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[Screening of exocrine pancreatic function (author's transl)]
Deutsche Medizinische Wochenschrift (1946)
|July 31, 1981
Summary
Oral pancreatic function tests like the fluoresceine dilaurate (FDL) and N-benzoyl-L-tyrosyl-para-amino-benzoic-acid (PABA) tests are less reliable for borderline pancreatic function. However, they offer a simpler alternative to faecal chymotrypsin (CH-F) for diagnosing exocrine insufficiency.
Area of Science:
- Gastroenterology
- Diagnostic Medicine
- Pancreatic Physiology
Background:
- Exocrine pancreatic insufficiency (EPI) diagnosis relies on accurate pancreatic function tests.
- Oral tests offer potential convenience but require validation against established methods.
- The secretin-pancreozymin (secretin-CCK) test is considered a gold standard for assessing pancreatic exocrine function.
Purpose of the Study:
- To evaluate the diagnostic validity of oral pancreatic function tests (fluoresceine dilaurate [FDL] and N-benzoyl-L-tyrosyl-para-amino-benzoic-acid [PABA]) in comparison to the secretin-pancreozymin (secretin-CCK) test.
- To assess the utility of faecal chymotrypsin (CH-F) estimation as a comparative measure.
- To determine the effectiveness of these tests across different severities of pancreatic dysfunction.
Main Methods:
- Intra-individual comparison of FDL-test, PABA-test, and CH-F estimation against the secretin-CCK test in 67 patients.
- Patients categorized into normal, borderline restricted, and manifest exocrine pancreatic insufficiency groups based on secretin-CCK results.
- Sensitivity analysis performed for each test within the defined patient groups.
Main Results:
- Diagnostic value of FDL, PABA, and CH-F tests is limited in patients with borderline restricted pancreatic function (sensitivity: 38%, 40%, 31% respectively).
- In manifest exocrine pancreatic insufficiency, FDL, PABA, and CH-F tests demonstrated similar sensitivity (67%, 63%, 62% respectively).
- Oral tests, particularly FDL, are a simpler diagnostic alternative to CH-F but do not replace the secretin-CCK test.
Conclusions:
- Oral pancreatic function tests (FDL, PABA) and CH-F estimation show limited sensitivity for borderline pancreatic dysfunction.
- These simpler tests are viable alternatives to CH-F assessment for diagnosing manifest exocrine pancreatic insufficiency.
- The secretin-pancreozymin (secretin-CCK) test remains the most valid diagnostic investigation for pancreatic exocrine function.