Effectivity of qualitative urinary trypsinogen-2 measurement in the diagnosis of acute pancreatitis: a randomized, clinical study.

Background: There is no any definite diagnostic test for acute pancreatitis. In the present study we investigated the value of the qualitative urinary trypsinogen-2 measurement in the diagnosis of acute pancreatitis by an immuno-chromatographic dipstick test.

Methods: A prospective, randomized, clinical trial was planned on 99 patients (53 male, 46 female; male/female : 1.11; age range: 16-83; mean age: 37.4). Patients were divided into two groups: 50 cases were referred to our emergency surgical unit due to abdominal pain and diagnosed with acute pancreatitis by abdominal computerized tomography (CT) (Group 1); 49 cases were referred to our emergency surgical unit due to abdominal pain and whose abdominal CTs did not show any sign of acute pancreatitis (Group 2). Qualitative urinary trypsinogen-2 measurement, abdominal CT and blood amylase values were obtained in all cases.

Results: In group 1, urinary trypsinogen-2 measurement was found positive in 28 cases out of 50 cases diagnosed with acute pancreatitis (56% sensitivity). In group 2, results were found positive in 3 out of 49 patients with abdominal pain, who lacked an acute pancreatitis diagnosis (90.9% specificity). Severe intra-abdominal inflammation was present in three cases of group 2 where we obtained false positive results which may stimulate the pancreatic exocrine secretion.

Conclusion: Qualitative measurements of urinary trypsinogen-2 in patients with abdominal pain may be useful in the diagnosis of acute pancreatitis. It is an easy, inexpensive, rapid and noninvasive method.