Serum trypsinogen-2 in the prediction of outcome in acute necrotizing pancreatitis

Background: The accuracy of serum trypsinogen-2 in predicting the severity of acute necrotizing pancreatitis (ANP) was prospectively evaluated in 52 consecutive patients. Methods: A new sensitive immunofluorometric assay was used for serum trypsinogen-2. Results: Mean values during the first 24 h were 42.1 mu g/l in control patients, 1435 mu g/l in uncomplicated cases, and 4090 mu g/l in complicated or fatal cases. There was a significant difference in serum trypsinogen-2 values between patients with uncomplicated and complicated disease (p=0.002) already on admission. When a cutoff level of 1000 mu g/l was used, patients with uncomplicated ANP were differentiated from patients with complicated ANP with a sensitivity of 91% and with a specificity of 71%. Conclusions: The immunofluorometric assay of serum trypsinogen-2 is a sensitive and specific method for prediction of the severity of the disease in necrotizing pancreatitis.