AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnos...AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.展开更多
BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP)concentration have been reported as prognostic markers for the diagnosis of acute pancrea...BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP)concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012.Urinary and serum samples were collected twice,at enrollment and on the following day for measuring target markers.The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT)Grade of the Japanese Ministry of Health,Labour,and Welfare criteria.RESULTS A total of 94 patients were enrolled during the study period.The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%)and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity,62.5%).The area under the curve(AUC)score of urinary trypsinogen-2 according to prognostic factors was 0.704,which was highest in all parameter.The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692,respectively,which shows higher than other pancreatic enzymes.The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis.Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.展开更多
AIM: To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.METHODS: Major databases including Medline, Embase, Science Cit...AIM: To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.METHODS: Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.RESULTS: In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively.CONCLUSION: uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis.展开更多
BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been incr...BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been increasingly used but its clinical value for the diagnosis of acute pancreatitis and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has not yet been systematically assessed. DATA SOURCES: A comprehensive search was carried out using PubMed (MEDLINE), Embase, and Web of Science for clinical trials, which studied the usefulness of UT-2 as a diagnostic marker for acute pancreatitis. Sensitivity, specificity and the diagnostic odds ratios (DORs) with 95% confidence interval (CI) were calculated for each study and were compared with serum amylase and lipase. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated. RESULTS: A total of 18 studies were included. The pooled sensitivity and specificity of UT-2 for the diagnosis of acute pancreatitis were 80% and 92%, respectively (AUC=0.96, DOR=65.63, 95% CI: 31.65-139.09). The diagnostic value of UT-2 was comparable to serum amylase but was weaker than serum lipase. The pooled sensitivity and specificity for the diagnosis of post-ERCP pancreatitis were 86% and 94%, respectively (AUC=0.92, DOR=77.68, 95% CI: 24.99-241.48).CONCLUSIONS: UT-2 as a rapid test could be potentially used for the diagnosis of post-ERCP pancreatitis and to an extent, acute pancreatitis. Further studies are warranted to confirm these results.展开更多
Objective: To investigate the value of urinary trypsi-nogen activation peptide (TAP) in the early predic-tion of severe acute pancreatitis and to compare itwith acute physiology and chronic health evaluationⅡ (APACHE...Objective: To investigate the value of urinary trypsi-nogen activation peptide (TAP) in the early predic-tion of severe acute pancreatitis and to compare itwith acute physiology and chronic health evaluationⅡ (APACHE Ⅱ).Methods: We assessed the predictive value of urinaryTAP concentrations measured by a competitive en-zyme-linked immunosorbent assay. Urine sampleswere collected for detecting TAP concentrations atadmission, and 24, 48, and 72 h from 41 patientswith acute pancreatitis (12 with severe disease, 29with mild disease) who presented within 48 h the on-set of symptoms and from 11 control patients, whileAPACHE Ⅱ scores were recorded at 48 h after ad-mission.Results: The peak median urinary TAP concentrationwas seen at admission. The median urinary TAPconcentration at admission for severe pancreatitis (95nmol/L) was significantly higher than the medianfor patients with mild pancreatitis (20 nmol/L, P【0. 005) and controls (15 nmol/L, P【0. 005). TAPconcentrations were significantly higher in patientswith severe acute pancreatitis than the median in pa-tients with mild pancreatitis (P【0. 05) and controls(P【0. 05) on days 2 to 3. The median APACHE Ⅱscores of severe patients were significantly differentfrom those of mild patients (10.5 vs 6.0, P【0.01).The sensitivity, specificity, positive predictive, andnegative predictive values of an admission urinaryTAP≥35 nmol/L for severe pancreatitis were91.7%, 89.7%, 78.6% and 96.3%, whereas 48 hafter admission the values for APACHE Ⅱ scores(≥9) were 75.0%, 72.7%, 52.9% and 87.5%. Inprediction of disease severity, the urine TAP concen-tration was much better than APACHE Ⅱ at 48 h.Conclusions: Urinary TAP obtained at the first 48 hof the onset of symptoms can predict severe acutepancreatitis. In prediction of disease severity, theurinary TAP is much better than APACHE Ⅱ score.展开更多
