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)

Forty patients with pancreatic diseases (11 cancer, 1 islet cell tumor, 12 mucin-producing tumor, 1 teratoma, and 15 chronic pancreatitis) were studied in vivo with ERP and were also scanned with an intraductal ultrasound (IDUS) probe at a frequency of 30 MHz inserted into the main pancreatic duct. The usefulness of in vivo IDUS was evaluated by comparison of images with the ERP findings. IDUS was of diagnostic value in 18 of the 40 patients; it distinguished between 4 malignant and 6 benign causes of localized stenosis revealed by ERP, provided parenchymal information in 2 cases with only displacement revealed by ERP (1 islet cell tumor and 1 teratoma), and determined the extent of tumor in 6 cases with main-duct-type mucin-producing tumor. Ten of 11 cancer, 4 of 12 mucin-producing tumor, 1 islet cell tumor, and 11 of 15 chronic pancreatitis (previously scanned in vivo), and 2 islet cell tumor (not scanned in vivo), were resected and scanned in vitro. Fifteen normal pancreases from autopsy subjects were also scanned in vitro. The IDUS images were then compared with corresponding histopathological sections from the 15 normal pancreases and 28 post-operative pancreatic specimens. Differential diagnosis of the pancreatic diseases by echo patterns was possible in all cases except those with intraductal papillary adenocarcinoma and adenoma.
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PMID:Differential diagnosis of pancreatic diseases with an intraductal ultrasound system. 801 24

The role of laparoscopy in the diagnostic evaluation of ascites of unknown origin was studied in 129 patients. Laparoscopic results were as follows: (1) Carcinomatosis peritonei in 78 (60.5%). Peritoneal biopsies in 76 of these cases revealed malignancy in 67 (adenocarcinoma 62, lymphoma 4, mesothelioma 1) and tuberculosis in 5; specimens were inadequate for diagnosis in 4. (2) Tuberculous peritonitis in 26 (20.2%). Peritoneal biopsies in 24 of these cases revealed tuberculosis in 22 and non-specific chronic peritonitis in 2. (3) Cirrhosis in 7 (5.4%). (4) No gross abnormality in 18 (14.0%). Of the latter, causes of ascites had already been identified in 13 (72.2%), including chronic renal failure in 7, systemic lupus erythematosus in 2, constrictive pericarditis in 2, chronic pancreatitis with chylous ascites in 1, and retroperitoneal lymph node metastasis with chylous ascites in 1. Thus, laparoscopic observation in combination with biopsy established the cause of ascites of unknown origin in 111 (86.0%) of 129 patients. Most of the 18 patients without gross laparoscopic abnormality had underlying disease identified as a cause of ascites; laparoscopy was indicated in these cases to exclude other processes that may also cause ascites.
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PMID:The role of laparoscopy in the evaluation of ascites of unknown origin. 805 29

Interpretation of pancreatic biopsy material can pose substantial difficulties, particularly in the presence of chronic pancreatitis where ductular changes and fibrosis may mimic adenocarcinoma. We examined whether differences in cell kinetics could aid in the distinction between pancreatic carcinoma and chronic pancreatitis. Pancreatic tissue was obtained by percutaneous ultrasonographic guided biopsy. There were a total of thirty-four cases comprising patients with chronic pancreatitis (N = 11) and those with adenocarcinoma (N = 23). The cell cycle activity was determined in sections of routinely paraffin-processed, formalin-fixed biopsy material using immunohistochemical stains for the monoclonal proliferating cell nuclear antigen antibody PCNA (PC 10), a 36 kd nuclear protein synthesized in the late G 1 and S phase. After calculating the PCNA index (% of positively staining nuclei compared to total number of nuclei counted) these were compared in the conditions studied. The PCNA indices in chronic pancreatitis were low with a mean of 5%, while those of adenocarcinoma were 53% (p < 0.001). In conclusion, the PCNA index in pancreatic adenocarcinoma is significantly higher than in chronic pancreatitis. Determination of the PCNA index may be helpful as an adjunct in the diagnosis of problematic cases.
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PMID:Proliferating cell nuclear antigen (PCNA) in pancreatic adenocarcinoma. 810 28

