Diagnostic value of serum immunoreactive trypsin assay in pancreatic diseases using enzyme immunoassay.

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An enzyme immunoassay for human cationic trypsin was set up using anti-trypsin IgG coated polystyrene balls as the solidphase antibody, peroxidase-labeled anti-trypsin IgG as the conjugate and TLCK-trypsin as the standard. The sensitivity of the assay was 18.8ng/ml. The coefficients of variation were 1.9 to 9.3% within one assay and 5.4 to 18.5% between assays. The normal range of serum immunoreactive trypsin (IRT) in 98 controls was 43 to 185ng/ml (mean±2SD). Serum IRT was elevated in all 15 patients with acute pancreatitis, 12 of 39 with chronic pancreatitis and 22 of 34 with pancreatic cancer. The rate of serum IRT elevation in chronic pancreatitis group and pancreatic cancer group was higher than that of serum amylase elevation. The IRT was low in 13 of 39 patients with chronic pancreatitis, which coincided with advanced exocrine insufficiency. Abnormally high serum IRT was rare in nonpancreatic diseases (gallstone 11/40, liver cirrhosis 11/27, peptic ulcer 10/25, irritable bowel syndrome 0/15, diabetes mellitus 5/26) except chronic renal failure (26/31). Serum IRT determination is more useful for diagnosis in pancreatic diseases than amylase.
財団法人日本消化器病学会の論文