The relationship between M3 cholinergic receptor agonist （carbachol） hyperstimulationinduced pancreatic acinar cellular injury and trypsinogen activation or NF-κB activation in rats was studied in vitro. Rat pancre...The relationship between M3 cholinergic receptor agonist （carbachol） hyperstimulationinduced pancreatic acinar cellular injury and trypsinogen activation or NF-κB activation in rats was studied in vitro. Rat pancreatic acinar ceils were isolated, cultured and treated with carbachol, the active protease inhibitor （pefabloc）, and NF-κB inhibitor （PDTC） in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar ceils. The results showed that as compared with control group, 10-3 mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells （P〈0. 01） following the treatment with a high concentration of carbachol （10^-3 mol/L） in vitro. The addition of 10^-2mol/L PDTC didn＇t result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol （10^-3 mol/L） in vitro （P〉0. 05）. It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-κB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.展开更多
The relationship between intracelluar trypsinogen activation and NF-κB activation in rat pancreatic acinar cells induced by M3 cholinergic receptor agonist （carbachol） hyperstimulation was studied. Rat pancreatic a...The relationship between intracelluar trypsinogen activation and NF-κB activation in rat pancreatic acinar cells induced by M3 cholinergic receptor agonist （carbachol） hyperstimulation was studied. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active protease inhibitor （pefabloc） and NF-κB inhibitor （PDTC） in vitro. Intracelluar trypsin activity was measured by using a fluorogenic substrate. The activity of NF-κB was monitored by using electrophoretic mobility shift assay. The results showed that after pretreatment with 2 mmol/L pefabloc, the activities of trypsin and NF-κB in pancreatic acinar cells treated with high concertrations of carbachol （10^-3 mol/L） in vitro was significantly decreased as compared with control group （P〈0.01 ）. The addition of 10^-2 mol/L PDTC resulted in a significant decrease of NF-κB activities in pancreatic acinar cells after treated with high concertrations of carbachol （10^-3 mol/L） in vitro, but the intracelluar trypsinogen activity was not obviously inhibited （P〉0.05）. It was concluded that intracelluar trypsinogen activation is likely involved in the regulation of high concertrations of carbachol-induced NF-κB activation in pancreatic acinar cells in vitro. NF-κB activation is likely not necessary for high concertrations of carbachol-induced trypsinogen activation in pancreatic acinar cells in vitro.展开更多
Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible...Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.展开更多
基金Supported by grants from the Institute de Salud Carlos III No.C03/02,No. G03/156
文摘AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.
文摘BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP)concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis.AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan.METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012.Urinary and serum samples were collected twice,at enrollment and on the following day for measuring target markers.The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT)Grade of the Japanese Ministry of Health,Labour,and Welfare criteria.RESULTS A total of 94 patients were enrolled during the study period.The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%)and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity,62.5%).The area under the curve(AUC)score of urinary trypsinogen-2 according to prognostic factors was 0.704,which was highest in all parameter.The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692,respectively,which shows higher than other pancreatic enzymes.The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade.CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis.Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.
基金Supported by Technology Supported Program of Sichuan Province, No. 2011SZ0291the National Natural Science Foundation of China, No. 81072910National Institute for Health Research, United Kingdom
文摘AIM: To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.METHODS: Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.RESULTS: In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively.CONCLUSION: uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis.
基金supported by grants from the National Natural Science Foundation of China(2009SZ0201)National Institute of Health Research UK
文摘BACKGROUND: Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been increasingly used but its clinical value for the diagnosis of acute pancreatitis and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has not yet been systematically assessed. DATA SOURCES: A comprehensive search was carried out using PubMed (MEDLINE), Embase, and Web of Science for clinical trials, which studied the usefulness of UT-2 as a diagnostic marker for acute pancreatitis. Sensitivity, specificity and the diagnostic odds ratios (DORs) with 95% confidence interval (CI) were calculated for each study and were compared with serum amylase and lipase. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated. RESULTS: A total of 18 studies were included. The pooled sensitivity and specificity of UT-2 for the diagnosis of acute pancreatitis were 80% and 92%, respectively (AUC=0.96, DOR=65.63, 95% CI: 31.65-139.09). The diagnostic value of UT-2 was comparable to serum amylase but was weaker than serum lipase. The pooled sensitivity and specificity for the diagnosis of post-ERCP pancreatitis were 86% and 94%, respectively (AUC=0.92, DOR=77.68, 95% CI: 24.99-241.48).CONCLUSIONS: UT-2 as a rapid test could be potentially used for the diagnosis of post-ERCP pancreatitis and to an extent, acute pancreatitis. Further studies are warranted to confirm these results.
