不是一种有用的诊断测试。