Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001418 (adenocarcinoma)
 68,496 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the period 1963 to 1988, we treated 45 patients with cystic neoplasms of the pancreas. The patients were divided into group 1, which included 26 patients treated between 1963 and 1983, and group 2, which included 19 patients treated between 1984 and 1988. The rate of resection for cystadenoma was 67% for group 1 (n = 15) and 100% for group 2 (n = 11). The operative mortality rate was 0% for both groups. Pathologically, 17 patients (69%) had serous cystadenoma and nine (31%) mucinous adenoma. Except for 5 of the 15 patients from group 1 who died of other causes, all patients are healthy. The resection rate for cystadenocarcinoma was 36% for group 1 (n = 11) and 100% for group 2 (n = 8). In 2 patients from group 1 and 1 patient from group 2, the tumors had been diagnosed previously as benign by operative biopsy of the cyst wall. There was no operative mortality in either group. Cystic neoplasm was suspected from the results of ultrasonography and computed tomography in 70% of the patients in group 2. In 2 patients (25%), the preoperative diagnosis of pseudocyst associated with chronic pancreatitis was made. Adenocarcinoma was diagnosed in 3 patients by needle biopsy and cytologic examination of pancreatic juice. Eighty-two percent (9 patients) of group 1 died of recurrent carcinoma; 2 patients were alive without disease at 5 and 8 years. Thirty-eight percent (3 patients) of patients in group 2 died of recurrent carcinoma, two patients died of other causes, and 3 patients are still alive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cystadenoma and cystadenocarcinoma of the pancreas. 261 66

Immunohistochemical studies of neuron-specific enolase were performed on pancreatic tissues from patients with insulinoma, nonfunctioning islet cell tumor, chronic pancreatitis, and pancreatic adenocarcinoma, and from 5 normal patients. The concentration of neuron-specific enolase was also measured in the sera of patients and in the pancreatic tissue, and the tissues were stained for carbohydrate antigen 19-9 by immunohistochemical techniques. Neuron-specific enolase was localized in nerve fibers, normal islet cells, and islet cell tumors; its concentration was elevated only in the tissue of islet cell tumors and in serum from patients with insulinoma. In the pancreatic tissue of pancreatitis or pancreatic adenocarcinoma, various changes in acini and islets were present. The altered islets stained clearly for neuron-specific enolase and could easily be distinguished from altered, unstained acini in cases of pancreatitis or pancreatic adenocarcinoma. Islets in the pancreatic tissue remained intact with various morphologic changes, although acini had degenerated severely. Carbohydrate antigen 19-9 was localized in all the carcinoma cells in the pancreatic tissue and in some of the normal pancreatic ducts. No cells were simultaneously immunostained by anti-neuron-specific enolase and anti-carbohydrate antigen 19-9 antibodies. Thus, neuron-specific enolase is a good marker for islet cell tumor, and is valuable for examining islets in pancreas with various disorders both alone and in combination with other tumor markers.
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PMID:Immunohistochemical study of neuron-specific enolase and CA 19-9 in pancreatic disorders. The value of neuron-specific enolase as a marker for islet cell and nerve tissue. 301 9

Previous studies have shown that the DU-PAN-2 antigen is elevated in approximately 70% of serum samples obtained from pancreatic adenocarcinoma patients, and within the normal range (less than 400 U/ml) in 99% of normal subjects. In this study, the DU-PAN-2 antigen level of the serum and pancreatic ductal fluid in patients with malignant pancreatic disease were compared to antigen levels in patients with benign pancreatic diseases. Six percent of patients with chronic pancreatitis and 13% of patients with severe acute pancreatitis had elevated DU-PAN-2 antigen levels in their sera. Pancreatic ductal fluid DU-PAN-2 levels were elevated in 33% (11 of 33) of patients with pancreatic adenocarcinomas, whereas 16% (5 of 31) of patients with chronic pancreatitis and 38% (8 of 21) of control patients had elevated secretion levels. Unlike DU-PAN-2, the tumor markers carcinoembryonic antigen (CEA) and carcinoma (CA) 19-9 were elevated in 90 and 100%, respectively, of secretions of patients with pancreatic adenocarcinoma. However, CEA and CA 19-9 ductal fluid levels were also elevated in patients with chronic pancreatitis (CEA: 61%; CA 19-9: 85%), and therefore these markers are not helpful in distinguishing benign from malignant pancreatic disease. The physiologic implications of elevated DU-PAN-2 serum antigen levels in patients with normal ductal fluid DU-PAN-2 levels are discussed.
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PMID:DU-PAN-2 levels in serum and pancreatic ductal fluids of patients with benign and malignant pancreatic disease. 317 10

