Biochemical evaluation of patients with acute pancreatitis

In this study we determined the clinical accuracy of alpha (2)-macroglobuli n, alpha -amylase, C-reactive protein, lipase, non-esterified fatty acids, pancreatic alpha -amylase and phospholipase A in the diagnosis and prognosi s of acute pancreatitis in a group of patients with acute abdominal pain us ing receiver operator characteristic curve analysis. We investigated 59 pat ients with acute pancreatitis and 72 patients with extrapancreatic diseases of gastrointestinal origin. On the basis of initial enzyme activities, at cut-offs of 245 U/I for amylase. 656 U/I for lipase, and 182 U/I for pancre atic alpha -amylase, the diagnostic efficiencies were 0.993, 0.980, and 0.9 75, respectively. Receiver operator characteristic curve analysis showed th e same diagnostic accuracies. We evaluated the accuracy of serum alpha (2)- macroglobulin, C-reactive protein, non-esterified fatty acids end phospholi pase A for differentiation between acute necrotizing pancreatitis and acute oedematous pancreatitis. C-reactive protein had the highest prognostic acc uracy of the parameters studied (the area under curve = 0.9082) and at a cu t-off value of 126 mg/l, sensitivity and specificity were 0.759 and 0.912, respectively. The role of the clinical laboratory in the investigation of p atients with acute pancreatitis continues to evolve and biochemical paramet ers are a good diagnostic and prognostic: option.