PANCREATITIS ASSOCIATED PROTEIN AS AN EARLY MARKER OF ACUTE-PANCREATITIS

Background-Measuring serum pancreatitis associated protein (PAP) in ac ute pancreatitis has proved valuable in monitoring the course of the d isease and the recovery of the patient. Aims-The aim was to analyse th e utility of PAP on admission as a diagnostic and prognostic marker of acute pancreatitis. Patients-Values of PAP were prospectively analyse d in 80 healthy volunteers, 164 patients with abdominal pain but witho ut pancreatitis, 109 patients with mild acute pancreatitis, and 38 pat ients with severe acute pancreatitis. Methods-The diagnosis of acute p ancreatitis was verified with clinical, laboratory, radiological, and in some cases findings at operation or necropsy. Results-Mean (95% con fidence intervals) serum PAP values were 27 (24 to 29) mu g/l in healt hy volunteers, 78 (59 to 96) mu g/l in patients with abdominal pain, 1 91 (134 to 247) mu g/l, in patients with mild acute pancreatitis, and 599 (284 to 914) mu g/l in patients with severe acute pancreatitis. Di fferences between the groups were significant (p=0 . 04-0 . 01). Despi te the differences in means, the ranges overlapped between the groups. The sensitivity of PAP on admission to detect acute pancreatitis was 38%-53% and the respective specificity 89%-77% depending on the cut of f level. The sensitivity of PAP to detect severe acute pancreatitis wa s 45%-68% and the specificity 74%-59% depending on the cut off level. Conclusions-Admission PAP did not distinguish severe from mild acute p ancreatitis better than C reactive protein. Measurement of PAP does no t give appreciable diagnostic advantages in the early phase of acute p ancreatitis.