Serial estimation of urinary trypsinogen-2 levels in patients of acute pancreatitis: a new prognostic indicator

Rinki Meena; Surender Kumar; Abhinav Arun Sonkar; Faraz Ahmad; Wahid Ali; Kushagra Gaurav; Anit Parihar; Vijay Kumar Singh

doi:10.18203/2320-6012.ijrms20243698

Authors

Rinki Meena Department of General Surgery, King George Medical University, Lucknow, U. P., India
Surender Kumar Department of General Surgery, King George Medical University, Lucknow, U. P., India
Abhinav Arun Sonkar Department of General Surgery, King George Medical University, Lucknow, U. P., India
Faraz Ahmad Department of General Surgery, King George Medical University, Lucknow, U. P., India
Wahid Ali Department of Pathology, King George Medical University, Lucknow, U. P., India
Kushagra Gaurav Department of General Surgery, King George Medical University, U. P. Lucknow, India
Anit Parihar Department of Radiodiagnosis, King George Medical University, Lucknow, U. P., India
Vijay Kumar Singh Department of Community Medicine and Public Health, King George Medical University, Lucknow, U. P., India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20243698

Keywords:

AP, CRP, Trypsinogen-2, Amylase, Lipase

Abstract

Background: Acute abdominal discomfort is a common symptom of acute pancreatitis (AP). However, because most clinics are unable to rapidly monitor pancreatic enzymes, early detection of AP is challenging. Therefore, the purpose of this study is to investigate the utility of serial urine trypsinogen-2 measurement as a prognostic indicator in individuals with AP.

Methods: A total of 60 patients with AP who presented to the surgical emergency department within 72 hours of symptom onset were included in the study, regardless of sex or age. AP was classified into mild, moderate and severe according to the revised Atlanta classification. Patient’s urine samples were collected at admission, day 3, day 5, and day 7 for determination of urine trypsinogen-2 level.

Results: The mean value of S. amylase (IU/l), S. lipase (IU/l), C-reactive protein (CRP) (mg/l), and urinary trypsinogen 2 were increased in severe compared with mild AP. The mean value of urinary trypsinogen 2 was significantly decreased from day 1 to day 7 after treatment in the mild, moderate, and severe AP groups. With these cut-off values, urinary trypsinogen 2 had a sensitivity of 92.3%, specificity of 42.9%, positive productive value (PPV) of 75%, and negative productive value (NPV) of 75% for diagnosing the severity of AP. These tests demonstrate the accuracy of urinary trypsinogen-2 to determine severity of AP.

Conclusions: In a cross-sectional study, urinary trypsinogen-2 can be used as both diagnostic and prognostic indicator for AP.

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