Resumo

LOPES, Sandra et al. Comparative Evaluation of 13C-mixed Triglyceride Breath Test as a Non-Invasive Diagnostic Test of Pancreatic Exocrine Function. J Port Gastrenterol. [online]. 2011, vol.18, n.4, pp.179-185. ISSN 0872-8178.

AIMS: To assess the value of ¹³C-mixed triglyceride breath test (¹³C-MTG-BT) compared to faecal fat excretion and faecal elastase, in the diagnosis of exocrine pancreatic insufficiency (EPI) in chronic pancreatitis (CP). To correlate results of analysed tests with disease severity. To evaluate the reproducibility of the ¹³C-MTG-BT and among all which is the preferred test. MATERIAL/METHODS: Thirty consecutive patients with moderate (7) and severe (23) CP (Group A) and 19 controls (Group B) were prospectively studied. CP diagnosis and grading was done by Cambridge’s classification. Faecal fat and elastase: Van de Kamer and ELISA methods, respectively. ¹³C-MTGBT included: solid test meal, 1 breath sample before and 12 after meal. Diagnostic accuracy of each test was evaluated by ROC curves. RESULTS: ¹³C-MTG-BT shows the highest accuracy [AUC = 0.938;(p = 0.0001)] compared to faecal elastase [AUC = 0.843;(p = 0.0001)] and faecal fat excretion [AUC = 0.620;(p = 0.13)] in the discrimination between group A and B. The highest accuracy of the ¹³C-MTG-BT [AUC = 0.925;(p = 0.0001)] is above all observed in the diagnosis of moderate EPI, compared to faecal elastase [AUC = 0.515;(p = 0.9)] and faecal fat excretion [AUC = 0.530;(p = 0.8)]. ¹³C-MTG-BT shows high reproducibility (r = 0.891;p < 0.001) and it is the method of choice. CONCLUSIONS: ¹³C-MTG-BT is the preferred non-invasive and reproducible method, which shows the highest accuracy in EPI associated with CP, namely in moderate cases.

Palavras-chave : Exocrine pancreatic insufficiency; Chronic pancreatitis; 13C-mixed triglyceride breath test; Faecal elastase-1 test; Faecal fat excretion test.

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