Pancreatography in chronic pancreatitis: international definitions.

Axon, A. T. R.; Classen, Meinhard; Cotton, Peter B.; Cremer, Michel; Freeny, Patrick C.; Lees, W. R.

doi:10.1136/gut.25.10.1107

Cited by 436 publications

(158 citation statements)

References 2 publications

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“…Diagnosis of chronic pancreatitis relied upon the presence of pancreatic calcifications and/or irregularity of pancreatic ducts, according to Cambridge Classification (Axon et al, 1984) on computed tomography scan and endoscopic retrograde pancreatography, respectively. Etiology of chronic pancreatitis was alcoholic in 30 patients and idiopathic in one patient.…”

Section: Control Groupmentioning

confidence: 99%

Differential diagnosis between chronic pancreatitis and pancreatic cancer: value of the detection of KRAS2 mutations in circulating DNA

et al. 2002

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KRAS2 mutations in codon 12 have been detected in about 80% of pancreatic cancers. The aim of this study was to evaluate the value of KRAS2 mutations detection in circulating deoxyribo nucleic acid to differentiate pancreatic cancer from chronic pancreatitis. Circulating deoxyribo nucleic acid was isolated from serum in 47 patients with histologically proven pancreatic adenocarcinomas (26 males, median age 65 years) and 31 controls with chronic pancreatitis (26 males, median age 48 years). Mutations at codon 12 of KRAS2 gene were searched for using polymerase chain reaction and allele specific amplification. Serum carbohydrate antigen 19.9 levels were also determined. KRAS2 mutations were found in 22 patients (47%) with pancreatic cancer and in four controls with chronic pancreatitis (13%) (P50.002). None of the latter developed a pancreatic cancer within the 36 months of median follow-up. The sensitivity, specificity, positive and negative predictive values of serum serum KRAS2 mutations for the diagnosis of pancreatic cancer were 47, 87, 85 and 52%, respectively. KRAS2 mutations were not related to age, gender, smoking habit, tumour stage, or survival. Among the 26 patients with normal or non-contributive (due to cholestasis) serum carbohydrate antigen 19.9 levels, 14 (54%) had KRAS2 mutations. The combination of KRAS2 and carbohydrate antigen 19.9 gave a sensitivity, specificity, positive and negative predictive values for the diagnosis of pancreatic cancer of 98, 77, 87 and 96%, respectively. Detection of KRAS2 mutations in circulating deoxyribo nucleic acid has a low sensitivity but a specificity about 90% for the diagnosis of pancreatic cancer. It seems particularly useful when serum carbohydrate antigen 19.9 levels are normal or inconclusive. A combined normal serum carbohydrate antigen 19.9 and absence of circulating KRAS2 mutations makes the diagnosis of pancreatic cancer extremely unlikely.

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Section: Control Groupmentioning

confidence: 99%

Differential diagnosis between chronic pancreatitis and pancreatic cancer: value of the detection of KRAS2 mutations in circulating DNA

et al. 2002

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“…None of the patients drank alcohol on a daily basis, and there were no clinical or biochemical signs (albumin, aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, and international normalized ratio within normal limits ϫ 1.5) of affected liver function. The diagnostic criteria of chronic pancreatitis were according to Layer et al (12), and all chronic pancreatitis subjects had unequivocal morphological changes of the pancreas evident by ultrasonography, computed tomography scan, magnetic resonance cholangiopancreatography, or endoscopic retrograde cholangiopancreatography according to the Cambridge classification (14).…”

Section: Methodsmentioning

confidence: 99%

Reduced Incretin Effect in Type 2 Diabetes

et al. 2007

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were studied. Blood was sampled over 4 h on 2 separate days after a 50-g oral glucose load and an isoglycemic intravenous glucose infusion, respectively. The incretin effect (100% ؋ [␤-cell secretory response to oral glucose tolerance test ؊ intravenous ␤-cell secretory response]/␤-cell secretory response to oral glucose tolerance test) was significantly (P < 0.05) reduced (means ؎ SE) in patients with chronic pancreatitis and secondary diabetes (31 ؎ 4%) compared with patients with chronic pancreatitis and NGT (68 ؎ 3) and healthy subjects (60 ؎ 4), respectively. In the type 2 diabetes group, the incretin effect amounted to 36 ؎ 6%, significantly (P < 0.05) lower than in chronic pancreatitis patients with NGT and in healthy subjects, respectively. These results suggest that the reduced incretin effect is not a primary event in the development of type 2 diabetes, but rather a consequence of the diabetic state. Diabetes

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“…In Japan, chronic pancreatitis is classified into compensated, transitional, and uncompensated phases. Exocrine pancreatic disorder (that includes digestive and absorptive disorders) and abnormal glucose tolerance (pancreatic diabetes) occur as chronic pancreatitis progresses; therefore, to improve prognosis, pharmacological and nutritional therapies should be given in accordance with the stage of the disease [33][34][35].…”

Section: Treatment Strategymentioning

confidence: 99%

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

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Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles. These revised guidelines also refer to early chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009. They include such items as health insurance coverage of high-titer lipase preparations and extracorporeal shock wave lithotripsy, new antidiabetic drugs, and the definition of and treatment approach to pancreatic pseudocyst. The accuracy of these guidelines has been improved by examining and adopting new evidence obtained after the publication of the first edition.

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Pancreatography in chronic pancreatitis: international definitions.

Cited by 436 publications

References 2 publications

Differential diagnosis between chronic pancreatitis and pancreatic cancer: value of the detection of KRAS2 mutations in circulating DNA

Differential diagnosis between chronic pancreatitis and pancreatic cancer: value of the detection of KRAS2 mutations in circulating DNA

Reduced Incretin Effect in Type 2 Diabetes

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

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