Diagnostic Efficacy of Fecal Elastase-1 in Patients with Chronic Pancreatitis Diagnosed by Endoscopic Ultrasound

Authors

1 Hepatology, Gastroenterology, and Infectious diseases, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

2 Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

3 Clinical Pathology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Pancreatic insufficiency in chronic pancreatitis (CP) is commonly underdiagnosed and undertreated. Endoscopic ultrasound (EUS) can diagnose CP more accurately. Fecal elastase-1 (FE-1) can be used as a simple noninvasive test for diagnosis of CP. Aim of the work: To study the diagnostic efficacy of FE-1 in patients with CP diagnosed by EUS. Patients and methods: A cross sectional study included 100 subjects referred to EUS unit for evaluation of upper gastrointestinal subepithelial lesions and pancreas. The pancreas was evaluated according to Rosemont criteria. 35 patients with features of CP were included in group 1. 35 patients with features of suggestive or indeterminate CP were included in group 2. 30 subjects with normal pancreatic features were included in group 3 as control group. FE-1 was determined by monoclonal antibody specific for pancreatic elastase-1. Results were reported in mcg/g of stool. Statistical analysis was done and P≤0.05 was considered statistically significant. Results: FE-1 level was decreased in patients with CP (79.46±53.04 mcg/g) relative to patients with suggestive or indeterminate CP (124.49±43.40 mcg/g) (p Conclusion: FE-1 is a sensitive noninvasive test for identifying patients with CP especially in severe FE-1 deficiency (/g). No correlation detected between FE-1 and level of pancreatic enzymes (amylase and lipase) (p>0.05).

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