We present a case of ductal adenocarcinoma originating in a heterotopic pancreas in a 60-year-old patient. The tumor developed at the esophagogastric junction in a hiatal hernia. The nontumoral pancreatic tissue showed ductal cystic dystrophy with enclosed stones, as well as lesions of chronic pancreatitis with metaplastic changes. The perigastric lymph nodes and the liver contained metastatic deposits. Malignant transformation in an ectopic pancreas is exceptional. To our knowledge, this would be the first case occurring in such a location. We review the literature on the subject and discuss the theory of the tumors arising in an aberrant pancreas.
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PMID:Ductal adenocarcinoma arising in a heterotopic pancreas situated in a hiatal hernia. 819 67

Changes in the basement membrane are present in various neoplastic conditions such as neurofibrosarcoma, cervical carcinoma, colorectal cancers and hepatoblastoma. This study examines the expression of type IV collagen in the basement membrane, using an immunohistochemical method, in the normal pancreas (n = 10), chronic pancreatitis (n = 15) and pancreatic adenocarcinoma (n = 30). The formalin fixed, paraffin embedded tissue was sectioned and pretreated with protease prior to immunostaining for type IV collagen. There was a statistically significant difference in type IV collagen expression between pancreatic carcinoma and chronic pancreatitis (P = 0.0001; chi 2 test with continuity correction). In pancreatic adenocarcinoma, type IV collagen distribution in the basement membrane was discontinuous and irregular or absent around individual or groups of neoplastic cells (n = 30). Most cases of chronic pancreatitis showed continuous pattern of basement membrane type IV collagen around residual ducts (n = 10). In the normal pancreas, only one of the ten cases showed discontinuous basement membrane around pancreatic ducts, while in the rest of the cases, the pattern was continuous. This study suggests that there is abnormal distribution of type IV collagen in the basement membrane in pancreatic carcinoma, which may be related to either abnormal deposition or degradation of the collagen. Immunostaining for type IV collagen may be of some diagnostic use for distinguishing pancreatic adenocarcinoma from problematic cases of chronic pancreatitis.
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PMID:Distribution of type IV collagen in pancreatic adenocarcinoma and chronic pancreatitis. 819 8

The p53 tumour suppressor gene and its protein products after point mutations are currently attracting wide attention in the investigation of human tumours. In this study we present the findings on percutaneous pancreatic biopsies of 82 cases after routine processing and immunostaining for the polyclonal p53 antibody CM1, an antibody directed against both wild and mutant forms of p53 protein. There were 51 carcinomas, 5 islet cell tumours, 16 cases of chronic pancreatitis (including one with atypical ductal epithelium) and seven histologically normal pancreatic biopsy specimens. None of the seven normal cases showed any definite nuclear immunostaining for p53. Thirty-two (63%) of the pancreatic adenocarcinomas showed moderate to intense immunoreactivity. Of the 16 cases of chronic pancreatitis, 11 were negative and three showed equivocal immunostaining. The one case with ductal epithelial atypia showed mild to moderate immunoreactivity. All islet cell tumours were negative. The expression of the p53 gene, therefore, appears increased in the majority of pancreatic adenocarcinomas while this is not observed in chronic pancreatitis or normal pancreatic tissue. Nuclear immunoreactivity for p53 protein may represent mutant forms because of the short half-life of the wild-type protein. The lack of p53 expression in some cases of pancreatic adenocarcinoma may be due to different types of mutant proteins not detectable by the CM1 antibody. Nuclear immunoreactivity to the p53 protein in pancreatic biopsy is more suggestive of a malignant tumour than chronic pancreatitis.
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PMID:Immunohistochemical demonstration of the p53 tumour suppressor gene product in cancer of the pancreas and chronic pancreatitis. 821 96

