CLINICAL SIGNIFICANCE OF SERUM ELASTASE-1 DETERMINATIONS IN PATIENTS WITH PANCREATIC DISORDERS

Abstract

The clinical significance of serum elastase-1 determinations were studied in 63 patients with pancreatic disorders, confirmed clinically and surgically, including 4 cases of acute pancreatitis (A.P.), 4 cases of relapsing acute pancreatitis (R.A.P.), 12 cases of chronic relapsing pancreatitis (C.R.P.), 29 cases of chronic pancreatitis (C.P.) and 14 cases of pancreatic carcinoma (P.Ca.). The serum elastase-1 level was determined by the radioimmunoassay kit (Dainabot Co., Japan). These level obtained was compared with the level of serum amylase in the same samples.
The incidence of hyperenzymemia for serum elastase-1 and amylase, determined at the first hospital days, was 66.7% (100% in A.P., R.A.P. and C.R.P., 41.4% in C.P. and 71.4% in P. Ca.) and 41.3% (100% in A.P., 75% in R.A.P., 83.3% in C.R.P., 6.9% in C.P., and 50% in P.Ca.), respectively. The incidence of abnormal elastase-1 elevation was much higher than that of amylase.
In the course of 9 patients with acute attack of pancreatitis, serum elastase-1 and amylase were measured. The mean duration of hyperenzymemia was 25±14 days (Mean±SD) in elastase-1, while 7±5 days in amylase, indicating that the normalization of elastase-1 levels delayed in comparison to serum amylase levels. The serial changes of serum elastase-1 levels in the course after acute attack of pancreatitis tended to reflect the clinical manifestation much more than that of serum amylase.
From our observations, it was confirmed that the serum elastase-1 is much more sensitive for a diagnostic test of pancreatic diorders, and that the clinical courses of pancreatitis were reflected in the levels of elastase-1 than serum amylase.