Thirty-five consecutive cases of adenocarcinoma of the ampulla of Vater seen over the past 36 years were reviewed. The introduction of new diagnostic techniques over the course of this study improved the accuracy of preoperative diagnosis but did not lead to earlier diagnosis. The surgical resectability rate was 88%, and 53% of postoperative survivors were free of disease at 5 years. Of the 14 patients with metastases to regional lymph nodes, 27% survived disease-free for 5 years. Surgical mortality was 25% for the entire series but has been reduced to 6.6% over the past decade. Surgical mortality was primarily due to leakage of the pancreaticojejunostomy; the risk of pancreaticojejunostomy leak correlated inversely with the degree of chronic pancreatitis in the pancreatic remnant. In 35% of resected cases, a benign adenomatous component was contained within the cancer of the ampulla of Vater. Cure rates are good for this lesion. The most important factor in maximizing cure rate is careful attention to the technical details of pancreaticojejunostomy in order to minimize surgical mortality. Benign adenomas appear to be a frequent precursor of carcinoma of the ampulla of Vater.
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PMID:Carcinoma of the ampulla of Vater. 331 48

This report describes a rapid, easy, and safe means of saving the spleen while resecting or fully mobilizing the pancreatic tail. The pancreas is separated from the spleen by dividing the splenic artery and vein distal to the tip of the pancreas. The spleen survives on the short gastric vessels, which are carefully preserved. The technique has been applied successfully in 22 of 25 consecutive patients with chronic pancreatitis (n = 13), acute pancreatitis and pancreatic necrosis (n = 3), cystic neoplasm of the pancreas (n = 4), islet cell tumor (n = 2), and ductal adenocarcinoma (n = 3). The spleen could not be saved in three patients because of splenic hilar involvement by tumor or scar. Normal postoperative blood cell counts and spleen scans proved splenic viability and function. There was only one complication, a late splenic abscess that developed in a spleen of twice-normal size. It is concluded that in most instances the distal pancreas can be mobilized for resection or inspection without the need for splenectomy. Splenomegaly may be a contraindication because the short-vessel gastric blood supply may be inadequate to nourish the increased tissue mass. The technique is applicable to the treatment of pancreatic tumors, trauma, and pancreatitis.
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PMID:Conservation of the spleen with distal pancreatectomy. 335 79

The presentation of pancreatic adenocarcinoma as acute or chronic pancreatitis has been well documented; however, there has been only one previous report of either functioning or nonfunctioning pancreatic neuroendocrine tumors associated with pancreatitis. At the Medical University of South Carolina in Charleston, from March 1982 through September 1987, we have managed four patients with nonfunctioning pancreatic islet cell tumors or carcinoids, which presented with attacks of pancreatitis. Three of the patients had recurrent bouts of upper abdominal and lower dorsal back pain with elevation of the serum amylase. One patient presented initially with acute upper abdominal pain and elevation of the serum amylase. Each patient had an endoscopic retrograde cholangeography pancreatography (ERCP) pattern involving the pancreatic duct which was characterized by diffuse dilatation proximal to the site of obstruction. One of the four had a tumor blush on splanchnic angiography. Each patient had CT evidence of a mass in the head of the pancreas; however, one of the four was found to have diffuse involvement of the entire gland at operation. Surgical therapy varied: (a) local excision of the ampullary area with re-anastomosis of the pancreatic duct to the duodenum and choledochoduodenostomy; (b) bypass with cholecystoduodenostomy and caudal pancreaticojejunostomy; (e) total pancreatectomy; or (d) bypass with a Roux-en-Y cholecystojejunostomy and gastrojejunostomy. The choice of the procedure was based on the patient's condition and operative findings.
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PMID:Nonfunctioning pancreatic neuroendocrine tumors presenting as pancreatitis: report of four cases. 337 32

