Dominguez-Muñoz J Enrique
Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Curr Opin Gastroenterol. 2020 Sep;36(5):421-427. doi: 10.1097/MOG.0000000000000664.
Pancreatic function tests are mainly used for the diagnosis of exocrine pancreatic insufficiency (EPI) in patients with pancreatic diseases or after pancreatic or gastric surgery. Breath tests evaluate not just pancreatic secretion but the digestion capacity of the pancreas. These tests are good candidates for the diagnosis of EPI as they are noninvasive, accurate and easy to apply to clinical practice.
The C-labelled mixed triglyceride (MTG) breath test has been optimized and validated against adequate reference methods for the diagnosis of EPI in patients with chronic pancreatitis and for the evaluation of the efficacy of pancreatic enzyme replacement therapy (PERT). In addition, reported C-MTG breath test results in patients with other pancreatic diseases and after pancreatic and gastric surgery support the accuracy and clinical applicability of this test. The evidence of pancreatic function breath tests with other C-labelled substrates is limited.
Increasing evidence supports the accuracy and clinical usefulness of the C-MTG breath test for the diagnosis of EPI and the evaluation of the efficacy of PERT in different clinical conditions. Commercial availability of this test is required for a wide clinical use. The use of optimized and validated breath test protocols is mandatory.
胰腺功能测试主要用于诊断胰腺疾病患者或胰腺或胃手术后的外分泌性胰腺功能不全（EPI）。呼吸测试不仅评估胰腺分泌情况，还评估胰腺的消化能力。这些测试因其无创、准确且易于应用于临床实践，是诊断EPI的理想选择。
¹³C标记的混合甘油三酯（MTG）呼吸测试已针对诊断慢性胰腺炎患者的EPI以及评估胰酶替代疗法（PERT）疗效的适当参考方法进行了优化和验证。此外，关于其他胰腺疾病患者以及胰腺和胃手术后的¹³C-MTG呼吸测试结果支持了该测试的准确性和临床适用性。使用其他¹³C标记底物进行胰腺功能呼吸测试的证据有限。
越来越多的证据支持¹³C-MTG呼吸测试在不同临床情况下诊断EPI和评估PERT疗效方面的准确性和临床实用性。广泛临床应用需要该测试具备商业可用性。必须使用经过优化和验证的呼吸测试方案。
