使用标准化胰腺组织学评估对60只猫进行血清特异性fPL(™)和1,2 - 二 - 月桂酰 - 消旋甘油 - 3 - 戊二酸 - (6'-甲基试卤灵)酯检测的比较
Comparison of Serum Spec fPL(™) and 1,2-o-Dilauryl-Rac-Glycero-3-Glutaric Acid-(6'-Methylresorufin) Ester Assay in 60 Cats Using Standardized Assessment of Pancreatic Histology.
作者信息
Oppliger S, Hilbe M, Hartnack S, Zini E, Reusch C E, Kook P H
机构信息
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Institute for Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
出版信息
J Vet Intern Med. 2016 May;30(3):764-70. doi: 10.1111/jvim.13924. Epub 2016 Mar 10.
BACKGROUND
Feline pancreas-specific lipase (Spec fPL) is considered a useful test for the antemortem diagnosis of pancreatitis in cats. A recent study found good agreement between the results of the Spec fPL and catalytic 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay. Prospective studies evaluating their sensitivity and specificity are lacking.
OBJECTIVES
To compare the results of the Spec fPL and the DGGR assays with a standardized histologic assessment of the pancreas.
ANIMALS
Sixty client-owned cats presented for necropsy.
PROSPECTIVE STUDY
Spec fPL concentrations and serum DGGR lipase activity were measured from the same blood sample. The pancreas was removed within 3 hours after euthanasia; serial transverse sections were made every 0.5 cm throughout the entire pancreas and reviewed using a histologic grading scheme. Sensitivity and specificity for the Spec fPL and DGGR assay results were determined.
RESULTS
The sensitivity and specificity for the Spec fPL assay (cutoff value ≥5.4 μg/L) was 42.1 [95% confidence interval (95% CI), 29.4-55.9%] and 100% (95% CI, 31.0-100.0%). The sensitivity and specificity for the DGGR assay (cutoff value >26 U/L) was 36.8 (95% CI, 24.7-50.7%) and 100% (95% CI, 31.0-100.0%). When lymphocytic inflammation up to 10% of a section was considered normal, the sensitivity and specificity for Spec fPL assay (cutoff value ≥5.4 μg/L) was 61.1 (95% CI, 36.1-81.7%) and 69.0% (95% CI, 52.8-81.9%) and the sensitivity and specificity for the DGGR assay (cutoff value >26 U/L) was 66.7 (95% CI, 41.2-85.6%) and 78.6% (95% CI, 62.8-89.2%).
CONCLUSIONS AND CLINICAL IMPORTANCE
Both lipase assays performed similarly well, but their agreement with histologic pancreatic inflammation was limited.
背景
猫胰腺特异性脂肪酶（Spec fPL）被认为是猫胰腺炎生前诊断的一项有用检测指标。最近一项研究发现，Spec fPL检测结果与催化型1,2 - O - 二月桂酰 - rac - 甘油 - 3 - 戊二酸 -（6'-甲基试卤灵）酯（DGGR）脂肪酶检测结果具有良好的一致性。目前缺乏评估它们敏感性和特异性的前瞻性研究。
目的
将Spec fPL和DGGR检测结果与胰腺的标准化组织学评估进行比较。
动物
60只由客户拥有并送来进行尸检的猫。
前瞻性研究
从同一血样中检测Spec fPL浓度和血清DGGR脂肪酶活性。安乐死后3小时内取出胰腺；在整个胰腺上每隔０.5厘米制作连续的横切片，并使用组织学分级方案进行检查。确定Spec fPL和DGGR检测结果的敏感性和特异性。
结果
Spec fPL检测（临界值≥5.4μg/L）的敏感性和特异性分别为42.1 [95%置信区间（95%CI），29.4 - 55.9%]和１００％（95%CI，31.0 - 100.0%）。DGGR检测（临界值>26U/L）的敏感性和特异性分别为36.8（95%CI，24.7 - 50.7%）和100%（95%CI，31.0 - 100.0%）。当将切片中高达10%的淋巴细胞性炎症视为正常时，Spec fPL检测（临界值≥5.4μg/L）的敏感性和特异性分别为61.1（95%CI；36.1 - 81.7%）和69.0%（95%CI，52.8 - 81.9%），DGGR检测（临界值>26U/L）的敏感性和特异性分别为66.7（95%CI，41.2 - 85.6%）和78.6%（95%CI，62.8 - 89.2%）。
结论及临床意义
两种脂肪酶检测表现相似，但它们与胰腺组织学炎症的一致性有限。
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