Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-five of 186 patients investigated for suspected pancreatic cancer had an unequivocal final diagnosis of either pancreatic cancer (58 patients) or chronic pancreatitis (27 patients). They had been studied prospectively using ultrasonography, computerized tomography, radionuclide scanning, endoscopic retrograde cholangiopancreatography (ERCP), selective celiac and superior mesenteric angiography, duodenal drainage studies, cytologic studies, serum carcinoembryonic antigen assay, and pancreatic oncofetal antigen assay, The results were compared to determine which test would most frequently and reliably differentiate between pancreatic cancer and pancreatitis in a patient believed to have one or other disease. Criteria for interpreting results, first for highest rate of correct diagnoses, and second for highest accuracy were derived. Applying these criteria, ultrasonography achieved the highest rate of correct diagnoses (97% of patients diagnosed with 84% accuracy). ERCP, duodenal drainage studies, and cytology were the most accurate tests ((86% accuracy each test) but, with this accuracy, ERCP most frequently gave a diagnosis (diagnosis rate: ERCP--70%, duodenal drainage--32%, cytology--35%). The results suggest that ultrasonography is the best noninvasive test, and that a combination of ERCP, pancreatic juice assay and cytology in a single procedure may prove to be the best discriminating investigation.
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PMID:Non-operative differentiation between pancreatic cancer and chronic pancreatitis. 44 2

We undertook to test the recent suggestion that measurement of immunoreactive carcinoembryonic antigen (CEA) in pancreatic secretion may be useful in diagnosis of pancreatic cancer. Using duodenal intubation and a perfusion method in 57 cases, we measured the rate of pancreatic CEA secretion into the duodenum under basal saline perfusion, alone and with continuous intravenous infusion of secretin (2 clinical units per kg per hr) and of cholecystokinin-pancreozymin (CCK, 15 Crick-Harper-Raper units per kg per hr); and we compared the CEA output with secretion of trypsin, lipase, and bicarbonate under the same conditions. Subsequent laparotomy revealed pancreatic carcinoma in 25 patients, pancreatitis in 7, other intraabdominal malignancies in 6, and benign nonpancreatic disorders in 19. CEA output rates did not differentiate all pancreatic-cancer patients from other patients in any test condition. However, pancreatic enzyme outputs were abnormal with almost 90% of cancers of the pancreatic head and with 75% of cancers of the pancreatic body and tail. For detection of pancreatic cancer, enzyme and bicarbonate outputs in response to CCK are more accurate than pancreatic CEA or bicarbonate outputs in response to secretin. Since CCK-stimulated enzyme outputs can be related accurately to malabsorption (not reported here), we prefer them to bicarbonate output for assessment of pancreatic function.
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PMID:Prospective evaluation of the pancreatic secretion of immunoreactive carcinoembryonic antigen, enzyme, and bicarbonate in patients suspected of having pancreatic cancer. 89 42

Nineteen patients with pancreatitis and 40 with pancreatic carcinoma were examined for certain immunological characteristics (immunoglobulins, immune complexes, PHA-induced lymphocyte proliferation) and for the level of carcinoembryonic antigen (CEA) and CA 19-9 depending on blood bilirubin. Hyperbilirubinemia was identified in 21 patients with carcinoma and in 3 suffering from pancreatitis. Both patients' groups manifested an increase of the IgA level. Especially high characteristics were seen in hyperbilirubinemia. The level of other class immunoglobulins and immune complexes did not depend on blood bilirubin. The patients demonstrated suppression of PHA-induced lymphocyte response by autologous plasma, with more remarkable suppression being observable in hyperbilirubinemia. The level of CEA or CA 19-9 was increased in 89% of the patients with pancreatic carcinoma and in 30% of pancreatitis patients. No relationship was recorded between the level of oncofetal antigens and blood bilirubin.
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PMID:[The immunological indices in inflammatory and tumorous diseases of the pancreas]. 150 77

