Comparison of Endoscopic Retrograde Pancreatography with Functional and Histologic Changes in Chronic Pancreatitis

Heij, H. A.; Obertop, H.; Blankenstein, M. van; Nix, G. A. J. J.; Westbroek, D. L.

doi:10.3109/02841858709177350

Cited by 17 publications

(3 citation statements)

References 6 publications

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“…Unfortunately, simple, indirect measurements of decreased pancreatic function do not show abnormality until CP is considerably advanced. Imaging or function tests may not reveal early CP, and the results of these tests do not necessarily correlate with each other [5][6][7][8][9] . The quest continues for useful biological and functional markers of early-stage CP.…”

Section: Introductionmentioning

confidence: 99%

Fractalkine and TGF-β1 levels reflect the severity of chronic pancreatitis in humans

Yasuda¹,

Ito²,

Oono³

et al. 2008

WJG

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AIM:To clarify whether serum chemokine and cytokine levels can become useful biological and functional markers to assess the severity of chronic pancreatitis (CP). This study aimed at clarifying whether serum chemokine and cytokine levels can become useful biological and functional markers to assess the severity of CP. METHODS: Serum monocyte chemoattractant protein-1 (MCP-1), transforming growth factor beta-1 (TGF-β1), and soluble type fractalkine (s-fractalkine) concentrations were examined in patients with CP (n = 109) and healthy controls (n = 116). Severity of disease was classified in patients with CP by a staging system. Relationships between stage-specific various clinical factors and serum MCP-1, TGF-β1, and s-fractalkine levels were investigated. Furthermore, 57 patients with non-alcoholic CP were similarly evaluated in order to exclude influence of alcohol intake. RESULTS: Patients with CP showed significant higher levels of serum TGF-β1 and s-fractalkine, but not MCP-1, compared to the controls. Serum TGF-β1 in the severe stage and s-fractalkine in the mild and the severe stage of CP significantly increased compared to those of controls. However, it was observed that both TGF-β1 and s-fractalkine levels were affected by alcohol intake. In patients with non-alcoholic CP, serum TGF-β1 showed significant increase in the moderate stage of CP, and serum s-fractalkine revealed significant increase in the early stage of CP. CONCLUSION: It is suggested that the measurement of serum F-fractalkine is useful to diagnose earlystage CP. Moreover, the combined determination of both, s-fractalkine and TGF-β1, in human sera may be helpful in evaluating the severity status of CP.

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Section: Introductionmentioning

confidence: 99%

Fractalkine and TGF-β1 levels reflect the severity of chronic pancreatitis in humans

Yasuda¹,

Ito²,

Oono³

et al. 2008

WJG

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“…Pancreatic function testing has been compared with histopathology in several studies, which demonstrated a high correlation with ERCP and a complimentary effect in patients with normal pancreatograms. [7][8][9][10] The diagnostic hierarchy has been challenged most effectively by endoscopic ultrasound with fine needle aspiration (EUS-FNA). EUS-FNA has proven to have similar sensitivity to ERCP for diagnosing pancreatitis, and the additional ability to obtain histopathology from FNA has improved the specificity of this modality.…”

mentioning

confidence: 99%

Endoscopic Retrograde Cholangiopancreatography and Histopathology Correlation for Chronic Pancreatitis

Vitale

Davis

Zavaleta

et al. 2009

The American Surgeon™

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Endoscopic retrograde cholangiopancreatography (ERCP) is debated as the gold standard for diagnosing and staging chronic pancreatitis (CP). The Cambridge classification grades CP on ECRP findings from normal (Grade I) to marked (Grade V). Comparison is needed with histopathology, which is considered the true gold standard to set the accuracy of any diagnostic test. A retrospective study included patients with CP who underwent ERCP and histopathology examination after surgical resection between 2001 and 2006. ERCP findings were staged according to the Cambridge classification. Thirty-one patients underwent initial diagnostic ERCP and surgical resection for chronic pancreatitis between 2001 and 2006 (61% women, 39% men). Patients with CP were diagnosed based on ERCP findings and the Cambridge classification as having normal (2 of 31 [6.5%]), equivocal (4 of 31 [13%]), mild (3 of 31 [9.7%]), moderate (15 of 31 [48%]), and marked (7 of 31 [23%]) pancreatitis. Patients experienced a mean of 5.5 ERCPs with pancreatic duct stenting before surgery and demonstrated a mean time of 25 months (range, 6 months to 3 years) between initial diagnosis and surgery. Surgeries for chronic pancreatitis included 13 (42%) subtotal pancreatectomies, 10 (32%) Whipples, and 8 (26%) distal pancreatectomies. The ERCP findings and histopathology reports correlated in 23 (74%) patients, whereas in eight (26%), findings did not correlate. The early disease group's (9 of 31 classified as normal, equivocal, or mild) ERCP findings correlated with histopathology in 6 of 9 patients (67%). Patients classified as moderate and marked had a correlation of 17 of 22 (77%). ERCP demonstrates a high correlation with pathology for assessing the severity of CP using the Cambridge classification grading system. Patients with normal, equivocal, or mild disease still represent a difficult patient subset for surgical decisionmaking. ERCP findings accurately predict pathology and thus should be used to help formulate the surgical plan.

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“…Although a strong association between the severity of morphological and that of functional changes has been demonstrated [1][2][3][4], direct function tests seem to detect more accurately early forms of the disease [5][6][7]. In fact, it is generally accepted that direct pancreatic function tests may be useful to detect chronic pancreatitis in the absence of morphological changes [8,9]. Because of that and because of a high specificity, the secretin-cholecystokinin or the secretin-caerulein test (SCT) is considered the gold standard for evaluating the exocrine pancreatic function [10].…”

Section: Introductionmentioning

confidence: 99%

Quantification of pancreatic zinc output as pancreatic function test: Making the secretin-caerulein test applicable to clinical practice

et al. 2004

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Comparison of Endoscopic Retrograde Pancreatography with Functional and Histologic Changes in Chronic Pancreatitis

Cited by 17 publications

References 6 publications

Fractalkine and TGF-β1 levels reflect the severity of chronic pancreatitis in humans

Fractalkine and TGF-β1 levels reflect the severity of chronic pancreatitis in humans

Endoscopic Retrograde Cholangiopancreatography and Histopathology Correlation for Chronic Pancreatitis

Quantification of pancreatic zinc output as pancreatic function test: Making the secretin-caerulein test applicable to clinical practice

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