Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Pancreas. 2012 Aug;41(6):869-75. doi: 10.1097/MPA.0b013e3182480ab7.
A simple urinary trypsinogen-2 test was evaluated for the diagnosis of acute pancreatitis.
This prospective multicenter study enrolled consecutive patients with acute abdominal pain who presented to the emergency department or who were hospitalized at 1 of 21 medical institutions in Japan. Patients were tested with urinary trypsinogen-2 dipstick test and a quantitative trypsinogen-2 assay, and these values were compared with serum amylase and lipase findings.
A total of 412 patients were enrolled. The trypsinogen-2 dipstick test was positive in 107 of 156 patients with acute pancreatitis (sensitivity, 68.6%) and in 33 of 256 patients with nonpancreatic abdominal pain (specificity, 87.1%). The sensitivity for the diagnosis of pancreatitis caused by alcohol and gallstones by the dipstick test was 72.2% and 81.8%, respectively, which was much higher than those associated with amylase testing. There are several degrees of positivity within the urinary trypsinogen-2 dipstick test. Modification of the cutoff point such that positive (+) and most positive (++) results were interpreted as a positive result, the specificity and positive likelihood ratio increased to 92.2% and 7.63, respectively.
This simple, rapid, easy, and noninvasive urinary trypsinogen-2 test can diagnose or rule out most cases of acute pancreatitis.
评估一种简单的尿胰蛋白酶原-2 检测法用于诊断急性胰腺炎。
本前瞻性多中心研究纳入了因急性腹痛就诊于急诊科或日本 21 家医疗机构住院的连续患者。患者接受尿胰蛋白酶原-2 检测和定量胰蛋白酶原-2 检测，将这些检测值与血清淀粉酶和脂肪酶检测结果进行比较。
共纳入 412 例患者。156 例急性胰腺炎患者中有 107 例（敏感性 68.6%）和 256 例非胰腺性腹痛患者中有 33 例（特异性 87.1%）尿胰蛋白酶原-2 检测阳性。与淀粉酶检测相比，尿胰蛋白酶原-2 检测用于诊断酒精和胆石性胰腺炎的敏感性分别为 72.2%和 81.8%。尿胰蛋白酶原-2 检测存在不同程度的阳性结果。将检测结果分为阳性（+）和强阳性（++），此时特异性和阳性似然比分别提高至 92.2%和 7.63。
这种简单、快速、易于操作、非侵入性的尿胰蛋白酶原-2 检测法可用于诊断或排除大多数急性胰腺炎。
