Measurement of duodenal tryptic activity and 75Se-selenomethionine pancreatic scanning compared as tests of pancreatic function

McCarthy, Denis M.; Brown, Pamela

doi:10.1136/gut.10.11.913

Cited by 23 publications

(15 citation statements)

References 21 publications

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“…Analysis of the results showed that chronic or recurrent pancreatitis and carcinoma of the head of the pancreas were associated with extremely depressed peak trypsin levels (more than 3 sd below the normal mean in six out of eight and three out of three patients respectively). These findings support the original conclusions of Lundh (1962) and of subsequent workers (Cook et al, 1967;McCarthy and Brown, 1969).…”

Section: Discussionsupporting

confidence: 91%

Factors influencing duodenal trypsin levels following a standard test meal as a test of pancreatic function

Zeitlin¹,

Sircus²

1974

Gut

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SUMMARY In this investigation, the measurement of trypsin levels in duodenal juice following a standard test meal (Lundh test) was evaluated as a test of pancreatic function, and a study was made of diseases and other factors which may influence its diagnostic efficiency. The method of trypsin assay, which required only basic laboratory equipment, gave a linear concentration-activity curve, with a threshold at 50 jig of crystalline trypsin per ml. Intestinal juice could be frozen and stored for up to six weeks with no detectable loss of tryptic activity.The normal control values were very similar to those found by other workers and were unaffected by the sex or age of the subject. When used to assess 32 patients in whom the presence or absence of pancreatic disease had been clearly established, the test had a diagnostic success rate of 9400.Retrospective analysis of results from 98 patients showed that trypsin levels were generally grossly reduced in patients with chronic pancreatitis or carcinoma of the head of the pancreas. Trypsin levels were normal in most patients with steatorrhoea not of pancreatic origin. Levels were generally depressed to intermediate levels in patients with a diabetic glucose tolerance, with or without steatorrhoea, but no other sign of pancreatic insufficiency. Some lowering of trypsin levels was also noted in patients having an obstruction of the common bile duct. A small but significant depression of tryptic activity was noted in patients with villous atrophy and no pancreatic disease.

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Section: Discussionsupporting

confidence: 91%

Factors influencing duodenal trypsin levels following a standard test meal as a test of pancreatic function

Zeitlin¹,

Sircus²

1974

Gut

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“…Patients with neoplastic disease are reviewed in the context of a large sample where non-neoplastic pancreatic disease was common. Other aspects of this study have already been published (Melmed, Agnew, and Bouchier, 1968;Agnew, McCarthy, Melmed, and Bouchier, 1969;McCarthy and Brown, 1969;McCarthy, Kreel, Agnew, and Bouchier, 1969;McCarthy, 1970McCarthy, , 1972: in the present paper attention is concentrated on the value of scanning patients with neoplastic disease.…”

mentioning

confidence: 77%

“…All relevant data from each patient were coded and transferred to 105-hole punch cards (Paramount 30673.R) in order to allow analysis of multiple variables in the group as a whole. Brown, 1969;. In these papers it has been pointed out that no pattern of scan abnormality is unique to pancreatic carcinoma, though in the context of the particular case certain patterns may be suggestive of it.…”

Section: Patient Selectionmentioning

confidence: 99%

75Se-selenomethionine scanning in the diagnosis of tumours of the pancreas and adjacent viscera: The use of the test and its impact on survival

McCarthy¹,

Brown²,

Melmed³

et al. 1972

Gut

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SUMMARYThe results ofpancreatic scanning with 75Se-selenomethionine in 393 carefully documented patients over a two-year period are presented. On follow up 50 patients had operatively proven malignant tumours in the gland and a further 22 had similar tumours in adjacent organs, clinically mimicking carcinoma of the pancreas and in many cases causing scan abnormalities. Five patients had pancreatic adenomata. Remote tumours rarely affected the scan. Examination of the role of scanning in patients with neoplastic disease revealed that the test was effective in screening and in detection; false negative diagnoses were rare. By contrast, survival following diagnosis was extremely poor with only 8 % of pancreatic tumours resectable and 50 % metastasized at the time of surgery. Causes of pancreatic dysfunction, other than pancreatitis or carcinoma, which were associated with abnormalities on the scan are described and general aspects of reporting on the scan are discussed. The patterns seen in abnormal scans, while non-specific with regard to aetiology, were anatomically meaningful and useful adjuncts to the diagnosis of pancreatic disease. A normal scan excluded pancreatic cancer with a probability greater than 95 %.Following the development of successful pancreatic scanning in human subjects injected with 75Se-selenomethionine (Blau and Bender, 1962)

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“…Pancreatic scanning using 85Se is claimed to give similar results to the Lundh test (McCarthy and Brown, 1969), to the secretin test in diabetic patients (Lahdevirta, 1967), and to the secretin-CCK-PZ test (Brown et al, 1968), but Levrat and colleagues (1970) thought it less reliable than the secretin test in patients with a normal pancreas and in cases of chronic pancreatitis. Youngs and colleagues (1973) compared scanning with the Lundh test and found that the two tests were equally reliable in chronic pancreatitis but false abnormal scans occurred in patients with a normal pancreas.…”

Section: Comparison Of Pancreatic Function Tests and Selection Of Tesmentioning

confidence: 97%

Tests of Exocrine Pancreatic Function

Gowenlock

1977

Ann Clin Biochem

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Measurement of duodenal tryptic activity and 75Se-selenomethionine pancreatic scanning compared as tests of pancreatic function

Cited by 23 publications

References 21 publications

Factors influencing duodenal trypsin levels following a standard test meal as a test of pancreatic function

Factors influencing duodenal trypsin levels following a standard test meal as a test of pancreatic function

75Se-selenomethionine scanning in the diagnosis of tumours of the pancreas and adjacent viscera: The use of the test and its impact on survival

Tests of Exocrine Pancreatic Function

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