For evaluating the diagnostic rate of serum CA19-9 and carcinoembryonic antigen (CEA) in pancreatic malignancies and pancreatitis, 22 patients with pancreatic malignancy, 27 patients with acute pancreatitis and 7 patients with chronic pancreatitis were included in this prospective study. The normal values of CEA and CA19-9 were 2.0 ng/ml and 36 U/ml respectively in 10 healthy males and 11 healthy females. The positive rates of CEA (greater than 2.5 ng/ml) in pancreatic malignancy, acute pancreatitis and chronic pancreatitis were 50%, 47% and 38%, respectively. On the other hand, the positive rates of CA19-9 (greater than 37U/ml) in pancreatic malignancy, acute pancreatitis and chronic pancreatitis were 82%, 26% and 23%, respectively. In diagnosis of pancreatic malignancy, the positive rate of CA19-9 is higher than that of CEA (82% vs 50%), and CA19-9 has a sensitivity significantly higher in differentiating from pancreatitis than CEA. In 7 cases of pancreatic malignancy with metastasis (liver or peritoneum), all had abnormally high serum CA19-9 (greater than 195 U/ml), 6 of 7 had CA19-9 levels over 1000 U/ml. In the view of CEA, 6 of 7 had serum CEA over 5 ng/ml, one patient with peritoneal metastasis had normal CEA level. In this study, we conclude that the diagnostic rate of CA19-9 in pancreatic malignancies is better than that of CEA.
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PMID:[Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) values in patients with pancreatic cancer or pancreatitis]. 203 68

Monoclonal antibody defined antigen (CA19-9), carcinoembryonic antigen (CEA), ultrasonography (US) and computerized tomography (CT) were carried out as the tests in 113 patients suspected to have pancreatic cancer. Of 98 patients who underwent operation, 55 were found to have pancreatic cancer, 25 benign pancreatic disease, and 18 cancer of the biliary tract. Follow-up study was carried out for more than 1 year in 15 other patients suffering from pancreatitis without surgical intervention. The accuracy of CA19-9, US, CEA and CT was 87%, 69%, 61% and 56% respectively. The sensitivity of each test was CA19-9, 98%; US, 89%; CT, 80%; and CEA, 38%. The sensitivity of parallel test combined with CA19-9 and CEA was 100%. It may be regarded as the first step to detect pancreatic cancer in suspected population. The specificity of each test was CEA, 82%; CA19-9, 76%; US, 50% and CT, 40%. And the specificity of serial tests combined with CA19-9 and US was 90%. When these two tests were both positive, pancreatic cancer was highly suspected.
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PMID:Evaluation of non-invasive diagnostic tests in detecting cancer of the pancreas. 212 54

Comparative studies of pancreatic enzymes carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) were performed in various pancreatic disease. In acute pancreatitis as well as during acute exacerbation of chronic pancreatitis, all pancreatic enzymes were abnormally high. In chronic pancreatitis, they did not have any diagnostic sensitivity for pancreatic insufficiency. In pancreatic carcinoma, serum elastase levels may have a diagnostic value compared with other pancreatic enzymes. In studies of CEA and CA 19-9, both tumor markers were within normal range in benign pancreatitis but 27.7% of CEA and 30.7% of CA 19-9 in acute pancreatitis were above normal. In pancreatic carcinoma, although most of these patients had advanced disease, both tumor markers were extremely high and 61% for CEA and 71% for CA 19-9 were above normal. In patients with resected pancreatic carcinoma, serum CEA was slightly higher than normal CA 19-9 was much higher than normal. The sensitivity of CEA and CA 19-9 in this group were 33 and 77.7%, respectively. The results indicate that the CA 19-9 assay is a useful adjunct in the diagnosis of pancreatic carcinoma, possibly in the resectable stage especially combined measurement of serum elastase and CEA.
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PMID:Evaluation of serum pancreatic enzymes, carbohydrate antigen 19-9, and carcinoembryonic antigen in various pancreatic diseases. 241 Nov 25

