Role of Trypsin/Creatinine Clearance Ratio in the Differential Diagnosis of Chronic Pancreatic Disease

Trypsin/creatinine clearance ratio—a recently proposed screening test for pancreatic cancer-was assessed in 45 subjects (17 control subjects, 15 patients with pancreatic cancer, and 13 with chronic pancreatitis). A statistically significant increase of the ratio was detected not only in pancreatic cancer, but also in chronic calcifying pancreatitis. Thus, the previously reported clinical usefulness of the test in pancreatic cancer diagnosis was not substantiated by the present data. Although not fully investigated as yet, reasons for an abnormal ratio are probably independent of the neoplastic or inflammatory nature of the pancreatic disease. Since renal enzyme excretion (alpha-glucosidose, gamma-glutamyltranspeptidase, leucine aminopeptidase) was not found to be invariably elevated when trypsin/creatinine clearance ratio was increased, tubular damage cannot be assumed as constituting the only reason for an altered clearance ratio. © 1981, American Gastroenterological Association. All rights reserved.