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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The main case control studies and over 30 cohort studies of pancreatic cancer, performed during the period 1973-1988 are reviewed. For each type of risk factor a table is given which summarizes the conclusions of the various studies. The multifactorial etiology of this cancer is reflected by the number of different exposures studied. In our opinion, the effects of tobacco are indisputable even though they have not been systematically described in all studies. Cigarette smoking is associated with two-fold increase in risk. The effect of different forms of smoking, such as filter utilization, pipe, colour of tobacco, etc. on the risk are unclear. The effect of alcohol is less important although this needs to be confirmed. Tobacco use was not controlled in many studies where a positive results was obtained for alcohol. The same confounding effect has perhaps biased the results of several studies carried out for coffee drinkers. While not definitively confirmed, the elevated risk associated with coffee drinking appears to be plausible. Results on other dietary factors have not been widely reported. However, a positive association has been found for consumption of meat and fat and a negative one for vegetables and fruits. In some cases, these results are amplified by a dose-response effect. Further nutritional studies are required in order to resolve this question. Previous medical conditions have also been considered, in particular diseases of the pancreas, i.e. diabetes mellitus and pancreatitis. The results are not consistent, as causes and effects are not easy to detect. However, positive results for diabetes mellitus are more convincing than those for other conditions. Potential effects of work-related exposure have been analysed by many researchers although no firm conclusions can be drawn upon review of those results. Among the suspected risks, one has to consider the chemical industry and industrial exposure in oil refinery, aluminium reduction, and coke transformation. Occupations involving contact with dyes, paint and thinners could also be in the risk group.
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PMID:[Risk factors of cancer of the pancreas from analytic epidemiologic studies]. 218 May 1

In order to evaluate the efficacy of a monoclonal pancreatic (P) isoamylase assay in the diagnosis of chronic pancreatic disease and to compare the behavior of this test with that of amylase and elastase 1, these three enzymes were measured in the sera of 39 healthy controls, 28 patients with pancreatic cancer, 50 with chronic pancreatitis and 60 with extra-pancreatic diseases. In patients with chronic relapsing pancreatitis, increased P-isoamylase and elastase 1 values were found in similar percentages (about 70%), whereas the percentage for elevated amylase values was lower (52%). Elastase 1 was increased in 52% of patients with pancreatic cancer, while the other two enzymes were only occasionally elevated. The levels for all three enzymes were abnormal in some patients with extra-pancreatic diseases. It may be concluded that this assay for P-isoamylase determination is sufficiently sensitive and reliable in detecting pancreatic inflammation, even though some limitations concerning its specificity should be born in mind.
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PMID:Diagnostic utility of a new monoclonal antibody pancreatic isoamylase assay in chronic pancreatic diseases. 223 Jun 67

The relation between various aspects of medical history, selected indicator foods and the risk of pancreatic cancer was analyzed in a hospital-based case-control study conducted in Northern Italy on 247 patients with cancer of the pancreas, and 1,089 controls in hospitals for acute, nonneoplastic or digestive conditions. There was a significant association with history of pancreatitis (relative risk, RR 3.2, 95% confidence interval = 1.3-7.9), which was however reduced when the condition was first diagnosed at least 5 years previously. The point estimates were slightly, but not significantly, above unity for diabetes (RR = 1.5), gastrectomy (RR = 1.1) and cholelithiasis (RR = 1.3), and no association was found with liver disease or drug allergy. In relation to diet, there was some tendency for the risk to decrease with more frequent fruit consumption, but the results were largely inconsistent in relation to various indicators of meat, animal protein or fat intake. Although no important associations were found in this study with various aspects of medical history or diet indicators and pancreatic cancer risk, on account of the size of the dataset and the statistical power, this study contributes usefully to the debate on a common cancer whose causes are still largely undefined.
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PMID:Medical history, diet and pancreatic cancer. 224 64

Focal lesions of the pancreas or its surroundings comprise a variety of morphologic substrates that do not always require treatment. Cysts and neoplasms are the two important groups. Postpancreatic cysts are increasingly and successfully treated by endoscopy and interventions guided by ultrasound. They have to be distinguished from cystic neoplasms or intracavitary hemorrhage which have to be approached by primary surgery. Pancreatic malignancies do not necessarily invite to a fatalistic attitude. Only ductal pancreatic cancer carries a still poor prognosis although we have achieved a 20% 5 year survival rate if resection without residual tumor was possible. If lymph nodes were not involved 43% of patients survived for 5 years. Periampullary carcinoma and the other pancreatic neoplasms carry a much better prognosis. The search for focal pancreatic lesions must be particularly thorough in patients presenting with diabetes of sudden onset, persistent hyperamylasemia and in some cases with an acute, possibly severe pancreatitis without apparent cause and an age of over 40 years.
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PMID:[Surgical aspects of focal pancreatic lesions]. 225 60

