SERUM TRYPSINOGEN-2 IN THE PREDICTION OF OUTCOME IN ACUTE NECROTIZINGPANCREATITIS

Background: The accuracy of serum trypsinogen-2 in predicting the seve rity of acute necrotizing pancreatitis (ANP) was prospectively evaluat ed in 52 consecutive patients. Methods: A new sensitive immunofluorome tric assay was used for serum trypsinogen-2. Results: Mean values duri ng the first 24 h were 42.1 mu g/l in control patients, 1435 mu g/l in uncomplicated cases, and 4090 mu g/l in complicated or fatal cases. T here was a significant difference in serum trypsinogen-2 values betwee n patients with uncomplicated and complicated disease (p=0.002) alread y on admission. When a cutoff level of 1000 mu g/l was used, patients with uncomplicated ANP were differentiated from patients with complica ted ANP with a sensitivity of 98% and with a specificity of 71%. Concl usions: The immunofluorometric assay of serum trypsinogen-2 is a sensi tive and specific method for prediction of the severity of the disease in necrotizing pancreatitis.