The levels of carcinoembryonic antigen (CEA), elastase 1, and carbohydrate antigen determinant (CA 19-9) in the pancreatic cystic fluid and the serum from five patients with cystadenocarcinoma of the pancreas, one patient with retention cyst due to pancreatic carcinoma, three patients with cystadenoma, and eight patients with benign pseudocyst accompanying or following pancreatitis, were determined by immunoassay technique. Fluid from pancreatic cysts was obtained by ultrasonically-guided percutaneous fine-needle aspiration biopsy. The specimens were centrifuged and the supernatant was used for the measurement of CEA, elastase 1, and CA 19-9, while the cell pellet was examined cytologically. The levels of CEA in the aspirated fluid were significantly higher in patients with malignant cysts of the pancreas than in those with benign cystadenomas and pseudocysts. In contrast, the levels of elastase 1 were significantly lower in patients with malignant cysts than in those with benign pancreatic cysts. Although the levels of CA 19-9 were significantly higher in patients with malignant cysts than in those with pseudocysts, the overlap between the values of patients with malignant and benign pancreatic cysts is too great. The serum CA 19-9 was most useful, however, to distinguish an individual patient with malignant cysts of the pancreas from those with benign pancreatic cyst, since there were no significant differences between the levels of serum CEA and elastase 1 in patients with malignant and benign pancreatic cysts. Correct diagnoses were made cytologically in 4 (66.7%) of 6 patients with malignant cysts. In two patients with malignant cyst, in whom no cancer cells were detectable in the aspirated materials, levels of CEA were abnormally high, but high levels of elastase 1 did not occur. Therefore, the combined measurement of CEA and elastase 1 in the aspirated cystic fluid of the pancreas could be used as an aid in diagnosis of malignant cysts of the pancreas.
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PMID:Values of carcinoembryonic antigen, elastase 1, and carbohydrate antigen determinant in aspirated pancreatic cystic fluid in the diagnosis of cysts of the pancreas. 242 Apr 41

The ductular accumulation of "abnormal mucus" is the key histologic feature in cystic fibrosis. This material is periodic acid-Schiff positive and diastase resistant, suggesting that it is glycoprotein in nature. We used the avidin-biotin-peroxidase method to identify this material using antibodies to the serum glycoproteins carcinoembryonic antigen, alpha 1-antitrypsin, and alpha-fetoprotein on paraffin sections of pancreas obtained from a total of 21 patients: 9 with cystic fibrosis, 5 with chronic pancreatitis, and 7 controls. The control patients had normal pancreatic histologic findings, no alpha 1-antitrypsin or alpha-fetoprotein was demonstrated, and only the ductular epithelium reacted weakly for carcinoembryonic antigen. The pancreas in pancreatitis showed fibrosis, acinar atrophy, and ectasia of the ducts that contained only a small amount of periodic acid-Schiff-positive material. This material reacted weakly for carcinoembryonic antigen and alpha 1-antitrypsin. The appearance of the pancreas in cystic fibrosis was similar to that in chronic pancreatitis. However, the ducts contained a greater amount of periodic acid-Schiff-positive material, mostly in the form of globules that reacted strongly for carcinoembryonic antigen and alpha 1-antitrypsin and weakly for alpha-fetoprotein, as did the ductular epithelium. This study shows that the periodic acid-Schiff-positive material in cystic fibrosis contains at least the three serum glycoproteins and that the accumulation may represent a possible defect in cellular synthesis, assembly, or transport of glycoproteins in the ducts.
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PMID:Carcinoembryonic antigen, alpha 1-antitrypsin, and alpha-fetoprotein in the pancreas of patients with cystic fibrosis. 247 7

The morphologic characteristics of ductlike tubular complexes were studied in human acute pancreatitis. Pancreatic specimens were obtained from 10 patients who were operated on for acute pancreatitis. Immunocytochemistry for pancreatic enzymes, keratin, actin, and carcinoembryonic antigen were combined with lectin-binding studies and ultrastructural investigations. Irrespective of clinical onset and duration of pancreatitis, tubular complexes situated in the vicinity of fat necrosis were observed in all patients. Intermediate forms of ductlike structures were characterized by widening of acinar lumina, decreased height of acinar cells, and large autophagic vacuoles. These structures bound all of the lectins employed and retained their immunoreactivity to secretory proteins. Typical tubular complexes were composed of low cuboidal or flattened cells surrounding a large acinar lumen. They revealed a loss for pancreatic enzymes, a reduced lectin-binding for L-fucose and N-acetylgalactosamine, and an increase for cytoskeletal proteins (keratin, actin). It is concluded that tubular complexes in human acute pancreatitis represent degenerating acinar cells which lost their secretory and membrane characteristics.
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PMID:Histochemical and ultrastructural characteristics of tubular complexes in human acute pancreatitis. 253 80

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


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