Pancreas

Pancreatic Enzymes

Applications:

Acute pancreatitis Obstruction of the pancreatic duct

Amylase: Rapid rise Serum:

Urine: Persists longer

Lipase: Slower rise in the blood;

Following prognosis

Short-lived

lasts longer

Amylase

Starch Dextrins + Maltose + Maltotriose + Glucose

Molecular wt: Salivary 51 - 59000 depending on ref.Pancreatic 50 - 55000

• The major sources of this enzyme are the pancreas and salivary glands.

• The normal serum level is made up of approximately 2/3 salivary type and 1/3 pancreatic. Total serum amylase is measured almost exclusively to diagnose acute pancreatitis..

Amylase is elevated in:

• Acute pancreatitis• Carcinoma of the pancreas• Epidemic parotitis• Acute cholecystitis• Penetrating and perforated ulcers• Mesentaric thrombosis• Intestinal obstruction• Ruptured ectopic pregnancy• Uremia• Postcholangiography• Drugs: morphine, codeine

Urinary amylase

• Due to its small size, amylase is easily filtered by the glomerulus of the kidney and excreted in the urine.

• Therefore, urinary amylase should be increased in pancreatitis.

• Current practice is to implant the pancreas such that the exocrine drainage is into the urinary bladder and not the intestine.

• This makes it very convenient to monitor the function of the pancreas by measuring urinary amylase.

Lipase

Mol. Wt. = 46-50000• Lipases are defined as that group of enzymes which hydrolyze the glycerol esters of long-chain fatty acids.

• Most of the lipase that appears in the serum is produced in the pancreas, but some is also secreted by the gastric and intestinal mucosa.

• Lipase activity can be demonstrated in leukocytes, in adipose tissue and in breast milk. Calcium is a effector.

• Colipase is an exocrine pancreatic protein which serves as a cofactor, anchoring lipase at the substrate interface.

• Serum lipase is primarily measured for the diagnosis of pancreatitis and obstruction of the pancreatic duct.

Acid Phosphatase

ACPProstate + ACPRBC ACPTotal

ACPProstate + ACPRBC

L-Tartrate

ACPRBC(-)

ACPProstate

PSA Elevations

Condition Laboratory Values

Male with benign prostate hypertrophy

10.2 ± 8.97 ng/ml

Prostate Cancer Stage A 9.39 ± 8.09 ng/ml

Stage B 17.45 ± 16.83 ng/ml

Stage C 55.14 ± 51.65 ng/ml

Stage D 118.92 ± 50 ng/ml