Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Information from 72 patients from 7 families in England and Wales confirms that hereditary pancreatitis is inherited as an autosomal dominant conditions with limited penetrance. The degree of penetrance is approximately 80%. These patients have had recurrent attacks of abdominal pain starting from childhood or young adult life. The mean age of onset in the 7 families studied was 13.6 years. There were two peaks, with maximum numbers at 5 years and 17 years. The second peak was thought to represent genetically susceptible individuals having pain brought on by alcohol rather than representing evidence of genetic heterogeneity. Five of the 7 families had members with both childhood and adult ages of onset. Only 4 patients out of 72 had life-threatening disease and in the majority of cases the attacks of pain were of nuisance value only. Hereditary pancreatitis was implicated in only 1 patient's death and this was not definite. Patients appear to get better after a period of symptoms usually as they approach middle age, or after a severe attack. In older patients alcohol, emotional upsets, and fatty food appear to precipitate attacks. Pancreatic insufficiency (5.5%), diabetes mellitus (12.5%), pseudocysts (5.5%), and haemorrhagic pleural effusion are uncommon complications. Portal vein thrombosis occurred definitely in 2 patients and was suspected in 3 others. Carcinoma of the pancreas was not found in any of 72 patients studied in detail; however, 2 members from a family not visited personally had chronic pancreatitis and malabsorption going on to carcinoma. They may have suffered from a different disease. Genetic linkage information was too slight for many definite conclusions. However, there was no suggestion of linkage with any of the markers tested.
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PMID:Hereditary pancreatitis in England and Wales. 67 83

In a personal series of 188 patients with pancreatic disease referred for endoscopic retrograde cholangiography (ERCP), one or more ducts were cannulated in 168 patients; of the 168 patients; of the 168 patients, 19 had carcinoma and 149 had chronic pancreatitis. Abnormalities were found in 71 of the 149 patients with pancreatitis, either in the pancreatic duct, the bile duct, or both ducts. The demonstration of these abnormalities was of critical importance in planning the management of these patients. Ducts were normal in 78 patients. No benefit could be expected from operating upon these patients. It is concluded that approximately one half of the patients with chronic pancreatitis will have demonstrable lesions amenable to operation, and one half will not. ERCP is essential in the investigation and management of patients suspected of having chronic pancreatitis.
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PMID:Endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of chronic pancreatitis. 68 22

The extensive experience of the authors in endoscopic retorgrade pancreaticography is correlated with data in the literature to illustrate the spectrum of characteristic changes and diagnostic accuracy in several entities. These include chronic pancreatitis, calculous pancreatitis, necrotizing lesions and pseudocysts, carcinoma of the pancreas, and papillary stenosis, spasm, and carcinoma.
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PMID:Endoscopic retrograde pancreaticocholangiography in chronic diseases of the pancreas and in papillary stenoses. 70 Mar 15

Circulating CEA levels were determined in 102 patients wtih histologically proven pancreatic carcinoma and 26 patients with chronic pancreatitis. In the group with pancreatic carcinoma eleven patients had resectable tumors, the mean CEA in the nonjaundiced patients was 10 +/- 5 ng/ml while the mean value in jaundiced patients in this group was 27 +/- 40. Thirty-four patients with nonmetastatic locally unresectable disease had a mean serum CEA of 25 +/- 52 with a range of 1 to 250 ng/ml. Twenty-one percent had values of 5 ng/ml or less. The mean value in 57 patients with metastatic disease was 97 +/- 194 with a range of 0.05 to 1000 ng/ml and 19 percent had values of 5 ng/ml or less. Survival of patients with locally unresectable or metastatic carcinoma was significantly longer in those patients who had a normal CEA at the time of diagnosis. Circulating CEA in the metastatic group was much lower in patients with nonhepatic metastases as well as in those with well differentiated adenocarcinoma histology. Twenty-three patients with chronic pancreatitis and normal serum bilirubin had a mean CEA value of 5.3 +/- 4 ng/ml with 65% of values being 5 ng/ml or less but the CEA ranged from 4.6 to 27 in three who were jaundiced.
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PMID:Circulating carcinoembryonic antigen in pancreatic carcinoma. 70 16

A comparison has been made between a modified Lundh test and the secretin-CCK test. Thirty-four patients with pancreatic disease (chronic pancreatitis, n = 25; recurrent pancreatitis, n = 5; and pancreatic carcinoma, n = 4) and 20 patients with other gastrointestinal disorders were studied. The results showed that estimation of trypsin secretion, irrespective of the mode of stimulation, had a low sensitivity in detecting pancreatic disease. Estimation of bicarbonate secretion after secretin stimulation provided a more sensitive test, especially for disclosing chronic pancreatitis.
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PMID:The secretin-CCK test and a modified Lundh test. A comparative study. 72 16

