Development of a Specific Assay for Pancreatic Lipase Activity for Diagnostic Purposes

Determination of pancreatic lipase (E.C. 3.1.1.3) in serum is frequently required for diagnosing pancreatitis for at least two reasons. First, an increase in levels of pancreatic enzymes in blood or in urine is a part of the definition of acute pancreatitis [1]. Among the pancreatic enzymes, serum lipase activity is presently considered as the most efficient marker of this disease as shown in many comparative studies. As an example, data from 15 comparative studies published since 1985 indicate that the mean values of sensitivity of serum amylase, pancreatic isoamylase and lipase activity for the diagnosis of acute pancreatitis are 0.88 0.85 and 0.91 and those of specificity are 0.74 0.81 and 0.88, respectively. Second, several assays recently developed are easy to perform in an automated manner. Our goal is to analyze the characteristics of contemporary methods for lipase assay and to compare the results obtained by these methods for plasma samples from patients suffering from acute pancreatitis. The interassay agreement will be discussed and some recommendations will be formulated to improve the specificity and the accuracy of lipase assays for diagnostic use.