We evaluated clinical significance of fecal elastase-1(FE-1) in patients with pancreatic diseases and pancreatic dysfunction, in comparison with other tubeless test and secretin test.
Patients and Methods ; FE-1 was determined in healthy controls(n131),
chronic pancreatitis(CP)(n52), acute pancreatitis(AP)(n14), pancreatic
cyst(Pcyst)(n20), pancreatic cancer(Pca)(n12), post pancreatic surgery(post
P)(n28), biliary diseases(B)(n6), and gastro-duodenal ulcer(G)(n6).
Fecal chymotrypsin(FCT) and BT-PABA test were performed in those patients
digestive diseases. Secretin test collecting duodenal juice through a duodenal
tube was performed in only 65 patients described above.
Results ; FE-1 was 1504}100Ęg/g(M}SE) in healthy controls. Using a cut
off of 200Ęg/g, 94.6% for healthy controls had FE-1 above this limit.
FE-1 was 517}106Ęg/g in CP, 1802}437Ęg/g in AP, 525}109Ęg/g in Pcyst,
528}126Ęg/g in Pca, 135}36mg/g in post P, 1435}506Ęg/g in B, and 1115}325Ęg/g
in G, respectively.
Sensitivity in the diagnosis of CP was 51.9%, 46.2% and 54.8% for FE-1,
FCT, and BT-PABA test, respectively.
Specificity of FE-1 and FCT was 81.3% and 78.7%, while that of BT-PABA test was 44.4%.
Significant correlation was observed between FE-1 and secretory data including juice volume, maximum HCO3| concentration, and amylase output obtained form secretin test.
In diagnosis of severe pancreatic dysfunction classified based on secretin test, the sensitivity was 86.7% for FE-1, 66.7% for FCT, and 66.7% for BT-PABA test. The specificity was also 70.0%, 80.0%, and 54.3%, for FE-1, FCT, and BT-PABA test, respectively.
Conclusion ; These results indicate that FE-1 may be recommended as a new, noninvasive tubeless test of pancreatic function.
[Rinsho Byori 50 : 893`898, 2002]
*1Central Clinical Laboratories, Tokyo Women's Medical University, Tokyo 162-8666
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