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A Valuable Test for Detecting and Tracking Pancreatic Pseudocysts

Donald W. Weaver, MD; David L. Bouwman, MD; Alexander J. Walt, MB, ChB; Douglas Clink, MD; Sandra Sessions, MD; Jacqueline Stephany

Arch Surg. 1982;117(5):707-711.

Abstract
• Amylase-rich fluid that incubates ("ages") within a pancreatic pseudocyst undergoes a change that can be detected by isoenzyme analysis of amylase from the serum. This aging is a result of deamination of the asparagine and glutamine residues on the amylase molecule. Eighteen of 20 patients with surgically proved pseudocysts had greater than 15% aged (deaminated) amylase in their serum. Levels of aged amylase returned to normal following treatment of their pseudocysts. Twenty of 23 patients with acute pancreatitis had levels of aged amylase below 15% (P <.05). A criterion of 15% aged amylase resulted in 87% specificity, and 91% sensitivity for the diagnosis of pseudocysts. Because this test is noninvasive and easy to perform, it should become the ideal screen for patients at risk of development of pseudocysts. Endoscopic retrograde pancreatography, ultrasonography, and abdominal computed tomographic scanning should be reserved for confirmation of the diagnosis when the result of isoenzyme analysis is positive.

(Arch Surg 1982;117:707-711)

Author Affiliations
From the Department of Surgery, Wayne State University School of Medicine, Detroit.

Footnotes
Accepted for publication Dec 28, 1981.

Read at the 89th annual meeting of the Western Surgical Association, Albuquerque, Nov 18, 1981.

Reprint requests to Department of Surgery 6C, University Health Center, 4201 St Antoine, Detroit, MI 48201 (Dr Weaver).

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