In most patients presenting with acute pancreatitis, the cause can be established on the basis of initial history, physical examination, laboratory studies, and abdominal sonography. Patients with unexplained pancreatitis at that point are often considered to have idiopathic disease. However, a cause and, often, effective treatment to prevent recurrent pancreatitis are possible in many of these patients if an aggressive diagnostic approach is taken to discover undiagnosed hyperlipidemia, occult gallstones, abnormalities of the bile and pancreatic ducts, sphincter of Oddi dysfunction, pancreatic cancer and other tumors, and cystic fibrosis (in children and young adults).
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PMID:Idiopathic acute pancreatitis. 226 20

Endoscopic management of pancreatic diseases is a rapidly developing area. Many innovative techniques and types of equipment have become available. The indications for diagnostic and therapeutic intervention in may disease states are in evolution. Diseases such as acute gallstone pancreatitis, pancreatic cancer, and complications of chronic pancreatitis are being approached more aggressively. Controversy concerning application of these techniques is discussed in this article.
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PMID:Endoscopic management of pancreatic disorders. 226 28

Pancreatic abscess is a severe complication of pancreatitis usually caused by alcohol, gallstones, abdominal trauma, or prior operative procedures. Pancreatic cancer is a rare cause of acute pancreatitis and an extremely rare cause of pancreatic abscess. We report three patients with pancreatic abscess caused by cancer who experienced a prolonged, complicated course with delay in diagnosis and substantial morbidity.
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PMID:Adenocarcinoma of the pancreas producing pancreatitis and pancreatic abscess. 229 11

Pancreatic carcinoma (n = 7), pancreatitis tissue (n = 4), normal pancreas tissue (n = 5), colonic adenocarcinoma (n = 4) and in vitro human pancreatic cancer cell lines (n = 6) were studied with the murine monoclonal antibodies (MAbs) 3DS2A, AR1-28, AR2-20, Ca19-9 and CA17-1A to determine their immunohistologic specificity and sensitivity for use as radiolabeled diagnostic imaging agents. Using the avidinbiotin-immunoperoxidase staining technique, MAbs 3DS2A and AR1-28 stained 86 and 100% of pancreatic cancer specimens, respectively. MAbs 3DS2A and AR1-28 are suitable agents for use as radiolabeled diagnostic imaging agents in patients with pancreatic cancer.
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PMID:Murine monoclonal antibodies to human pancreatic cancer: specificity and sensitivity. 231 27

Basic evaluation of SPan-1 assay (SPan-1 RIA. BEAD) and clinical significance of serum SPan-1 levels for the diagnosis of pancreatic cancer were studied. This assay was reproducible, reliable and simple to perform. It required minimal samples (duplicate 50 microliters) and may be done within 4 hrs. Normal subjects (N = 1182) had serum SPan-1 antigen levels which ranged 0 to 42.8 units/ml with a mean of 7.5 units/ml and above 40 units/ml was considered to be positive. SPan-1 antigen levels in cultured medium of four out of five pancreatic cancer cell lines showed more than 1000 units/ml by this assay. While over 90% of pancreatic cancer patients had elevated levels of serum SPan-1 antigen, only 0-17% of patients with other malignant and non malignant gastrointestinal diseases such as pancreatitis (chronic or acute), gastric cancer or colon cancer had above normal levels. Furthermore, levels of serum SPan-1 antigen correlated well with treatment and recurrence of disease in patients with pancreatic and gastric cancer. These results suggest that determination of serum SPan-1 antigen levels by this assay kit is useful for the diagnosis and monitoring of pancreatic cancer.
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PMID:[Basic and clinical evaluation of measurement of pancreatic cancer associated antigen, SPan-1]. 232 7

A population-based case-control study was conducted to examine the relationship between certain medical conditions, the use of tobacco, alcohol and coffee, and the incidence of pancreatic cancer. Cases (N = 148) were married men ages 20 through 74 years diagnosed with pancreatic cancer from July 1982 through June 1986. Controls (N = 188) were identified by random digit dialing. Wives, responding as surrogates for both cases and controls, were interviewed by telephone and completed, alone, a food frequency questionnaire. The risk of pancreatic cancer was increased in individuals with a history of diabetes or pancreatitis, and decreased in those with a history of tonsillectomy. Individuals who had ever smoked cigarettes were at elevated risk of disease. This excess risk was confined to current smokers, in whom the odds ratio was 3.2 (95% CI 1.8-5.7); the risk among former smokers resembled that in those who had never smoked. There was no excess risk of pancreatic cancer among those who had ever used other forms of tobacco, including pipe tobacco, cigars and chewing tobacco. After adjustment for demographic and dietary characteristics, there was no association between pancreatic cancer risk and the intake of coffee, beer, red wine, hard liquor or all alcohol combined; a slight reduction in risk was seen among those consuming white wine daily.
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PMID:Risk of pancreatic cancer in relation to medical history and the use of tobacco, alcohol and coffee. 233 85


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