Comparative Study of Serum Amylase, Serum lipase and urinary Trypsinogen in Acute Pancreatitis

Acute pancreatitis is a common presentation in emergency department, presenting with acute abdomen. Urinary trypsinogen-2 strip test is convenient and comparable results with standard blood tests for acute pancreatitis (Serum amylase and lipase are most commonly used biochemical markers).

This study was done to compare the diagnostic accuracy of serum amylase, serum lipase and urinary trypsinogen-2, either alone or in combination in the diagnosis of acute pancreatitis.

51 patients presenting with acute abdomen and suspicious of acute pancreatitis were taken in this study. Serum amylase, serum lipase and urinary trypsinogen-2 dipstick test was performed at the time of admission. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) curve were calculated.

Out of 51 cases, 40 cases were diagnosed with acute pancreatitis and 11 cases served as control. Urine trypsinogen-2 test was positive in all 40 cases but negative in control with 100% sensitivity and specificity, and the area under ROC curve was 1. If serum amylase and serum lipase were considered together, the sensitivity was 95% and 45.4% specificity 45.4% with 0.964 ROC.

This study shows that the urinary trypsinogen-2 (dipstick test) has high PPV and NPV, and can be considered for regular use for diagnosing pancreatitis along with the conventional methods. It emphasizes requirement of controlled trials for confirming its reliability in daily use.