Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 662 – 667
ISSN: 2791-0814 (online) 2791-0807 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr093
ISSN: 2791-0814 (online) 2791-0807 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr093
A comparative analytical study of the impact of urine trypsinogens-2 in the diagnosis of acute pancreatitis
Dr. Raghavendra Srikanth B\(^{1}\), Dr. Asha Jyothi M\(^{2,*}\) and Dr. B. Sushma\(^{3}\)
\(^{1}\) Assistant Professor, Department of General Surgery, Alluri Sitarama Raju Academy of Medical Sciences Eluru 534005, West Godavari District, Andhra Pradesh, INDIA.
\(^2\) Assistant Professor, Department of General Surgery, Alluri Sitarama Raju Academy of Medical Sciences, Eluru 534005, West Godavari District, Andhra Pradesh, INDIA.
\(^3\) Final year Postgraduate, Department of General Surgery, Alluri Sitarama Raju Academy of Medical Sciences Eluru-534005, West Godavari District, Andhra Pradesh, INDIA.
Correspondence should be addressed to Dr. Asha Jyothi M at vlnvraju@gmail.com
Copyright © 2023 Dr. Raghavendra Srikanth B, Dr. Asha Jyothi M and Dr. B. Sushma. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: January 12, 2023 – Accepted: May 20, 2023 – Published: May 24, 2023
Abstract
Background: Acute pancreatitis is a very common disorder with a substantial burden on the healthcare system. Acute pancreatitis includes a wide spectrum of diseases varying from mild self-limiting symptoms to fulminant multi-organ failure and high mortality. Serum amylase and serum lipase, which are used for diagnosing acute pancreatitis, are relatively less sensitive and specific and give a lot of false positive or false negative values. Based on the immune-chromatographic method, the urinary trypsinogen-2 dipstick test is proposed to be a rapid method for diagnosing acute pancreatitis at the earliest.
Aim of the study: 1. To know the usefulness of urine trypsinogen-2 in accurately diagnosing acute pancreatitis 2. To compare the diagnostic role of urine trypsinogen-2 with that of serum amylase, serum lipase, and imaging studies in acute pancreatitis.
Materials and Methodology: 100 Patients presenting with acute upper abdominal symptoms like pain, vomiting, and abdominal distention, admitted to the emergency department of our hospital from January 2021 to January 2022, are enrolled in the study. Urine samples were obtained from all the patients and tested with Spot Urine trypsinogen-2 dipstick. Serum amylase and serum lipase tests were also simultaneously done in these patients. If required, patients are also evaluated with (USG) abdomen and (CECT) abdomen. The final diagnosis of acute pancreatitis is based on the clinical picture, serum amylase more than the threefold rise, and radiological findings. Urine trypsinogen-2 dipstick tests were compared with serum amylase, serum lipase, and imaging studies in patients with a final diagnosis of acute pancreatitis.
Results: Sensitivity of amylase and lipase was found to be 73.77% and 59.02%, respectively, whereas the sensitivity of trypsinogen was found to be 78.69%. The specificity of amylase and lipase was found to be 89.74% and 89.74%, respectively, whereas the specificity of trypsinogen was found to be 92.1%. Analyzing the data, it is found that the sensitivity and specificity of trypsinogen are higher than the routine investigations. Even though it has a low range of sensitivity, its high specificity ensures that the test can be used as a screening test to check the true negative cases.
Conclusion: 1. The urine Trypsinogen-2 dipstick test is a simple, rapid, easy, and noninvasive test that can diagnose or rule out most cases of acute pancreatitis. 2. Urine Trypsinogen-2 estimation does not require laboratory facilities. It is undertaken almost instantaneously (within 5 minutes) as opposed to serum amylase and lipase, results for which may require an hour to get back to the physician. 3. The urinary trypsinogen-2 test could be used as a screening test for acute pancreatitis. 4. Modification of the cutoff point of this assay increases the specificity to the point where it can be used for diagnosis. Qualitative rapid urine trypsinogen-2 test strip is easy to perform. Moreover, it is a reliable and useful screening test for acute pancreatitis in daily practice, particularly in healthcare units lacking laboratory facilities.
Aim of the study: 1. To know the usefulness of urine trypsinogen-2 in accurately diagnosing acute pancreatitis 2. To compare the diagnostic role of urine trypsinogen-2 with that of serum amylase, serum lipase, and imaging studies in acute pancreatitis.
Materials and Methodology: 100 Patients presenting with acute upper abdominal symptoms like pain, vomiting, and abdominal distention, admitted to the emergency department of our hospital from January 2021 to January 2022, are enrolled in the study. Urine samples were obtained from all the patients and tested with Spot Urine trypsinogen-2 dipstick. Serum amylase and serum lipase tests were also simultaneously done in these patients. If required, patients are also evaluated with (USG) abdomen and (CECT) abdomen. The final diagnosis of acute pancreatitis is based on the clinical picture, serum amylase more than the threefold rise, and radiological findings. Urine trypsinogen-2 dipstick tests were compared with serum amylase, serum lipase, and imaging studies in patients with a final diagnosis of acute pancreatitis.
Results: Sensitivity of amylase and lipase was found to be 73.77% and 59.02%, respectively, whereas the sensitivity of trypsinogen was found to be 78.69%. The specificity of amylase and lipase was found to be 89.74% and 89.74%, respectively, whereas the specificity of trypsinogen was found to be 92.1%. Analyzing the data, it is found that the sensitivity and specificity of trypsinogen are higher than the routine investigations. Even though it has a low range of sensitivity, its high specificity ensures that the test can be used as a screening test to check the true negative cases.
Conclusion: 1. The urine Trypsinogen-2 dipstick test is a simple, rapid, easy, and noninvasive test that can diagnose or rule out most cases of acute pancreatitis. 2. Urine Trypsinogen-2 estimation does not require laboratory facilities. It is undertaken almost instantaneously (within 5 minutes) as opposed to serum amylase and lipase, results for which may require an hour to get back to the physician. 3. The urinary trypsinogen-2 test could be used as a screening test for acute pancreatitis. 4. Modification of the cutoff point of this assay increases the specificity to the point where it can be used for diagnosis. Qualitative rapid urine trypsinogen-2 test strip is easy to perform. Moreover, it is a reliable and useful screening test for acute pancreatitis in daily practice, particularly in healthcare units lacking laboratory facilities.
Keywords:
Acute pancreatitis; Serum amylase; Serum lipase; Urine trypsinogen-2.