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Summary The serum diagnostic value of the foeto-acinar pancreatic protein (FAP protein), an oncofoetal pancreatic antigen, was tested in 201 patients. Of these, 112 suffered from malignant disease (57 patients had pancreatic carcinoma and 55, extra-pancreatic malignancies) and 89 had benign disease (49 patients with hepato-pancreato-biliary disease and 40 with other benign disease). FAP protein was measured by a competitive radioimmunoassay. In this technique, the normal cut-off level was 10% inhibition. This was deducted from values in 32 normal sera. FAP protein levels superior to 10% inhibition were found in 86% of patients with pancreatic cancer, in 31% with non-pancreatic malignancy, in 69% with benign hepatopancreato-biliary disease and in 20% with other benign diseases. Accordingly, sensitivity of FAP protein for pancreatic carcinoma was 86% and specificity, 66%. However, high FAP protein levels (>30% inhibition) were almost exclusively seen in patients with pancreatic cancer. At this cut-off level, specificity increased to 95% but sensitivity decreased to 51%. Determination of the carbohydrate antigen CA19/9 was made in parallel by a commercially available assay. At the cut-off level of 37uml-1, CAl9/9 in our serum panel had a sensitivity of 74% for pancreatic carcinoma and a specificity of 88%. In pancreatic cancer 55 out of 57 patients had elevated levels of either FAP protein or CA19/9 (sensitivity; 96%).

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Ultrastructural changes arising in the pancreas of the Syrian golden hamster after treatment with N-nitrosobis (2-oxopropyl) amine (BOP) were studied at short intervals. Alterations were found in acinar cells i.e. loss of zymogen granules, dilatation of granular endoplasmic reticulum, depolarization, irregular nucleus and separation of lateral surfaces (intermembranary spaces). As a result, the compact morphology of normal acini switched towards a new structure resembling a pseudo-ductule. Such alterations occurred from the 3rd month and preceded tumor formation. It is noteworthy that ducts and islets of Langerhans appeared unaltered in all instances. These results are consistent with the hypothesis that BOP induced pancreatic adenocarcinoma in hamsters originates in the acinar cell.

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