Fecal elastase-1 as a test for pancreatic function: a review.

Area of Science:

• Gastroenterology
• Biochemistry
• Clinical Diagnostics

Background:

• Pancreatic elastase-1 is a specific human protease synthesized by pancreatic acinar cells.
• It is stable and unaffected by external pancreatic enzyme treatments.
• Unlike fecal chymotrypsin, it correlates well with exocrine pancreatic function tests.

Purpose of the Study:

• To evaluate pancreatic elastase-1 measurement in stool as a diagnostic tool for exocrine pancreatic function.
• To compare its efficacy against fecal chymotrypsin and other oral pancreatic function tests.

Main Methods:

• Measurement of pancreatic elastase-1 in stool samples using an enzyme-linked immunosorbent assay (ELISA).
• Comparison of ELISA results with established diagnostic methods like endoscopic retrograde cholangiopancreatography (ERCP), computerized axial tomography (CT), fecal chymotrypsin determination, and oral pancreatic function tests (e.g., pancreolauryl test).

Main Results:

• ELISA for pancreatic elastase-1 is a sensitive, specific, and cost-effective non-invasive test.
• The test accurately assesses exocrine pancreatic function in patients with chronic pancreatitis.
• It demonstrates higher sensitivity and specificity for exocrine pancreatic insufficiency compared to fecal chymotrypsin.

Conclusions:

• Stool pancreatic elastase-1 measurement via ELISA is a valuable non-invasive diagnostic method for exocrine pancreatic insufficiency.
• It serves as an accurate and reliable alternative to invasive or less sensitive tests.
• This assay is comparable in performance to established oral pancreatic function tests.