Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149521 (chronic pancreatitis)
 7,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The immunohistologic distribution of the feto-acinar pancreatic protein (FAP), detected by the monoclonal antibody (MoAb) J28 using an indirect immunoperoxidase technique, is described. Tests were carried out on normal adult pancreas (n = 10), chronic pancreatitis (n = 14), pancreatic adenocarcinoma (n = 17), intraabdominal metastases of pancreatic and nonpancreatic origin (n = 22), metastatic tumors invading the pancreas (n = 3), nonpancreatic fetal (n = 39) and adult (n = 65) normal organs (n = 104), and nonpancreatic malignancies (n = 145). All sections were formalin fixed and paraffin embedded. In the normal pancreas, only a few positive acinar cells were found around some islets of Langerhans. In pancreatitis there was an increased expression of FAP protein in the acinar tissue in relation to inflammatory changes. In cases of primary pancreatic adenocarcinoma and metastatic tumors in the pancreas, a strong expression of FAP protein in the peritumoral acinar area was found. The tumors themselves were FAP protein negative, as were the nonpancreatic tumors and normal organs. It can be concluded that FAP protein, detected by MoAb J28 in tissue sections, is specific for pancreatic exocrine tissue with reactive changes.
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PMID:An immunohistologic study of the feto-acinar pancreatic protein (FAP) in the normal pancreas, chronic pancreatitis, pancreatic adenocarcinoma, and intraabdominal metastases of adenocarcinomas. 240 40

In patients with chronic pancreatitis, common bile duct obstruction is reported in 3.2-45.6% of patients; however, only 5-10% of all patients with chronic pancreatitis require operative decompression of the bile duct. The cause of the intrapancreatic stricture of the common bile duct may be either a fibrotic inflammatory restriction, or compression by a pseudocyst. Obstruction of the duodenum is much less common than common bile duct obstruction in chronic pancreatitis occurring in less than 1-2% of patients with chronic pancreatitis. Colonic obstruction secondary to pancreatitis is very infrequent. The intrapancreatic strictures of chronic pancreatitis are characteristically smooth and tapering on endoscopic retrograde cholangiopancreatography (ERCP), but in some patients, they may have a sharp cut-off and closely resemble the appearance of carcinoma of the pancreas invading the bile duct. The natural history of these intrapancreatic strictures is variable. They may progress and be associated with cholangitis, biliary cirrhosis, common duct stones, or may remain stable for years or regress. Prior pancreaticojejunostomy is not protective against the development of intrapancreatic biliary strictures which may follow in 5-30% of patients, with most authors reporting an incidence of less than 10%. Evaluation of alkaline phosphatase, bilirubin, the presence of jaundice, or the appearance of an intrapancreatic stricture on ERCP is not predictive of whether cholangitis or biliary cirrhosis may or may not develop. The incidence of cholangitis and biliary cirrhosis in patients with intrapancreatic stricture is 9.4% and 7.3%, respectively. Laennec's cirrhosis occurs in a similar number of patients. Operation is indicated in patients with intrapancreatic strictures of the common bile duct in association with chronic pancreatitis in patients developing cholangitis, biliary cirrhosis, common duct stones, progression of the stricture, persistent high elevations of alkaline phosphatase and/or bilirubin for over a month or inability to rule out cancer of the pancreas or periampullary region. The operation of choice is choledochoduodenostomy or Roux-en-Y choledochojejunostomy to bypass the obstructed intrapancreatic portion of the common bile duct. Persistent duodenal obstruction for over 3 or 4 weeks is an indication for gastrojejunostomy. Pain is not a feature of common bile duct obstruction in the absence of cholangitis. In the presence of pain associated with chronic pancreatitis, longitudinal pancreaticojejunostomy is the operation of choice combined with Roux-en-Y choledochojejunostomy. Some of the newer operations, e.g., the Beger and Frey procedures, may make the necessity of a separate operation for biliary decompression superfluous.
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PMID:Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. 240 39

We measured the pancreatic juice levels of antigen YH206, which is a new tumor marker of adenocarcinomas detected by monoclonal antibody YH206 (Hinoda et al., Int. J Cancer 24(5):653-658, 1988). Sandwich enzyme immunoassay revealed that samples from patients with pancreas cancer (n = 21) showed significantly higher values (P less than 0.01) than those of healthy controls (n = 15). Eight out of 21 (38.1%) samples from patients with pancreas cancer showed more than 100 U/ml, whereas only one out of 20 (5.0%) from patients with chronic pancreatitis exhibited more than 100 U/ml of antigen YH206. Simultaneous measurement of antigen YH206 and CA19-9 demonstrated that although a higher incidence of positivity in the case of pancreas cancer was obtained for both antigens, antigen YH206 showed much lower incidence of positivity (14%) than CA19-9 (57%) in patients with chronic pancreatitis. Therefore, the measurement of antigen YH206 in the pancreatic juice could be of use for the diagnosis of pancreas cancer.
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PMID:Significance of adenocarcinoma-associated antigen YH206 levels in the pancreatic juice. 240 94

