Table 1: Newer Enzymatic Markers of Pancreatitis

Marker Sensitivity % Specificity% Significance Number of subjects in the studies
Pancreatitis associated protein (PAP) [7] 100 94 Useful in diagnosis, but may not be a good marker for establishing severity. 70
Phosholipase A2 levels [8] 75 78 Role in pulmonary dysfunction can differentiate mild from severe pancreatitis as early as day 1. The diagnostic accuracy is low when compared to other biomarkers [9]. 85
Trypsinogen activated peptide [10-12] 58 (severity) 73 (severity) Serum levels are the best and earliest marker of acute pancreatitis. Urine TAP levels are more sensitive than amylase and lipase [13]. Can differentiate mild from severe forms and urinary detection adds to ease of establishing a diagnosis. 55-246 patients
Serine Protease inhibitor Kazal Type 1 and Human pancreatic secretory trypsin inhibitor [14] 71 (in predicting severity) 77 (in predicting severity) Not widely available, more sensitive than CRP in predicting severity of acute pancreatitis. 26
Tryspsinogen-2 and Trypsin-2-alpha 1 antitrypsin complex [15-17] 91(severity) 71 (severity) Useful in assessing the severity of pancreatitis. The sensitivity and specificity are similar to amylase and lipase [18]. Trypsinogen 2 is useful in diagnosing CRP associated pancreatitis. 31 to 100 patients
Procarboxypeptidase B and carboxypeptidase B activation peptide (CAPAP) [19,20] Procarboxypeptidase is similar in sensitivity to amylase and lipase. Persists for longer so useful in late stages. At day 3 it is useful in differentiating mild from severe forms. Carboxypeptidase B, can be detected in urine and a good marker of severity.