| Abstrakt: |
Human pancreas-specific protein (PASP) has been characterized previously as a serum marker for pancreatitis. It was then identified as pancreatic procarboxypeptidase B (PCB). The aim of the present study was to verify the usefulness of PASP (PCB) as a serum marker in patients with acute (n20) and chronic (n12) pancreatitis and in those following endoscopic retrograde cholangiopancreaticography (ERCP) (n44). Serum PASP values were analyzed by radioimmunoassay, with a range of normal values between 15 and 111 ng/ml. Between April 1992 and September 1992, 20 subjects (19–86 years of age) with acute pancreatitis (alcoholic, 8; biliary, 8; other, 4) were studied. We found edematous pancreatitis in 17 cases and severe hemorrhagic pancreatitis in three cases. At admission, peak levels of PASP (average value, 1,976 ± 329 ng/ml), pancreatic isoamylase (942 ± 151 U/L) and lipase (2,946 ± 534 U/L) were detected in 15 of 20, 16 of 20, and 12 of 20 cases, respectively. The etiology of the pancreatitis had no influence on the PASP values. Furthermore, 10 patients with alcoholic and two patients with nonalcoholic chronic pancreatitis (29–67 years of age) were studied. The average peak level of PASP was 1,229 ± 434 ng/ml. In this group, PASP paralleled the time course of amylase and lipase. Maximal PASP, amylase, and lipase levels were found in 11 of 12, nine of 12, and five of 12 patients, respectively, on the day of admission. ERCP was performed in 44 patients (36–87 years of age), demonstrating common bile duct stones in 16 and bile or pancreatic ductal tumors in 15 cases. Endoscopic papillotomy was performed in 26 of 44 patients (59). Following ERCP, three patients developed clinical signs of acute pancreatitis. Another six patients showed hyperamylasemia and hyperlipasemia without clinical signs of acute pancreatitis. Maximal mean values for PASP (151 ± 33), amylase (150 ± 13), and lipase (463 ± 138) were measured within 3 days following ERCP. We conclude that the analysis of PASP (PCB) levels during the course of inflammatory pancreatic disease does not offer more information for diagnosis or outcome of pancreatitis than the conventional determinations of amylase and lipase. |
