Comparative radiological and morphological study of human pancreas. Pancreatitis like changes in postmortem ductograms and their morphological pattern. Possible implication for ERCP.

Schmitz-Moormann, P; Himmelmann, G. W.; Brandes, J W; Fölsch, Ulrich R.; Lorenz-Meyer, H; Malchow, H; Soehendra, L N; Wienbeck, M

doi:10.1136/gut.26.4.406

Cited by 62 publications

(23 citation statements)

References 6 publications

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“…It is well known that normal subjects at this age exhibit some morphofunctional pancreatic alterations [21,22,[49][50][51]53] that could be taken for those characteristic of CP, but without evolution towards this disease. Consequently, morphofunctional pancreatic alterations with age may be another confounding factor.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of pancreatic fibrosis compatible with CP in autopsies of LC patients was between 2% and 20% when the presence or absence of hepatitis B or C was not taken into account [14,16,18,19] . In addition, the age-related changes in morphofunctional p a r a m e t e r s o f t h e p a n c r e a s m a y b e a n o t h e r confounder when the diagnosis of CP is based only on these parameters [49][50][51][52][53] . In a study using endoscopic ultrasonography and ERCP, Hastier et al [17] reported only moderate pancreatic alterations in 5.5% patients with alcoholic LC, without evolution to CP.…”

Section: Discussionmentioning

confidence: 99%

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Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Aparisi¹,

Sabater²,

Del-Olmo³

et al. 2008

WJG

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AIM:To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes. METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed. RESULTS: In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients. CONCLUSION:There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Aparisi¹,

Sabater²,

Del-Olmo³

et al. 2008

WJG

View full text Add to dashboard Cite

show abstract

“…That is, 7 of 15 highrisk individuals with moderately abnormal pancreatograms had a positive QMSP result in their juice compared with only 1 of 22 individuals with mildly abnormal or normal pancreatograms (P = 0.007). Although ERCP is the gold standard for the diagnosis and grading of chronic pancreatitis, autopsy studies indicate that structural changes in the pancreatic duct that mimic chronic pancreatitis can occur in individuals without pancreatitis (54). Some asymptomatic high-risk individuals who have gone to surgery have had evidence of chronic pancreatitis histologically (20,21), but this is often detected in the setting of an associated obstructing neoplasm that could have caused secondary pancreatitis.…”

Section: à6mentioning

confidence: 99%

DNA Methylation Alterations in the Pancreatic Juice of Patients with Suspected Pancreatic Disease

Matsubayashi

Canto

Sato³

et al. 2006

Cancer Research

203

148

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Molecular markers of pancreatic neoplasia could aid in the evaluation of visible pancreatic lesions and indicate neoplasia invisible to imaging. We evaluated methylation-specific PCR (MSP) assays that detect aberrantly methylated DNA for their use as markers of pancreatic neoplasia. Methylation analysis was done on pancreatic juice collected endoscopically or surgically from 155 individuals with suspected pancreatic disease: 56 patients had pancreatic ductal adenocarcinoma, 17 had intraductal papillary mucinous neoplasms, 26 had symptomatic chronic pancreatitis, 12 controls lacked evidence of pancreatic disease, and 44 were asymptomatic individuals at increased risk of developing familial pancreatic cancer undergoing screening for pancreatic neoplasia. Pancreatic juice DNA was analyzed for promoter methylation using conventional MSP assays for 17 genes. For six genes, pancreatic juice methylation was quantified using real-time quantitative MSP (QMSP; Cyclin D2, FOXE1, NPTX2, ppENK, p16, and TFPI2). Quantifying pancreatic juice methylation using QMSP with a cutoff of >1% methylated DNA could better predict pancreatic cancer than detecting methylation using conventional MSP. In the endoscopic group, 9 of 11 patients with pancreatic cancer, but none of 64 individuals without neoplasia had z1% methylation for two or more of the best five QMSP assays (82% sensitivity and 100% specificity; P < 0.0001). The prevalence of pancreatic juice methylation in patients with chronic pancreatitis was less than in patients with pancreatic cancer but higher than in controls and similar to high-risk individuals. The detection and quantification of aberrantly methylated DNA in pancreatic juice is a promising approach to the diagnosis of pancreatic cancer. (Cancer Res 2006; 66(2): 1208-17)

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“…The changes observed were interpreted as 'age-related'. However, they included perilobular and intralobular fibrosis, ductal hyperplasia, periductal fibrosis and even fat necrosis, characteristics of a chronic inflammation [37].…”

Section: Discussionmentioning

confidence: 99%

Chronic pancreatitis and diabetes mellitus

et al. 2002

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Comparative radiological and morphological study of human pancreas. Pancreatitis like changes in postmortem ductograms and their morphological pattern. Possible implication for ERCP.

Cited by 62 publications

References 6 publications

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

DNA Methylation Alterations in the Pancreatic Juice of Patients with Suspected Pancreatic Disease

Chronic pancreatitis and diabetes mellitus

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