文摘Objective: To investigate the value of urinary trypsi-nogen activation peptide (TAP) in the early predic-tion of severe acute pancreatitis and to compare itwith acute physiology and chronic health evaluationⅡ (APACHE Ⅱ).Methods: We assessed the predictive value of urinaryTAP concentrations measured by a competitive en-zyme-linked immunosorbent assay. Urine sampleswere collected for detecting TAP concentrations atadmission, and 24, 48, and 72 h from 41 patientswith acute pancreatitis (12 with severe disease, 29with mild disease) who presented within 48 h the on-set of symptoms and from 11 control patients, whileAPACHE Ⅱ scores were recorded at 48 h after ad-mission.Results: The peak median urinary TAP concentrationwas seen at admission. The median urinary TAPconcentration at admission for severe pancreatitis (95nmol/L) was significantly higher than the medianfor patients with mild pancreatitis (20 nmol/L, P【0. 005) and controls (15 nmol/L, P【0. 005). TAPconcentrations were significantly higher in patientswith severe acute pancreatitis than the median in pa-tients with mild pancreatitis (P【0. 05) and controls(P【0. 05) on days 2 to 3. The median APACHE Ⅱscores of severe patients were significantly differentfrom those of mild patients (10.5 vs 6.0, P【0.01).The sensitivity, specificity, positive predictive, andnegative predictive values of an admission urinaryTAP≥35 nmol/L for severe pancreatitis were91.7%, 89.7%, 78.6% and 96.3%, whereas 48 hafter admission the values for APACHE Ⅱ scores(≥9) were 75.0%, 72.7%, 52.9% and 87.5%. Inprediction of disease severity, the urine TAP concen-tration was much better than APACHE Ⅱ at 48 h.Conclusions: Urinary TAP obtained at the first 48 hof the onset of symptoms can predict severe acutepancreatitis. In prediction of disease severity, theurinary TAP is much better than APACHE Ⅱ score.
文摘The relationship between M3 cholinergic receptor agonist （carbachol） hyperstimulationinduced pancreatic acinar cellular injury and trypsinogen activation or NF-κB activation in rats was studied in vitro. Rat pancreatic acinar ceils were isolated, cultured and treated with carbachol, the active protease inhibitor （pefabloc）, and NF-κB inhibitor （PDTC） in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar ceils. The results showed that as compared with control group, 10-3 mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells （P〈0. 01） following the treatment with a high concentration of carbachol （10^-3 mol/L） in vitro. The addition of 10^-2mol/L PDTC didn＇t result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol （10^-3 mol/L） in vitro （P〉0. 05）. It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-κB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.
文摘The relationship between intracelluar trypsinogen activation and NF-κB activation in rat pancreatic acinar cells induced by M3 cholinergic receptor agonist （carbachol） hyperstimulation was studied. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active protease inhibitor （pefabloc） and NF-κB inhibitor （PDTC） in vitro. Intracelluar trypsin activity was measured by using a fluorogenic substrate. The activity of NF-κB was monitored by using electrophoretic mobility shift assay. The results showed that after pretreatment with 2 mmol/L pefabloc, the activities of trypsin and NF-κB in pancreatic acinar cells treated with high concertrations of carbachol （10^-3 mol/L） in vitro was significantly decreased as compared with control group （P〈0.01 ）. The addition of 10^-2 mol/L PDTC resulted in a significant decrease of NF-κB activities in pancreatic acinar cells after treated with high concertrations of carbachol （10^-3 mol/L） in vitro, but the intracelluar trypsinogen activity was not obviously inhibited （P〉0.05）. It was concluded that intracelluar trypsinogen activation is likely involved in the regulation of high concertrations of carbachol-induced NF-κB activation in pancreatic acinar cells in vitro. NF-κB activation is likely not necessary for high concertrations of carbachol-induced trypsinogen activation in pancreatic acinar cells in vitro.
文摘Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.
