POLYCLONAL PANCREATIC ELASTASE ASSAY IS SUPERIOR TO MONOCLONAL ASSAY FOR DIAGNOSIS OF ACUTE-PANCREATITIS

We compared the clinical values for diagnosis of acute pancreatitis of two commercial assays for pancreatic elastase: an ELISA procedure wit h monoclonal antibodies and a RIA technique with polyclonal antibodies . In 14 patients with acute pancreatitis, serum concentrations of elas tase determined by ELISA (ELISA-elastase) decreased much faster (half- life 0.4 days) than those of elastase determined by RIA (RIA-elastase) (2.2 days), amylase (0.8 days), or lipase (0.9 days). Serum samples f rom 253 additional patients with abdominal pain (32 of these with acut e pancreatitis) were analyzed. In sera collected up to 48 h after the onset of disease, the ROC curves showed a slightly higher diagnostic v alue of RIA-elastase. In samples taken later, at a sensitivity of 90% the specificity of RIA-elastase was 95% (ELISA-elastase 40%). We concl ude that serum ELISA-elastase is of much lower clinical value than RIA -elastase for diagnosis of acute pancreatitis.