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

Between 1956 and 1982, there were 55 pancreatoduodenectomies performed at the Medical University of South Carolina by 19 different surgeons. There were 26 resections for adenocarcinoma of the head of the pancreas and 16 resections for carcinoma of the ampulla of vater, carcinoma of the extrahepatic biliary ducts, and carcinoma of the duodenum. There were seven resections for chronic pancreatitis. There were two resections for trauma and three resections in the (1960s) for carcinoma of the stomach. There was one resection for cystadenocarcinoma of the pancreas. In the patients with carcinoma of the pancreas, resection was only performed when there was no gross evidence of extension beyond the parenchyma of the pancreas. Analysis of the resected specimen revealed 44% of the pancreatic carcinomas subsequently had positive lymph nodes. None of these patients became long-term survivors. Failure of the pancreato-jejunostomy was the most serious complication, occurring in 7 of 55 resections. There were no fistulas where a mucosal to mucosal anastomosis was performed to join the pancreas with the jejunum. The five-year survival for all patients with carcinoma of the pancreas was 11.6%. The 3 five-year survivors were from resections performed between 1956 and 1970. During these years, the mortality rate for the procedure was 21%. From 1970 to 1982 there were no five-year survivors from carcinoma of the pancreas. However, the mortality rate was 10.6%. The history and current controversies over this surgical procedure are reviewed.
 ...
PMID:Analysis of pancreatoduodenectomy. 396 88

Signet ring carcinoma of the pancreas is rare. We report a case which was remarkable for (1) diffuse, infiltrating growth which suggested chronic pancreatitis at laparotomy, and (2) an associated very high circulating carcinoembryonic antigen (CEA) level of 6400 ng/ml. The case report and autopsy are presented. Twelve other cases of pancreatic adenocarcinoma (non-signet ring) are compared with the signet ring carcinoma with respect to CEA staining and circulating levels. We conclude immunocytochemical staining of biopsy tissue for CEA is a useful adjunct in the interpretation of circulating CEA levels in pancreatic carcinoma.
 ...
PMID:Signet ring carcinoma of the pancreas, a rare variant with very high CEA values. Immunohistologic comparison with adenocarcinoma. 632 10

Ultrasonically guided fine-needle aspirations were done in the liver of 42 cases of malignancy established later by autopsy and biopsy. The sensitivity was 95.3%. Only in one case, in a metastasis of renal carcinoma, precise tumour classification was not possible cytologically. Pancreatic malignancies were biopsied in 28 cases with later verified diagnoses at post mortem and biopsy; the sensitivity was 85.7%. One pancreatic head adenocarcinoma tumour classification was not possible cytologically. In 16 cases of gastrointestinal carcinoma verified by operation the sensitivity was 93.8%. In one cirrhotic gastric carcinoma only insufficient cytological material could be aspirated despite several biopsies. There were no false positive results in any puncture. The cytological results in all malignancies (n = 86) agreed in 97.7% with later established histological tumour classifications. Two clinically relevant complications were observed (biliary peritonitis, haemoperitoneum). In 15 percutaneous fine-needle pancreaticographies it has been shown to be an advantage that pancreatic juice can be aspirated prior to contrast medium filling of the pancreatic duct. Hyperinstillation into the organ can thus be prevented. In addition, the pancreatic juice aspirate can be investigated cytochemically. Only part of the patients (indurating changes of the pancreas such as chronic pancreatitis) experienced an unpleasant or painful sensation. For this reason such patients should be given analgesics.
 ...
PMID:[Percutaneous, ultrasound-targeted fine-needle puncture biopsy (liver, pancreas, intestine) and ultrasound-targeted pancreatic duct puncture]. 661 5

