Abstract
This study assessed the diagnostic accuracy offecal elastase 1 in chronic pancreatitis. Fifty-threehealthy subjects, 44 patients with chronic pancreatitis(22 severe, 13 moderate, and 9 mild), and 43 patients with nonpancreatic digestive diseasewere studied. Elastase 1 concentration was determined ona small sample of feces using a commercially availablekit. Fecal chymotrypsin was also measured. With a cutoff level of 190 μg/g, all healthycontrols except one (98.1%), and the majority ofpatients with nonpancreatic digestive diseases (40 of43; 93.0%) had elastase values above this limit. Amongthe 44 patients with chronic pancreatitis, 34(77.3%) had pathological values: all 22 (100%) withsevere disease, 10 of 13 (76.9%) with moderate diseaseand 2 of 9 (22.2%) with mild disease. Chymotrypsinvalues were pathological in 25 of 44 (56.8%) patientswith chronic pancreatitis: 17 of 22 (77.2%) with severepancreatitis, 7 of 13 (53.8%) with moderatepancreatitis, and 1 of 9 (11.1%) with mild disease. The specificity was 95.8% for elastase 1 and 85.4%for chymotrypsin. The difference both in sensitivity andspecificity of the two enzymes was statisticallysignificant (P < 0.05). Fecal elastase 1 has a high sensitivity, superior to that of fecalchymotrypsin, in the diagnosis of chronic pancreatitis.For its simplicity and rapidity, it could represent thetubeless test of choice in chronicpancreatitis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Gullo L, Costa PL, Fontana G, Labò G: Inve stigation of exocrine pancreatic function by continuous infusion of caerulein and secretin in normal subjects and in chronic pancreatitis. Digestion 14:97–107, 1976
Niederau C, Grendell JH: Diagnosis of chronic pancreatitis. Gastroenterology 88:1973–1995, 1985
Sziegoleit A, Linder D: Die menschiliche pankrease lastase 1. Biochemische und klinische aspekte. Med Welt 42:682–684, 1991
Doppl WE, Schnell-Kretschmer H, Sziegoleit A, Klor HU: Pankrease lastase 1 im stuhl. Ein neue r parameter zur funtktionsdiagnostik des exokrinen pankreas. Med Welt 45:97–99, 1994
Dominguez-Munoz JE, Hieronymus C, Sauerbruch T, Malfertheiner P: Fecal elastase test: evaluation of a new noninvasive pancreatic function test. Am J Gastroenterol 90:1834–1837, 1995
Amann ST, Bishop M, Curington C, Toskes PP: Fecal pancreatic elastase 1 is inaccurate in the diagnosis of chronic pancreatitis. Pancreas 13:226–230, 1996
Glasbrenner B, Schon A, Klatt S, Beckh K, Adler G: Clinical evaluation of the faecal elastase test in the diagnosis and staging of chronic pancreatitis. Eur J Gastroenterol Hepatol 8:1117–1120, 1996
Loser C, Mollgaard A, Folsch UR: Faecal elastase 1: A novel, highly sensitive, and specific tubeless pancreatic function test. Gut 39:580–586, 1996
Stein J, Jung M, Sziegoleit A, Zeuzem S, Caspary WF, Lembcke B: Immunoreactive elastase 1: Clinical evaluation of a new noninvasive test of pancreatic function. Clin Chem 42:222–226, 1996
Bolondi L, Priori P, Gullo L, Santi V, Li Bassi S, Barbara L, Labò G: Relationship between morphological changes detected by ultrasonography and pancreatic exocrine function in chronic pancreatitis. Pancreas 2:222–229, 1987
Axon ATR, Classen M, Cotton PB, Cremer M, Freeny PC, Lees WR: Pancreatography in chronic pancreatitis: international definitions. Gut 25:1107–1112, 1984
Stein J, Purschian B, Bienek U, Caspary WF, Lembcke B: Near-infrared reflectance analysis (NIRA): A new dimension in the investigation of malabsorption syndromes. Eur J Gastroenterol Hepatol 6:889–894, 1994
Lusted LB: Decision-making studies in patient management. N Engl J Med 284:416–424, 1971
Ventrucci M, Gullo L, Daniele C, Priori P, Labò G: Pancreolauryl test for pancreatic exocrine insufficiency. Am J Gastroenterol 78:806–809, 1983
Ventrucci M, Gullo L, Daniele C, Priori P. Bartolucci C, Canali S, Agostini D, Labò G: Evaluation of BT PABA test in the diagnosis of exocrine pancreatic insufficiency. Ital J Gastroenterol 17:1–4, 1985
Gullo L, Pezzilli R, Ventrucci M, Barbara L: Caerulein induced plasma amino acid decrease: A simple, sensitive and specific test of pancreatic function. Gut 31:926–929, 1990
Sziegoleit A, Krause E, Klor HU, Kranacher L, Linder D: Elastase 1 and chymotrypsin B in pancreatic juice and feces. Clin Biochem 22:85–89, 1989
Lankisch PG, Schmidt I, Konig H, Lehnick D, Knollmann R, Lohr M, Liebe S: Faecal elastase 1: not helpful in diagnosing chronic pancreatitis associated with mild to moderate exocrine pancreatic insufficiency. Gut 42:551–554, 1998
Rights and permissions
About this article
Cite this article
Gullo, L., Ventrucci, M., Tomassetti, P. et al. Fecal Elastase 1 Determination in Chronic Pancreatitis. Dig Dis Sci 44, 210–213 (1999). https://doi.org/10.1023/A:1026691209094
Issue Date:
DOI: https://doi.org/10.1023/A:1026691209094