Correlations between serum trypsinogen-2 and pancreatic cancer.

Background/Aims: To investigate associations between serum trypsinogen-2, pancreatitis and pancreatic cancer (PC) and determine cutoff values for PC diagnosis. Methodology:We recruited 88 patients from Internal Medicine/Surgical Departments of General Military Hospital of Beijing PLA between 12/2009 and 6/2010. Serum samples were collected preoperatively from 23 PC patients, 30 pancreatitis patients and 35 healthy controls. Enzyme-linked immunosorbent assay was used to detect trypsinogen-2 semiquantitatively. Results: Serum trypsinogen-2 levels of PC and pancreatitis patients were significantly higher than those of controls (51.2 +/- 80.3, 107.7 +/- 98.1 vs. 1.0 +/- 0.5, p = 0.03, p<0.001) and significantly higher in pancreatitis vs. PC patients (107.7 +/- 98.1 vs. 51.2 +/- 80.3, p=0.01). Higher Balthazar CT grades correlated with higher trypsinogen-2 in pancreatitis group. ROC curves for trypsinogen-2 revealed optimal cutoff value 1.8 as lower PC detection limit with 95.7% sensitivity and 91.4% specificity, and optimal cutoff value 19.9 for upper PC detection limit with 87.0% sensitivity and 97.1% specificity. Trypsinogen-2 levels correlated with pancreatic injury level. An AUC of 0.73 (95% CI: 0.59-0.84, p=0.002) distinguished PC from pancreatitis. Conclusion: Serum trypsinogen-2 is associated with PC and pancreatitis. Levels between 1.8ug/L and 19.9 mu g/L strongly suggest PC. Detection of serum trypsinogen-2 may provide simple, sensitive, specific non-invasive initial screening for early PC diagnosis.