• Toshihiko Mayumi, Kazuo Inui, Iruru Maetani, Masamichi Yokoe, Teruo Sakamoto, Masahiro Yoshida, Shigeru Ko, Koichi Hirata, Tadahiro Takada, and Urinary Trypsinogen-2 Dipstick for Acute Pancreatitis Study Group of Japanese Society of Abdominal Emergency Medicine (UtrAP Study Group).
• Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
• Pancreas. 2012 Aug 1; 41 (6): 869-75.

ObjectivesA simple urinary trypsinogen-2 test was evaluated for the diagnosis of acute pancreatitis.MethodsThis prospective multicenter study enrolled consecutive patients with acute abdominal pain who presented to the emergency department or who were hospitalized at 1 of 21 medical institutions in Japan. Patients were tested with urinary trypsinogen-2 dipstick test and a quantitative trypsinogen-2 assay, and these values were compared with serum amylase and lipase findings.ResultsA total of 412 patients were enrolled. The trypsinogen-2 dipstick test was positive in 107 of 156 patients with acute pancreatitis (sensitivity, 68.6%) and in 33 of 256 patients with nonpancreatic abdominal pain (specificity, 87.1%). The sensitivity for the diagnosis of pancreatitis caused by alcohol and gallstones by the dipstick test was 72.2% and 81.8%, respectively, which was much higher than those associated with amylase testing. There are several degrees of positivity within the urinary trypsinogen-2 dipstick test. Modification of the cutoff point such that positive (+) and most positive (++) results were interpreted as a positive result, the specificity and positive likelihood ratio increased to 92.2% and 7.63, respectively.ConclusionsThis simple, rapid, easy, and noninvasive urinary trypsinogen-2 test can diagnose or rule out most cases of acute pancreatitis.

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