The results of all 53 pancreatoduodenectomies performed at one hospital were reviewed for operative mortality, accuracy of operative diagnosis and long term survival. Although carcinomas of the ampulla are much more rare than those of the pancreas, the number of patients in our operative series with adenocarcinoma of the ampulla approached the number with adenocarcinoma of the pancreas, indicating that only those with small, early lesions of the head of the pancreas were considered to be appropriate candidates for pancreatoduodenectomy. Six of the 21 patients with carcinomas of the pancreas had histologically favorable tumors (three papillary adenocarcinomas, two cystadenocarcinomas and one islet cell carcinoma), although only one of these was correctly diagnosed preoperatively or intraoperatively. Eight patients had benign conditions, half of whom underwent planned resections for chronic pancreatitis. The over-all operative mortality for our series was 13.2 per cent. The operative diagnosis was incorrect in seven patients. Excluding cystadenocarcinomas and islet cell carcinomas, four patients with carcinoma of the pancreas survived five years and six patients with carcinoma of the ampulla survived five years, with corresponding survival periods of 2.5 and 5.1 years following pancreatoduodenectomy. We conclude that: 1, pancreatoduodenectomy should be used in a highly selective manner by surgeons experienced with such operations; 2, the high diagnostic error rate and the occurrence of histologically favorable tumors of the pancreas make the arbitrary exclusion of all tumors of the pancreas for resectional therapy an unsound policy, and 3, pancreatoduodenectomy remains the best therapy for resectable tumors of the periampullary region.
 ...
PMID:Pancreatoduodenectomy for resectable malignant periampullary tumors. 662 27

An increased proportion of ductulelike structures, sometimes dilated, occurs in association with pancreatic adenocarcinoma, chronic pancreatitis, cystic fibrosis, and pancreatic ectasia associated with conditions such as uremia. This frequently is interpreted as ductular proliferation, implying origin in ductal elements. Recent animal studies have provided an altered view of pancreatic architecture that is consistent with acinar dedifferentiation leading to the ductulelike structures, or tubular complexes. The architecture of pancreas from organ donors was studied by light and scanning electron microscopy and by wax reconstruction of serial sections. It is concluded that the zymogen granule-containing cells of normal human exocrine pancreas are arranged as branching tubules that vary in diameter and curve acutely. The tubules frequently end blindly to form acinar structures; less frequently they anastomose. This arrangement is consistent with the interpretation that tubular complexes associated with pancreatic disease result from dedifferentiative changes in acinar cells. Tubular complexes may reflect a defect or defects common to pancreatic disease rather than ductular proliferation specific to each one.
 ...
PMID:Architecture of human pancreas: implications for early changes in pancreatic disease. 685 61

Tissue samples from seven patients with chronic pancreatitis were studied by light and electron microscopy, using samples from the pancreas of seven organ donors as a reference group. Tubular complexes were observed in four of the patients with chronic pancreatitis. Tubular complexes, which have been interpreted as resulting from "ductular reduplication" in other studies of chronic pancreatitis, and "ductular proliferation" in studies of pancreatic adenocarcinoma, were studied carefully to determine their origin. Extensive retrogressive changes in acinar cells leading to diminished zymogen granules, decreased cell height, and concomitant increase in luminal diameter were consistent with the interpretation that phenotypic modulation of acinar cells to take on the characteristics of ductular cells produced the tubules. This it is concluded that in chronic pancreatitis, as has been shown for pancreatic adenocarcinoma, the tubular complexes originate from acinar cells rather than from proliferation of preexisting ductules. Fibrosis and thickening of the basal lamina of exocrine pancreatic cells and capillaries were consistent with an altered capability for transmission of material between blood vessels and exocrine cells.
 ...
PMID:Origin of tubular complexes in human chronic pancreatitis. 710 34

A thirty-eight year-old man, treated medically since 1985 for a chronic pancreatitis, showed a choroidal infiltrate in the superior mid periphery of the left fundus. A thorough systemic examination could not reveal an underlying cause. The differential diagnosis of the lesion included metastasis, intraocular lymphoma and sarcoidosis. Two months later the lesion had increased both on fundoscopy and echography and was accompanied by a serous macular detachment. A choroidal biopsy showed a moderately well differentiated mucinous adenocarcinoma. The primary site could not be determined. The mucinous character is rather suggestive for a gastrointestinal origin. Gastro intestinal choroidal metastases, and more specifically the pancreatic ones, are however rare.
 ...
PMID:Choroidal biopsy in the diagnosis of a suspect intraocular lesions. 749 82

