This study was performed to investigate the behavior of
phospholipase A2 (PLA2) in serum and urine of patients with chronic
pancreatic diseases and to ascertain whether any factors influenced the results. In 30 controls, 45 patients with
pancreatic cancer, 54 with
chronic pancreatitis, and 64 with extrapancreatic diseases, serum and urinary PLA2, pancreatic
isoamylase and
RNase, and urinary N-
acetylglucosaminidase (NAG) were measured. Serum PLA2 levels were higher in patients with
chronic pancreatitis than in all the other groups. In our patients, only occasionally was urinary PLA2 elevated, the increase occurring almost exclusively in the presence of an acute inflammatory disease, e.g., relapsed
chronic pancreatitis or active
inflammatory bowel disease. A correlation was found between serum PLA2 and serum
RNase, an
indicator of tissue damage, but not between serum PLA2 and pancreatic
isoamylase. Urinary PLA2 output was correlated with its renal input and with
RNase output. No correlation was found between PLA2 output and pancreatic
isoamylase or NAG urinary excretion. In conclusion, (1) the determination of serum PLA2 activity may be an aspecific test of
pancreatic disease; (2) PLA2 urinary excretion occasionally increases, especially in the presence of severe phlogosis, which occurs in
chronic pancreatitis, in particular during relapse; and (3) irrespective of the tissue origin of urinary PLA2, its increased excretion may be accounted for in part by its increased circulating levels. It is, however, more likely the consequence of a renal tubular dysfunction, which is sometimes found in patients with
pancreatic diseases.