SERUM COMPLEX OF TRYPSIN 2 AND ALPHA(1) ANTITRYPSIN AS DIAGNOSTIC ANDPROGNOSTIC MARKER OF ACUTE-PANCREATITIS - CLINICAL-STUDY IN CONSECUTIVE PATIENTS

Objective-To estimate the usefulness of serum concentrations of the co mplex of trypsin 2 and alpha(1) antitrypsin in diagnosing and assessin g the severity of acute pancreatitis in comparison with serum C reacti ve protein, amylase, and trypsinogen 2 concentrations (reference marke rs). Design-Markers were measured in consecutive patients admitted wit h acute abdominal pain that was either due to pancreatitis or to other disease unrelated to the pancreas (controls). Setting-Department of s urgery of a teaching hospital in Helsinki. Subjects-110 patients with acute pancreatitis and 66 with acute abdominal diseases of extrapancre atic origin. On the basis of the clinical course, acute pancreatitis w as classified as mild (82 patients) or severe (28 patients). Main outc ome measures-Clinical diagnosis of acute pancreatitis and severity of the disease. Results-At admission all patients with acute pancreatitis had clearly raised concentrations of trypsin 2-alpha(1) antitrypsin c omplex (32 mu g/l), whereas only three of the controls had such values . Of the markers studied, trypsin 2-alpha(1) antitrypsin complex had t he largest area under the receiver operating curve, both in differenti ating acute pancreatitis from extrapancreatic disease and in different iating mild from severe disease. Conclusions-Of the markers studied, t rypsin 2-alpha(1) antitrypsin complex was the most accurate in differe ntiating between acute pancreatitis and extrapancreatic disease and in predicting a severe course for acute pancreatitis.