In a prospective study of 46 patients with suspected pancreatic disease the provisional diagnoses arrived at independently by isotope scanning (IS), ultrasonography (USS) and computed tomography (CT) have been compared. In the control group, IS and CT were associated with a higher false positive rate than USS; The isotope scan was abnormal in most patients with proven chronic pancreatitis and cancer. The results from USS and CT were similar when structural changes were present. USS was superior in diagnosing pancreatic carcinoma and was a convenient means to follow the progression of acute pancreatitis to final resolution or the development of a pseudocyst. CT proved especially useful in accurately delineating cysts, pseudocysts and calculi prior to planning surgery and in assessing disease in contiguous viscera.
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PMID:A clinical evaluation of isotope scanning, ultrasonography and computed tomography in pancreatic disease. 73 53

A critical "blind" evaluation of 129 randomly selected angiographic examinations was carried out including 37 control patients, 58 patients affected by proven chronic relapsing pancreatitis and 34 patients with cancer of the pancreas. In 48.5% of the control patients a completely normal angiographic picture was found. The false positives were found in 10.8% of chronic pancreatitis and in pancreatic carcinoma in 5.5% of the cases. Equivocal signs were found in 35.2%. The percentage of the false negative results in chronic pancreatitis was 34.4% (of which 8.6% were suggestive of pancreatic cancer). In pancreatic cancer positive results were seen in 70.6% of the cases. The percentage of the false negatives was 26.5% (suggestive of chronic pancreatitis); equivocal signs were found in 2.9% of these patients. Notwithstanding the not-negligible percentage of errors, angiography can be usefully employed in diagnosis of pancreatic disorders.
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PMID:Angiography in chronic pancreatitis and pancreatic cancer. A critical evaluation. 74 14

In 90 patients pressure measurements in the pancreatic duct (50 cases) and in the common bile duct (20 cases) were performed endoscopically. In the normal pancreas an averaged basis pressure in Wirsung's duct of 22.2 cm H2O was found with a range of 9.6 to 37.0 cm H2O. In two cases of marked chronic pancreatitis and in one case of pancreatic carcinoma the secretion pressure was considerably diminished. The mean basic pressure of the common bile duct amounted to 12.0 cm H2O with a range of 7.3 to 17.0 cm H2O. The pressure values in the duodenum were found to be considerably lower than in the pancreatic duct and the bile duct; they amounted to 5.3 cm H20 with a range of 0.6 to 10.9 cm H20. In both ducts two different patterns of ondulations were found: tracings of slight ondulations, i.e. slow pressure changes with a constant average pressure and tracings of coarse ondulations with quick increase and drop in pressure. It will be discussed, how these findings can be related to physiology and pathophysiology of the pancreatic and biliary duct system. The clinical relevance for detection of excretory insufficiency of the pancreas and of pathologic changes leading to stenosis of the duct system are considered.
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PMID:[Basic pressure in the pancreatic duct and in the bile duct: results from 50 standardized duodenoscopic transpapillary pressure measurements (author's transl)]. 84 Jan 26

Comparative studies between activity of serumlipase, lipaseevocationstest and endoscopic retrograde cholangiopancreaticography (ERCP) in 45 patients with chronic pancreatitis, pancreatic cysts or pancreatic carcinoma confirm, that elevated enzyme values after caerulein stimulation indicate an alteration of the pancreatic parenchyma. However, this findings does not give information on the etiology of the damage. On the basis of the presented results it seems that the lipase-evocationstest has only limited value as screening method within the total of clinical methods for the assessment of light and medium severe stages of chronic pancreatitis and accompanying forms of pancreatitis. There is no evidence that this method may be used for screening for carcinoma of the pancreas. A positive result gives a valuable information, but the lack of an increase of lipase activity does not exclude the existence of pancreatic affection. In each case with clinical suspicion for pancreatic disease further diagnostic investigation by the ERCP and additional radiographic methods should be performed.
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PMID:[The importance of the serumlipaseevocationtest and the retrograde pancreaticography for the diagnosis of chronic pancreatic affections (author's transl)]. 84 Jan 29

The bile ducts were visualised using endoscopic retrograde cholangiopancreatography (ERCP), percutaneous or intravenous cholangiography in 38 patients with non-gallstone chronic pancreatitis. Stenosis of the intrapancreatic portion of the distal common bile duct was demonstrated in 11 patients. Ten of the 11 developed transient cholestasis during exacerbations of their chronic pancreatitis. In six cholestasis eventually persisted requiring surgical relief. Secondary biliary cirrhosis was present in one patient. No evidence of pancreatic carcinoma was found in the patients explored surgically. Ten of the patients are alive more than one year after diagnosis. Chronic pancreatitis was of alcoholic aetiology in 10 of the patients with biliary stenosis. Cholestasis and biliary stricture are common but poorly recognised complications of non-gallstone chronic pancreatitis, especially when pancreatitis is severe and due to alcohol.
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PMID:Chronic pancreatitis: a cause of cholestasis. 85 77


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