Activation peptide of carboxypeptidase B and anionic trypsinogen as early predictors of the severity of acute pancreatitis

Citation
S. Appelros et al., Activation peptide of carboxypeptidase B and anionic trypsinogen as early predictors of the severity of acute pancreatitis, BR J SURG, 88(2), 2001, pp. 216-221
Citations number
25
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
BRITISH JOURNAL OF SURGERY
ISSN journal
0007-1323 → ACNP
Volume
88
Issue
2
Year of publication
2001
Pages
216 - 221
Database
ISI
SICI code
0007-1323(200102)88:2<216:APOCBA>2.0.ZU;2-9
Abstract
Background: Early prediction of severity is important in the management of patients with acute pancreatitis. The presence of activation peptides and c ertain pancreatic proenzymes in plasma and urine has been shown to correlat e with severity. This study was designed to assess the value of measuring l evels of the activation peptide of carboxypeptidase B (CAPAP) and of anioni c trypsinogen. Methods: Concentrations of CAPAP and anionic trypsinogen were measured in t he urine and serum in 60 patients with acute pancreatitis. Preset cut-off l evels were used to analyse the accuracy of the tests. Severity was classifi ed retrospectively according to the Atlanta classification. Results: Concentrations of CAPAP in urine and serum and of anionic trypsino gen in urine correlated with the severity of the pancreatitis. CAPAP in uri ne showed the highest accuracy. The overall accuracy was 90 per cent, with a positive predictive value of 69 per cent and a negative predictive value of 98 per cent. Conclusion: In this study, measurement of CAPAP in urine was an accurate wa y to predict the severity of acute pancreatitis, and was superior to assay of anionic typsinogen in urine and serum. Measurement of CAPAP in urine may be of value in the management of individual patients with pancreatitis and in the selection of patients for therapeutic trials.