This study describes the immunohistologic distribution of carcinoembryonic antigen (CEA) in 30 fetal pancreata, 5 normal adult pancreata, 11 cases of chronic pancreatitis without carcinoma, 16 cases of chronic pancreatitis with carcinoma, and 20 cases of primary pancreatic adenocarcinoma. The position of CEA-cross-reacting antigen, especially of nonspecific cross-reacting antigen (NCA), was also studied in the case of chronic pancreatitis and pancreatic adenocarcinoma. For this purpose, both monospecific antibodies to CEA and NCA, as well as cross-reacting antibodies, were used in an indirect immunoperoxidase technique. CEA reactivity could not be detected, neither during pancreatic development nor in chronic pancreatitis with or without associated adenocarcinoma. In 15 of 20 pancreatic adenocarcinomas, CEA positivity was found both with membranous and cytoplasmic localization. With the use of the cross-reacting antibodies, all cases of chronic pancreatitis and pancreatic adenocarcinomas showed positive staining of both ductal and tubular structures. Antibodies to NCA closely mimicked the results obtained with the cross-reacting antibodies both in pancreatitis and adenocarcinoma. From the authors' results it can be concluded that CEA is not a developmental antigen of the pancreas. Furthermore, NCA cross-activity of anti-CEA antibodies is an important reason of false positive reaction in chronic pancreatitis. Moreover, true CEA positivity in the pancreas appears to be restricted to adenocarcinoma of the exocrine pancreas.
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PMID:Immunohistochemistry of CEA in the human pancreas during development, in the adult, chronic pancreatitis, and pancreatic adenocarcinoma. 338 42

Carbohydrate antigen (CA) 19-9 is a new tumor marker, defined by a monoclonal antibody. Serum CA 19-9 concentrations and computed tomography (CT) findings were studied in 55 patients with histologically proven adenocarcinoma, and in 22 patients with chronic pancreatitis. CA 19-9 was useful in 83% of cases for the differential diagnosis between pancreatic carcinoma and chronic pancreatitis, and serum CA 19-9 levels in pancreatic carcinoma were highly related to the size of tumors. Serum CA 19-9 levels greater than 37 U/ml were seen in patients with a tumor of less than 3 cm, 3 to 5 cm, and greater than 5 cm in diameter 13% (1/8), 90% (19/21), and 92% (24/26) of cases, respectively. Tumor location, however, was unrelated to serum CA 19-9 value. These results indicated that the measurement of serum CA 19-9 concentrations would be useful in most, if not all, cases for the differential diagnosis between pancreatic carcinoma and chronic pancreatitis, and for the evaluation of tumor burden in patients with pancreatic carcinoma.
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PMID:Serum CA 19-9 concentrations and computed tomography findings in patients with pancreatic carcinoma. 345 52

Serum CA 19-9 levels were measured in 63 patients with ductal pancreatic adenocarcinoma and in 49 patients with chronic pancreatitis. Concentrations were abnormally high (greater than 40 U/ml) in 57 (90%) patients with cancer and only in 5 (10%) patients with chronic pancreatitis. All patients with falsely normal serum values had poorly differentiated carcinomas. Median CA 19-9 concentrations were progressively higher in patients with more advanced cancer. Fifteen of 16 (93%) patients with localized cancer has abnormal serum levels but only 5 (31%) of them had values greater than 120 U/ml, which was the highest score observed in patients with chronic pancreatitis. Pure pancreatic juice was obtained endoscopically from 23 patients with pancreatic cancer and from 20 with chronic pancreatitis. CA 19-9 concentrations in pancreatic juice were significantly higher in patients with cancer than in non-neoplastic patients. All 11 patients with resectable cancer investigated had a ratio of CA 19-9 to secretory protein concentration in pancreatic juice above the range of patients with chronic pancreatitis. We conclude that serum CA 19-9 determination is highly sensitive and specific for the differential diagnosis of pancreatic cancer versus chronic pancreatitis. However, moderately increased values (less than 120 U/ml), as seen in patients with localized pancreatic adenocarcinoma, are not conclusive for malignancy. The measurement of CA 19-9 to total protein ratio in pure pancreatic juice is proposed as an adjunctive, accurate diagnostic marker for early stages of pancreatic adenocarcinoma.
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PMID:Determination of CA 19-9 antigen in serum and pancreatic juice for differential diagnosis of pancreatic adenocarcinoma from chronic pancreatitis. 346 66

The results of 117 consecutive endoscopic retrograde cholangiopancreatographic (ERCP) examinations in patients with adenocarcinoma carcinoma of the pancreas, performed over a six year period, are reported. The diagnostic accuracy of this procedure (80.3 per cent) was higher than that of computed tomography (63.6 per cent) and ultrasonography (54.0 per cent). Fewer false negative diagnoses were made by retrograde cholangiopancreatography (7.7 per cent) than with the other procedures (28 per cent each). Analysis of the total ERCP experience during the study period revealed a false positive rate for malignancy of 5.6 per cent. In situations where investigations are performed by individuals with a broad spectrum of expertise, ERCP is superior to other methods in diagnosing pancreatic carcinoma, even in areas with a high prevalence of chronic pancreatitis.
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PMID:Diagnostic yield of endoscopic retrograde cholangiopancreatography in carcinoma of the pancreas. 352 40


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