Abstract
Diagnostic significance of serum immunoreactive elastase-1 was studied in 137 patients with pancreatic disease, 335 with various nonpancreatic diseases, and 416 healthy controls by using radioimmunoassay. Frequency of abnormally high serum elastase values exceeding 410 ng/dl was 100% in acute pancreatitis (N=14), 40% in chronic pancreatitis (N=80), and 72% in pancreatic cancer (N=43). In pancreatic cancer the mean value of serum elastase in resectable cancer (N=19) was significantly higher than that in unresectable cancer (N=24). Sensitivity, specificity, and efficiency of serum elastase in pancreatic cancer were 72.1%, 98.3%, and 95.9% against healthy controls; 72.1%, 85.9%, and 83.6% against nonpancreatic digestive diseases; and 72.1%, 60.0%, and 64.2% against chronic pancreatitis at a cutoff level of 410 ng/dl, respectively. High serum elastase could be a diagnostic clue to detect pancreatic duct obstruction due to pancreatic cancer, although further examination should be done by endoscopic retrograde pancreatography and other imaging studies.
Similar content being viewed by others
References
Schneider IJ, Tindel S, Molnar J, State D: Elastase-induced hemorrhagic pancreatitis. Gastroenterology 42:779, 1962
Loeven WA: Human pancreatic elastolytic enzymes and atherosclerosis and lung emphysema in elderly people. J Atheroscler Res 10:379–390, 1969
Kueppers F, Bearn AG: A possible experimental approach of the association of hereditary α1-antitrypsin deficiency and pulmonary emphysema. Proc Soc Exp Biol Med 121: 1207–1209, 1966
Janoff A, Scherer J: Mediators of inflammation in leucocyte lysosomes. J Exp Med 128:1137–1155, 1968
Legrand Y, Pignaud G, Caen JP, Robert B, Robert L: Separation of human blood platelet elastase and proelastase by affinity chromatography. Biochem Biophys Res Commun 63:224–231, 1975
Hornebeck J, Derouette JC, Robert L: Isolation, purification and properties of aortic elastase. FEBS Lett 58:66–70, 1975
Heimburger N: Biochemistry of proteinase inhibitors from human plasma: A review of recent development.In Bayer Symposium V, Proteinase Inhibitors. H Fritz, H Tschesche, LJ Greene, E Truscheit (eds). New York, Springer-Verlag, 1974, pp 14–22
Geokas MC, Brodrick JW, Johnson JH, Largman C: Pancreatic elastase in human serum. J Biol Chem 252:61–67, 1977
Ooyama T, Kawamura K, Orimo H, Murakami M: Radioimmunoassay method for measurement of pancreatic elastase-1 in human serum. Igaku No Ayumi 105:91–97, 1978
Mizuno R, Hayakawa T, Noda A: Elastase secretion in pancreatic disease. Am J Gastroenterol 80:113–117, 1985
Caraway WT: A stable starch substrate for the determination of amylase in serum and other body fluids. Am J Clin Pathol 32:97–99, 1959
Hayakawa T, Noda A, Kondo T, Okumura N, Sakakibara A, Kameya A, Katada N, Nagai K: Diagnostic significance of serum elastase determination by a RIA kit. J Adult Dis 11:1295–1299, 1981
Wallenstein S, Zucker CL, Fleiss JL: Some statistical methods useful in circulation research. Circ Res 47:1–9, 1980
Baron JH: Pancreatic function tests.In Topics in Gastroenterology 3, SC Truelove, MJ Goodman (eds). Oxford, Blackwell Scientific, 1975, pp 129–133
Murata A, Fujimoto K, Kitahara T, Matsuda Y, Ogawa M, Kosaki G: Molecular forms of human pancreatic elastase-1 in serum and determination by radioimmunoassay. Jpn J Gastroenterol 78:1985–1990, 1981
Kimura H: Studies on elastase in pancreatic diseases. Jpn J Gastroenterol 76:2004–2016, 1979
Watanabe S, Shiratori K, Oi I, Kozu T, Takeuchi T: Clinical significance of serum elastase-1 determination in patients with pancreatic disorders. Jpn J Gastroenterol 80:1001–1006, 1983
Murata A, Ogawa M, Fujimoto K, Kitahara T, Matsuda Y, Kosaki G: Radioimmunoassay of human pancreatic elastase-1. Enzyme 30:29–37, 1983
Satake K, Chung YS, Umeyama K: Serum elastase-1 levels in pancreatic disease. Am J Surg 144:239–242, 1982
Tatsuta M, Yamamura H, Noguchi S, Ichii M, Ishii H, Okuda S: Values of serum carcinoembryonic antigen and elastase-1 in diagnosis of pancreatic carcinoma. Gut 25:1347–1351, 1984
Murata A, Ogawa M, Fujimoto K, Kitahara T, Kosaki G: Changes in serum immunoreactive pancreatic elastase-1 in acute pancreatitis. Hepato-Gastroenterol 29:278–280, 1982
Kameya A, Hayakawa T, Noda A, Kondo T: Differential determination of serum isoamylase using amylase inhibitor and its clinical application. Am J Gastroenterol 80:54–59, 1985
Lifton LJ, Slickers KA, Pragay DA, Katz LA: Pancreatitis and lipase. JAMA 229:47–50, 1974
Elias E, Redshaw M, Wood T: Diagnostic importance of changes in circulating concentrations of immunoreactive trypsin. Lancet 2:66–68, 1977
Hayakawa T, Noda A, Kondo T: Diagnostic value of serum trypsin in pancreatic diseases. Biliary Tract Pancreas 2:1131–1136, 1981
Hayakawa T, Noda A, Kondo T, Shibata T, Murase T, Sugimoto Y, Ogawa Y: Diagnostic value of serum immunoreactive lipase assay in pancreatic diseases using enzyme immunoassay. Jpn J Gastroenterol 82:2809–2815, 1985
Hayakawa T, Noda A, Kondo T: Changes in serum pancreatic enzymes during 2 months' abstinence in asymptomatic chronic alcoholics. Am J Gastroenterol 77:625–629, 1982
Masoero G, Andriulli A, Bianco A, Benitti V, Marchetto M, De La Pierre M: Diagnostic accuracy of serum cationic trypsinogen estimation for pancreatic diseases. Dig Dis Sci 27:1089–1094, 1982
Bell JS, Go VLW: Laboratory diagnosis of pancreatic disease.In Gastroenterology, Vol 6. JE Berk, WS Haubrich, MH Kalser, JL Roth, F Schaffner (eds). Philadelphia, WB Saunders, 1985, pp 3877–3892
Villano BCD, Brennan S, Brock P, Bucher C, Liu V, McClure M, Rake B, Space S, Westrick B, Schoemaker H, Zurawski VR Jr: Radioimmunometrick assay for a monoclonal antibody-defined tumor marker, CA19-9. Clin Chem 29:549–552, 1983
Author information
Authors and Affiliations
Additional information
This study was supported in part by a research grant for intractable pancreatic disease and a cancer grant 58-21 from Ministry of Health and Welfare, Japan.
Rights and permissions
About this article
Cite this article
Hamano, H., Hayakawa, T. & Kondo, T. Serum immunoreactive elastase in diagnosis of pancreatic diseases. Digest Dis Sci 32, 50–56 (1987). https://doi.org/10.1007/BF01296687
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01296687