Akut Pankreatitin Erken Teşhisi ve Şiddetinin Belirlenmesinde İdrar Tripsinojen-2 Testinin Kullanılması: Prospektif bir Çalışma

Early diagnosis and prediction of severity in acute pancreatitis using urine trypsinogen-2 dipstick test: A prospective study

Kamer E, Ünalp HR, Derici H, Tansuğ T, Önal MA

Department of Surgery, İzmir Atatürk Training and Research Hospital

 

World J Gastroenterol 2007 December;13(46):6208-6212

AIM: To evaluate the use of the trypsinogen-2 dipstick (Actim Pancreatitis) test for early diagnosis and prediction of severity in acute pancreatitis (AP).

METHODS: Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test (UTDT) and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis.

RESULTS: UTDT was positive in 87 (94.6%) of the AP patients and in two (8%) controls (P < 0.05). Positive UTDT was found in 61 (92.4%) of 66 (71.7%) patients with mild pancreatitis and in all (100%) of the 26 (28.3%) with severe pancreatitis (P > 0.05). UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis (6.2 +/- 2.5 d vs 2.0 +/- 1.43 d, P < 0.05). The sensitivity, specificity, positive predictive value, negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively.

CONCLUSION: UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.

Duyurular
Bu sayfalarda Dr. Turhan Tansuğ’un radyoloji arşivindeki çeşitli patolojilere ait konvansiyonel radyolojik görüntülerden örneklere yer verilecektir.
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