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Clinical Chemistry 42: 685-690, 1996;
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Clinical Chemistry, Vol 42, 685-690, Copyright © 1996 by American Association for Clinical Chemistry

Urine trypsinogen-2 as marker of acute pancreatitis

J Hedstrom, V Sainio, E Kemppainen, P Puolakkainen, R Haapiainen, E Kivilaakso, KO Schauman and UH Stenman
Department of Clinical Chemistry, University of Helsinki, Finland.

We examined the clinical utility of urine trypsinogen-2 as a marker of acute pancreatitis (AP). Fifty-nine patients with AP, 42 with acute abdominal diseases of extrapancreatic origin, and 63 without evidence of acute abdominal disease were studied. Urine trypsinogen-2 was determined by a time-resolved immunofluorometric assay. As reference methods we used serum trypsinogen-2, urine amylase, and serum amylase. The diagnostic accuracy of the markers was evaluated by receiver- operating characteristic (ROC) analysis. At admission, urine trypsinogen-2 differentiated patients with AP from controls with high accuracy. The area under the ROC curve (AUC) was 0.978, which was equal to that of serum trypsinogen-2 (0.998) and serum amylase (0.969) and significantly larger than that of urine amylase. For differentiation between severe and mild AP, urine trypsinogen-2 (0.730) was equal to serum trypsinogen-2 (0.721), and clearly better than amylase in serum and urine. These results suggest that determination of urine trypsinogen-2 is a useful test to detect AP and to evaluate disease severity.


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M. Lempinen, M.-L. Kylanpaa-Back, U.-H. Stenman, P. Puolakkainen, R. Haapiainen, P. Finne, A. Korvuo, and E. Kemppainen
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E. A. Kemppainen, J. I. Hedstrom, P. A. Puolakkainen, V. S. Sainio, R. K. Haapiainen, V. Perhoniemi, S. Osman, E. O. Kivilaakso, and U.-H. Stenman
Rapid Measurement of Urinary Trypsinogen-2 as a Screening Test for Acute Pancreatitis
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