We have compared responsiveness of serum
lipase and
amylase activity to the pancreatic exocrine stimulation with
cerulein and
secretin (CS test) in normal subjects and patients with pancreas-related and other diseases. The
lipase and
amylase activities were measured by a sensitive colorimetric method, the BALB-
DTNB method and the Caraway method, respectively. The percentage of positive
lipase and
amylase response cases was as follows: confirmed
chronic pancreatitis (N = 22), 27 and 14%; suspected
chronic pancreatitis (N = 37), 46 and 32%;
pancreatic cancer (N = 16), 44 and 25%;
biliary tract diseases (N = 11), 14 and 14%; miscellaneous (N = 11), 0 and 18%; normal subjects (N = 13), and partial
pancreatectomy (N = 5), 0 and 0%, respectively. The serum
lipase response cannot be regarded as specific for
pancreatic diseases because the
lipase response cases were found in
biliary tract diseases as well. However, in view of frequent, fast, and intense responsiveness to the CS test, the serum
lipase activity measured by the BALB-
DTNB method may be more useful than the serum
amylase as an auxiliary diagnostic aid for suspected
pancreatitis which might develop into confirmed
chronic pancreatitis or
cancer of the head or body of the pancreas.