HUMAN PANCREAS-SPECIFIC PROTEIN PROCARBOXYPEPTIDASE-B - A USEFUL SERUM MARKER OF ACUTE-PANCREATITIS

The aim of this study was to evaluate the serum behavior of human panc reas-specific protein/procarboxypeptidase B (hPASP/PCPB) in the early phases of acute pancreatitis, and to calculate its sensitivity and spe cificity in comparison with those of serum amylase and lipase in the d iagnosis of this illness. Twenty-six acute pancreatitis patients were studied; the pancreatitis was of biliary origin in 11, due to alcohol abuse in 8, and due to other causes in 7. Sixteen patients had mild pa ncreatitis and 10 the severe form of the disease. Thirty-one patients with nonpancreatic acute digestive diseases were also studied. Serum c oncentrations of hPASP/PCPB, amylase and lipase were determined in all subjects on admission to the study as well as dairy for the following 5 days in acute pancreatitis patients. All patients with acute pancre atitis had abnormally high serum hPASP/PCPB, amylase and lipase concen trations on the first day of admission. On the sixth day of the diseas e, 76% of acute pancreatitis patients had abnormally high serum concen trations of hPASP/PCPB, whereas only 48% (p < 0.05) had elevated serum amylase and lipase. No differences in serum levels of hPASP/PCPB, amy lase or lipase were found between patients with alcoholic pancreatitis and those with other etiological forms of the disease, or between tho se with mild and severe forms of pancreatitis. The specificity of the three serum pancreatic protein assays, calculated on the 31 patients w ith nonpancreatic acute digestive diseases, was 90% for both hPASP/PCP B and lipase, 75% for amylase. Serum hPASP/PCPB showed the same high s ensitivity as amylase and lipase for the diagnosis of acute pancreatit is in the first 24 h of the disease, but elevated values of this prote in persisted longer than those of serum amylase and lipase.