EXOCRINE PANCREATIC FUNCTION TEST BY A SYNTHETIC PEPTIDE IN PANCREATIC AND HEPATOBILIARY DISEASES

In Comparison with Pancreozymin Secretin Test

Abstract

PFT is a new exocrine pancreatic function test by means of measurement of PABA recovery in 6 hour urine after oral administration of BT-PABA which is specifically cleaved by the pancreatic chymotrypsin to release PABA.
To evaluate its diagnostic value, we performed PFT in 220 patients with pancreatic and hepatobiliary diseases and 29 controls. The results were compared with pancreozymin secretin test (PS test) in 111 patients.
Following results were obtained. 1) PFT value was significantly decreased in chronic pancreatitis, pancreatolithiasis, cancer of the pancreas, and hepatobiliary diseases. 2) A good correlation was obtained between the PFT value and each of three parameters of PS test (p<0.001 respectively). 3) PFT value was decreased in 62.5%, 92% and 100% of patients with one, two, and three abnormal parameters on PS test respectively. 4) PFT value was decreased in almost all patients with more than one abnormal parameter of more than moderate degree on PS test. However, only half of patients with minimal to mild abnormality on PS test showed decreased PFT. 5) A decrease of pancreatic chymotrypsin output was observed in 2 of the patients who showed abnormal PFT despite normal PS test. This finding is interesting in the light of non-parallel secretion of pancreatic enzymes. These results indicate that PFT is a simple and useful test to detect exocrine pancreatic insufficiency of more than moderate degree.