Very late activation (VLA) receptors mediate cell adhesion to extracellular matrix, mainly by acting as adhesion receptors to fibronectin, collagen, and laminin as well as to other cells. These interactions not only regulate normal cell-extracellular matrix contact, but also are thought to be involved in metastasis and invasive tumor growth. Using immunohistochemistry [the alkaline phosphatase-anti-alkaline phosphatase (APAAP) technique] we compared the expression and distribution of VLA receptors in normal pancreatic tissue, chronic pancreatitis, and ductal pancreatic adenocarcinoma. Immunohistochemically, VLA alpha 2 and VLA alpha 6 were moderately to strongly expressed on the basal surface of ductal and acinar cells in normal pancreatic tissue, whereas centroacinar cells predominantly expressed VLA alpha 3 and VLA alpha 5. Similarly, pancreatic carcinoma showed an intensive staining for VLA alpha 2 and VLA alpha 6 with a diffuse distribution on the cell surface. Expression of VLA alpha 3 and VLA alpha 5 in pancreatic carcinoma was heterogeneous, ranging from moderate to weak and lost in about 50% of the cells. As our results suggest, cell-basement membrane interaction in ductal and acinar pancreatic cells is primarily mediated through VLA alpha 2 and VLA alpha 6, whereas VLA alpha 3 and VLA alpha 5 are the major VLA receptors on centroacinar cells. In pancreatic carcinoma a loss (VLA alpha 5) or redistribution (VLA alpha 2, VLA alpha 6) of VLAs was observed. This redistribution of VLA alpha 2 and VLA alpha 6 may reflect a loss of spatial arrangement of tumor cells and their ability to randomly interact with extracellular matrix structures during invasion and metastasis.
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PMID:Expression and distribution of VLA receptors in the pancreas: an immunohistochemical study. 825 85

The immunohistochemical detection of lactoferrin was carried out with the PAP technique on pancreatic tissue samples of 23 patients, operated for acute (13) or chronic (4) pancreatitis as well as for adenocarcinomas (6). In order to control our immunohistochemical technique and the antisera produced by us we studied some tissue samples of human mammary gland and parotis. We detected lactoferrin in the glands of parotis and mammae as well as of their secretions. In the pancreatic tissue we found a positive reaction only in granulocytes of inflammatory areas with the exception of a luminal reaction on the surface of acinar cells in one case of pancreatic adenocarcinoma. We would like to interpret our results with the hypothesis of granulocytic origin of immunochemically detectable lactoferrin in the pancreatic juice of patients, especially in cases of chronic pancreatitis.
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PMID:Immunohistochemical detection of lactoferrin in different human glandular tissues with special reference to the exocrine pancreas. 827 35

Eleven patients underwent choledochoduodenostomy under laparoscopic control: 5 for adenocarcinoma of head of pancreas, including 2 with extension into duodenum, 3 for chronic pancreatitis. 1 for gastric carcinoma with pancreatic infiltration 1 for carcinoma of ampulla and 1 for stenosing papillitis. Mean duration of operation was 97.9 minutes and mean hospital stay 7.8 days. No immediate or delayed postoperative complications were reported. The advantages of this method are the marked reduction in recovery time, especially in severely debilitated elderly patients, and the absence of postoperative pain.
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PMID:[Choledochoduodenal anastomosis by laparoscopy]. 834 19

In order to evaluate the utility of positron emission tomography (PET) with 18F-labelled deoxyglucose (FDG) for detection of pancreatic cancer 15 patients with pancreatic masses shown by computed tomography were investigated. Static PET scans covering an axial field of view of 15 cm were obtained 45 min after intravenous injection of 150-300 MBq FDG. Focally increased FDG accumulation was present in 12 out of 13 patients with histologically proven adenocarcinoma, in particular in eight of nine lymph node and four of five liver metastases. Scans of two patients with chronic pancreatitis confirmed by surgery revealed a normal FDG distribution. Contrast between tumour and normal tissue depended the metabolic situation prior to FDG injection. High ratios were found in fasting patients whereas no elevated FDG uptake was measured in an insulin-dependent diabetic suffering from carcinoma of the pancreatic head. We conclude that FDG PET might have the potential for detection and even differentiation of pancreatic carcinoma from chronic pancreatitis. Further studies are necessary to substantiate these preliminary findings and to optimize results in diabetic patients.
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PMID:Pancreatic cancer detected by positron emission tomography with 18F-labelled deoxyglucose: method and first results. 835 20


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