Gut Liver.  2017 Nov;11(6):878-883. 10.5009/gnl17066.

Low Serum Pancreatic Amylase and Lipase Values Are Simple and Useful Predictors to Diagnose Chronic Pancreatitis

• Oh HC
• Kwon CI
• El Hajj II
• Easler JJ
• Watkins J
• Fogel EL
• McHenry L
• Sherman S
• Zimmerman
• Lehman GA

• KMID: 2395394
• DOI: http://doi.org/10.5009/gnl17066

Abstract

BACKGROUND/AIMS
This study aimed to evaluate the diagnostic role of low serum amylase and lipase values in the detection of chronic pancreatitis.
METHODS
Patients underwent endoscopic retrograde cholangiopancreatography and were diagnosed with non-calcific chronic pancreatitis (NCCP; n=99) and calcific chronic pancreatitis (CCP; n=112). Patient serum amylase and lipase values were compared with those of healthy controls (H; n=170).
RESULTS
The median serum amylase (normal range, 19 to 86 U/L) and lipase values (7 to 59 U/L) (P₂₅-P₇₅) were 47.0 (39.8 to 55.3) and 25.0 (18.0 to 35.0) for H, 34.0 (24.5 to 49.0) and 19.0 (9.0 to 30.0) for NCCP, and 30.0 (20.0 to 40.8) and 10.0 (3.0 to 19.0) for CCP, respectively. The cutoff values with the highest diagnostic accuracy for discriminating NCCP from H were 40 U/L for amylase and 20 U/L for lipase, respectively, and for CCP from H were 38 U/L for amylase and 15 U/L for lipase, respectively. For the diagnosis of NCCP with a criterion of serum amylase < 40 and lipase < 20 U/L, the sensitivity, specificity, positive predictive value, and negative predictive values were 37.4%, 88.8%, 66.1%, and 70.9%, respectively.
CONCLUSIONS
Serum amylase and/or lipase levels below the normal serum range are highly specific for chronic pancreatitis patients. Clinicians should not ignore low serum pancreatic enzyme values.

Keyword

Amylases; Lipase; Pancreatitis; chronic

MeSH Terms

Amylases*
Cholangiopancreatography, Endoscopic Retrograde
Diagnosis
Humans
Lipase*
Pancreatitis
Pancreatitis, Chronic*
Sensitivity and Specificity
Amylases
Lipase