To study incidence and cause of hyperamylasemia in various diseases, serum amylase was determined in 1371 consecutive patients and subsequent isoamylase analysis was carried out in 91 hyperamylasemic sera. Hyperamylasemia was observed in various diseases: acute pancreatitis (5/5), chronic pancreatitis (0/3), mumps (3/3), cerebrovascular diseases (2/39), respiratory diseases (6/69), heart diseases (5/89), liver diseases (16/101), cholelithiasis (0/13), diabetes mellitus (2/66), peptic ulcer (0/46), other digestive diseases (0/33), malignant tumor (9/249), renal failure (21/25), intraabdominal surgery (9/35), extraabdominal surgery (2/20), trauma (1/23), and miscellaneous (10/552). Salivary type hyperamylasemia due to dominant increase of salivary type isoamylase occurred in over half of the hyperamylasemic patients. Knowledge of hyperamylasemia in various diseases and routine isoamylase analysis of hyperamylasemic sera would enhance diagnostic accuracy and exclude unnecessary treatment of pancreatitis solely because of the presence of hyperamylasemia.
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PMID:Clinical value of routine isoamylase analysis of hyperamylasemia. 242 26

Diagnostic significance of serum immunoreactive elastase-1 was studied in 137 patients with pancreatic disease, 335 with various nonpancreatic diseases, and 416 healthy controls by using radioimmunoassay. Frequency of abnormally high serum elastase values exceeding 410 ng/dl was 100% in acute pancreatitis (N = 14), 40% in chronic pancreatitis (N = 80), and 72% in pancreatic cancer (N = 43). In pancreatic cancer the mean value of serum elastase in resectable cancer (N = 19) was significantly higher than that in unresectable cancer (N = 24). Sensitivity, specificity, and efficiency of serum elastase in pancreatic cancer were 72.1%, 98.3%, and 95.9% against healthy controls; 72.1%, 85.9%, and 83.6% against nonpancreatic digestive diseases; and 72.1%, 60.0%, and 64.2% against chronic pancreatitis at a cutoff level of 410 ng/dl, respectively. High serum elastase could be a diagnostic clue to detect pancreatic duct obstruction due to pancreatic cancer, although further examination should be done by endoscopic retrograde pancreatography and other imaging studies.
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PMID:Serum immunoreactive elastase in diagnosis of pancreatic diseases. A sensitive marker for pancreatic cancer. 243 45

Certain alterations of blood group substance (BGS) expression have been observed in gastrointestinal cancer tissues. However, in the pancreas little is known about BGS expression by normal or malignant tissue. The present immunohistochemical study analyzed simultaneously the expression of A, B, H, Lewisa (Lea), and Lewisb (Leb) antigens in specimens of normal pancreas, chronic pancreatitis, and pancreatic carcinoma (primary and metastatic). In normal pancreas all five antigens were expressed in ducts, ductules, and acini, but not in islets. Acinar cells expressed A, B, H, and Leb in supranuclear cytoplasm, whereas Lea was found mainly on centroacinar cells. Only BGSs that were appropriate for the host's blood type were expressed, except for one case of Lea deletion. BGS expression by chronic pancreatitis tissue closely resembled that by normal tissue. In primary pancreatic cancer two cancer-associated alterations were noted that were not found in either normal pancreas or chronic pancreatitis. Deletion of an expected A, B, H, or Leb antigen occurred in approximately 25% of cases, particularly in more poorly differentiated cancers. Incompatible expression of an unexpected A or B antigen occurred in 33% of cases, regardless of degree of differentiation. Metastatic pancreatic cancers also exhibited BGS deletion and incompatibility. In both primary and metastatic cancers the incidence of incompatible A or B expression was higher in cancers from the United States than in cancers from Japan, but the incidence of BGS deletion was similar between the two countries. It was concluded that deletion of A, B, H, or Leb antigens and incompatible expression of A or B antigens are cancer-associated events in the pancreas.
J Natl Cancer Inst 1987 Sep
PMID:Cancer-associated alterations of blood group antigen expression in the human pancreas. 244 45