This is the first description of the detection of pancreatic adenocarcinoma peritoneal metastasis by established radiolabeled polymerase chain reaction (PCR) based Ki-ras mutational analysis. The present study evaluates both routine cytology and Ki-ras mutational analysis in the detection of peritoneal micrometastases in 24 subjects with pancreatic adenocarcinoma compared to seven control cases of chronic pancreatitis and seven control cases of cholecystitis. Locoregional extension, vascular invasion, and distal metastases were confirmed in 21/24 (88%) of the subjects with pancreatic adenocarcinoma by compute tomography, angiography, endosonography, or laparoscopy. The most common site of histologically confirmed extrapancreatic involvement was the vasculature (29%), followed by the liver (25%), duodenum (17%), peritoneum (17%), and lymph nodes (12%). Peritoneal lavage cytology was positive in 3/24 (12%) cases of pancreatic carcinoma while Ki-ras codon 12 mutational analysis was positive in 2/24 (8%). Two histologically confirmed cases of peritoneal metastases were not detected by either methodology, while peritoneal lavage cytology detected malignant cells in one case with histologically confirmed lymph node metastasis.
 ...
PMID:Peritoneal exfoliative cytology and Ki-ras mutational analysis in patients with pancreatic adenocarcinoma. 749 64

The diagnostic value of bile salt-dependent lipase for pancreatic diseases was tested in sera of 187 patients. Of these patients, 76 suffered from pancreatic carcinoma, 43 from nonmalignant liver diseases (cirrhosis and chronic hepatitis), 18 from acute pancreatitis, and 20 from chronic pancreatitis. The remaining subjects were controls without pancreatic pathology. Bile salt-dependent lipase was determined by a sandwich enzyme-linked immunosorbent assay using polyclonal antibodies. Amylase and CA 19-9 antigen were also determined. In sera from control patients, the mean level of bile salt-dependent lipase was 1.5 micrograms/L. This level is quite similar to that of patients with benign liver diseases (1.1 micrograms/L) and with chronic pancreatitis (1.4 micrograms/L), but it was raised to 3.5 micrograms/L in patients with acute pancreatitis and decreased to 0.5 microgram/L in subjects with pancreatic adenocarcinoma. Thirty percent of control subjects and 73% of cancer patients had a bile salt-dependent lipase serum level below the cutoff value of 0.5 microgram/L. In acute pancreatitis, 11 of 16 subjects had levels above 1.5 micrograms/L. Amylase level largely increased in acute pancreatitis but was normal in all other groups. Concerning CA 19-9 antigen, 65% of control patients and > 80% of patients with nonmalignant pancreatic or liver diseases had normal levels. In sera from cancer patients, 80% presented with high levels. Accordingly, 36 of 38 patients with pancreatic cancer had either low serum levels of bile salt-dependent lipase (< 0.5 microgram/L) or high values of CA 19-9 antigen (> 37 U/ml; sensitivity 95%).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Is bile salt-dependent lipase concentration in serum of any help in pancreatic cancer diagnosis? 750 10

Acinar and ductal cells of the normal pancreas express cytokeratin (CK) patterns which indicate a heterogeneity of ductal epithelia. On account of the CK of pancreatic adenocarcinoma, it would seem to be probable that tumor epithelia possess a considerable potential for squamous epithelium metaplasia. Comparative studies of CK expression by ductal carcinoma of the pancreas and carcinoma of bile ducts, stomach and large intestine as well in cases of chronic pancreatitis have demonstrated the usefulness of CK for differential diagnosis of these conditions. From the number of apomucins, mainly MUC1 is produced in the normal pancreas. This capacity is maintained in pancreas carcinoma and cell lines derived from it.
 ...
PMID:Cytokeratins and mucins as molecular markers of cell differentiation and neoplastic transformation in the exocrine pancreas. 752 52


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>