Validity of the Urinary Trypsinogen-2 Test in the Diagnosis of Acute Pancreatitis
Mayumi T et al. – The simple, rapid, easy, and noninvasive urinary trypsinogen–2 test can diagnose or rule out most cases of acute pancreatitis.Methods
- 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.