Antigen T (Thomsen-Friedenreich), a precursor of blood group MN antigens, with the determinant of a carbohydrate (Gal-GalNac), antigen Lewisx (Lex), a trisaccharide found on Type 2 blood group oligosaccharide chains, Sialo-Lex, the derivatives: of Lex and Lewisy (Ley), a difucosylated tetrasaccharide have, behaved as the oncodevelopment tumor-associated antigens in human colon. In the present study, using monoclonal antibodies in immunohistochemical method, the expression and distribution of these antigens in pancreatic cancer and normal pancreatic tissue were observed and compared. It was found that monoclonal antibody AH8-258 derived against antigen T, SSEA-1 and FH-4 derived against short and long chain antigens Lex, FH-6 and IB 9 derived against Sialo-Lex antigen preferentially stained most pancreatic cancer tissues but rarely the normal pancreatic tissues. However, monoclonal antibodies AH-6, KH-1 and CC-1, derived against antigen Ley, stained the majority of tissues regardless of being malignant or normal and were not able to differentiate cancer from the normal tissues. Antigens T, Lex, Sialo-Lex and Ley were also expressed in chronic pancreatitis but the chance of monoclonal antibodies staining in these tissues (18 approximately 36%) was markedly lower than the staining in cancer tissues (54 approximately 77%) except Ley. It is suggested that in human pancreas, haptens T, Lex and Sialo-Lex, the oncodevelopmental cancer-associated antigens, are highly specific markers for malignancy and likely helpful in the early diagnosis of pancreatic cancer.
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PMID:[Pancreatic cancer-associated new carbohydrate antigen]. 245 61

Serum levels of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 were determined in 41 patients with pancreatic carcinoma and compared with those 71 patients with chronic pancreatitis and 17 patients with digestive non-pancreatic carcinoma, in an attempt to evaluate their relative values in the diagnosis of pancreatic cancer. Trypsinogen and elastase 1 levels were the most frequently abnormal (56%), followed by pancreatic isoamylase (39%), lipase (34%), and amylase (27%). In 4 patients with resectable cancer levels of all serum enzymes were within normal limits, with the single exception of a low trypsinogen level in one patient. No significant differences in the behavior of serum enzymes were found between patients with pancreatic cancer and those with chronic pancreatitis or digestive non-pancreatic cancer. The results of our study indicate that measurement of serum pancreatic enzymes is of limited usefulness in the diagnosis of pancreatic cancer.
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PMID:[Serum pancreatic enzymes in the diagnosis of carcinoma of the pancreas]. 246 5

Significant obstructive jaundice in chronic pancreatitis is generally considered to be rare. Eleven of 57 consecutive patients with proven chronic pancreatitis have developed significant obstructive jaundice of more than transient duration. Eight presented as jaundice complicating known pancreatitis and three as jaundice of unknown cause. Life table analysis showed a steady rise in the risk of developing jaundice up to the end of 10 years from the onset of chronic pancreatitis. Jaundice was found to occur in the presence of more "destructive" disease, and jaundiced patients had a higher incidence of pancreatic calcification, diabetes and malabsorption at the time of presentation with jaundice. Obstructive jaundice caused by chronic pancreatitis was found to carry a good prognosis for jaundice, for pain and for life. Only one of the 11 patients died in hospital. It is important to distinguish chronic pancreatitis from cancer in these patients. Pre-operative and intra-operative cytology have been helpful. Stent insertion is not an appropriate method of treatment for these patients because of the benign nature of the disease and the possibility of exacerbating the pancreatitis. It is important to be aware of another form of "malignant masquerade" causing obstructive jaundice.
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PMID:Obstructive jaundice in chronic pancreatitis. 248 66

This study was performed to ascertain the role of serum markers and simple clinical data in detecting pancreatic cancer and in distinguishing this malignancy from chronic pancreatitis and other gastrointestinal diseases. Serum CA 19-9, tissue polypeptide antigen and carcinoembryonic antigen were measured in 38 control subjects, 37 patients with pancreatic cancer, 39 with chronic pancreatitis and 44 with extra-pancreatic diseases mainly of gastrointestinal origin. Clinical data recorded included age, sex, presence of pancreatic calcifications, weight loss, pain, jaundice, alcohol abuse, diabetes mellitus. Serum markers gave a correct allocation of the subjects in 48.1% of the cases with pancreatic cancer patients correctly predicted in 62.2%. Clinical data correctly diagnosed 74.2% of subjects. Chronic pancreatitis was identified in 84.6% of the cases and pancreatic cancer in 64.9%. The first clinical variables selected were pain and age. The addition of serum markers to clinical data did not enhance accuracy of the results. We conclude that the diagnosis of chronic pancreatic diseases should first be suspected on the basis of accurately recorded simple clinical data; serum markers seem to be only occasionally useful. Since indicative clinical data and serum markers become positive in the advanced phases of pancreatic cancer, early diagnosis of this malignancy still remains an objective to reach.
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PMID:[Role of serum markers and or various clinical parameters in the diagnosis of pancreatic carcinoma]. 248 91


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