Fecal elastase-1 as a test for pancreatic function: a review

Clin Chem Lab Med. 2002 Apr;40(4):325-32. doi: 10.1515/CCLM.2002.051.


Pancreatic elastase-1 is a specific human protease synthetized by the acinar cells. Immunoreactive elastase-1 cannot be detected in either porcine or bovine pancreatic enzyme preparations. It is very stable and, in contrast to fecal chymotrypsin, elastase is unaffected by exogenous pancreatic enzyme treatment, and correlates well with exocrine pancreatic function tests. The measurement of this proteolytic enzyme in stool by means of an enzyme-linked immunosorbent assay (ELISA) is a sensitive, specific, and relatively inexpensive non-invasive test. It is an accurate function test for patients with chronic pancreatitis confirmed by endoscopic retrograde cholangiopancreatography and computerized axial tomography. It shows higher sensitivity and specificity for exocrine pancreatic insufficiency than fecal chymotrypsin determination and is comparable to oral pancreatic function tests such as the pancreolauryl test.

Publication types

  • Review

MeSH terms

  • Animals
  • Enzyme-Linked Immunosorbent Assay
  • Exocrine Pancreatic Insufficiency / diagnosis
  • Exocrine Pancreatic Insufficiency / enzymology
  • Exocrine Pancreatic Insufficiency / metabolism
  • Feces / enzymology*
  • Humans
  • Pancreatic Elastase / analysis*
  • Pancreatic Elastase / chemistry
  • Pancreatic Elastase / metabolism
  • Pancreatic Function Tests*
  • Pancreatitis / classification
  • Pancreatitis / diagnosis
  • Pancreatitis / enzymology
  • Sensitivity and Specificity


  • Pancreatic Elastase