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Clinical Chemistry 45: 1768-1773, 1999;
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(Clinical Chemistry. 1999;45:1768-1773.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Time-resolved Immunofluorometric Assay of Trypsin-1 Complexed with {alpha}1-Antitrypsin in Serum: Increased Immunoreactivity in Patients with Biliary Tract Cancer

Johan Hedström1,a, Caj Haglund2, Esko Kemppainen2, Maarit Leinimaa1, Jari Leinonen1 and Ulf-Håkan Stenman1

1 Department of Clinical Chemistry and
2 Second Department of Surgery, University of Helsinki, FIN-00029 Helsinki, Finland.
a Address correspondence to this author at: Clinical Research Institute, Helsinki University Central Hospital Ltd, P.O. Box 105, FIN-00029 Helsinki, Finland. Fax 358-9-47174804; e-mail johan.hedstrom{at}huch.fi

Background: Increased serum concentrations of trypsin immunoreactivity occur in patients with biliary tract cancer. To characterize this trypsin, we developed a sensitive time-resolved immunofluorometric assay for trypsin-1 complexed with {alpha}1-antitrypsin (AAT) and studied the concentrations of this complex in sera from healthy individuals (n = 130) and patients with benign biliary disease (n = 32), biliary tract cancer (n = 17), pancreatic cancer (n = 27), and hepatocellular cancer (n = 12).

Methods: We used a trypsin-1-specific monoclonal antibody on the solid phase and a europium-labeled polyclonal antibody to AAT as tracer. The detection limit was 0.42 µg/L. The validity of the trypsin-1-AAT test for detection of biliary tract cancer was compared with trypsin-2-AAT and CA19-9.

Results: Increased concentrations of trypsin-1-AAT (>33 µg/L) were found in 76% of patients with biliary tract cancer, and the concentrations were significantly higher than in those with benign biliary disease (P <0.0001). The median concentration of trypsin-1-AAT in serum from patients with biliary tract cancer was 3.7-fold higher than in healthy controls, 2.6-fold higher than in patients with benign biliary tract disease, 1.7-fold higher than in patients with pancreatic cancer, and 2.0-fold higher than in patients with hepatocellular cancer.

Conclusions: Of the markers studied, trypsin-1-AAT had the largest area (0.83) under the receiver operating curve in differentiating biliary tract cancer from benign biliary tract disease. Our results suggest that trypsin-1-AAT is a new potential marker for biliary tract cancer.




The following articles in journals at HighWire Press have cited this article:


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 Clin. Chem.Home page
J. M. Andersen, J. Hedstrom, E. Kemppainen, P. Finne, and P. Puolakkainen
The Ratio of Trypsin-2-{{alpha}}1-Antitrypsin to Trypsinogen-1 Discriminates Biliary and Alcohol-induced Acute Pancreatitis
Clin. Chem., February 1, 2001; 47(2): 231 - 236.
[Abstract] [Full Text] [PDF]


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