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
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.