Endoscopic ultrasound and IL-8 in pancreatic juice to diagnose chronic pancreatitis

Background/Aim: Pancreatic juice (PJ) [IL-8] has been proposed as a marker for pancreatic diseases. We compared the accuracy of PJ [ IL-8] and endoscopic ultrasound (EUS) to diagnose chronic pancreatitis (CP). Methods: 79 patients with symptoms suspicious for CP were enrolled. PJ emptied into the duodenum was collected during an upper endoscopy with IV secretin and [IL-8] was measured. CP was diagnosed when PJ [IL-8] was > 20 pg/ml. CP was diagnosed at EUS when 6 4 of the 9 established criteria were present. CP was diagnosed by using composite gold standard: ERCP, histology, CT or MRI, and clinical follow-up ( mean 20 months). Results: 38 patients had CP, whereas 41 patients had no pancreatic disease. To diagnose CP, PJ [IL-8] was significantly less sensitive compared to EUS ( 47 vs. 71%), but equally accurate ( 71 vs. 80%) and specific ( 93 vs. 88%). By combining PJ [IL-8] and EUS, sensitivity and specificity significantly increased to 82% ( either IL-8 or EUS positive) and 100% ( both IL-8 and EUS positive). Conclusions: Both PJ [IL-8] and EUS are accurate diagnostic modalities for CP. PJ collection can be performed at the time of EUS. PJ [IL-8] and EUS are complementary with higher sensitivity and specificity when used together. Copyright (C) 2007 S. Karger AG, Basel and IAP.