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

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

doi:10.1177/028418518702800312

Cited by 21 publications

(12 citation statements)

References 16 publications

(11 reference statements)

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“…Furthermore, imaging or function tests may not reveal early chronic pancreatitis, and their results do not necessarily correlate with each other. [4][5][6][7][8]14 However, pancreatic function tests are commonly performed if pancreatic disease is possible. The simplest noninvasive tests measure exocrine pancreatic enzymes in blood samples.…”

Section: Current State Of Chronic Pancreatitis Diagnosismentioning

confidence: 99%

“…Furthermore, imaging or function tests may not reveal early chronic pancreatitis, and the results of these tests do not necessarily correlate with each other. [4][5][6][7][8] The quest continues for useful biological and functional markers of early-stage chronic pancreatitis. 9 Recently, chemokines have come to be known as an important factor in the progression of chronic pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

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Can measurement of chemokines become useful biological and functional markers of early-stage chronic pancreatitis?

Ito

2007

J Gastroenterol

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Chronic pancreatitis, an irreversible inflammatory disease of the pancreas, is characterized by chronic inflammatory cell infiltration, acinar cell degeneration, and development of fibrosis, which lead to impairment of pancreatic exocrine and endocrine function. Despite marked progress in diagnostic tools and, especially, imaging methods, no consensus has been reached on nomenclature in diagnosis of chronic pancreatitis. A major problem is that no reliable diagnostic test exists for early-stage chronic pancreatitis. The identification of the chemokine system, however, has elucidated the molecular mechanisms of the inflammation contributing to the development of fibrosis in the progression of chronic pancreatitis. Inflammatory chemokines are obviously associated with the chemoattraction of leukocytes in early-stage chronic pancreatitis. Migration of monocytes into the pancreas is one of the earliest events in the formation of pancreatic fibrosis. In particular, monocyte chemoattractant protein-1 (MCP-1) is considered to be a prefibrogenic factor in the progression of chronic pancreatitis. Lately, fractalkine/CX3CL1 is reported to be a membrane-spanning adhesion molecule that can be cleaved from the cell surface to produce a soluble chemoattractant. Our preliminary study showed that serum soluble fractalkine did not correlate with MCP-1 or transforming growth factor beta1 and increased in patients with early-stage chronic pancreatitis. Furthermore, serum soluble fractalkine did not correlate with pancreatic-specific enzymes, such as pancreatic amylase and lipase, and N-benzoyl-L-tyrosyl-p-aminobenzoic acid test results. Therefore, measurement of soluble fractalkine in human serum may be useful as a diagnostic marker of early-stage chronic pancreatitis, and should be considered in future studies, including detailed investigations of soluble fractalkine in patients with chronic pancreatitis.

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Section: Current State Of Chronic Pancreatitis Diagnosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can measurement of chemokines become useful biological and functional markers of early-stage chronic pancreatitis?

Ito

2007

J Gastroenterol

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“…[43][44][45][46][47] It is suggested that if only one of the examinations such as those listed in Table 3 had been performed, the diagnosis would have been missed in approximately 20% of cases. 47,48 Indeed, the second Marseilles symposium concluded that pancreatic function testing and imaging procedures complement each other, and that a grading system based on both types of procedures may provide an important diagnostic advantage and should be prospectively investigated.…”

Section: Problems With the Jps Criteria 2001 For The Diagnosis Of Chrmentioning

confidence: 99%

Chronic pancreatitis in Japan: epidemiology, prognosis, diagnostic criteria, and future problems

Ōtsuki

2003

Journal of Gastroenterology

111

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Chronic pancreatitis is a chronic clinical disorder characterized by irreversible damage to the pancreas and the development of histologic evidence of inflammation and fibrosis, and eventually the destruction and permanent loss of exocrine and endocrine tissue. A nationwide survey in Japan revealed an increase in the total number of patients treated for chronic pancreatitis from 32 000 in 1994 to 42 000 in 1999. The overall prevalence and the incidence rate of chronic pancreatitis also increased, from 28.5 and 5.4, respectively, in 1994 to 32.91 and 5.77 per 100 000 population, respectively, in 1999. Diagnostic criteria for chronic pancreatitis in Japan were proposed by the Japan Pancreas Society in 1995 and revised in 2001. The criteria were established to rule out false-positive cases and to confidently diagnose definite and probable cases of chronic pancreatitis, and thus easily detect advanced chronic pancreatitis, but the criteria are unable to lead to the early diagnosis of chronic pancreatitis. Cancer is the major cause of death in patients with chronic pancreatitis in Japan (49.6% of all deaths in patients with chronic pancreatitis). Clarification of the mechanisms by which possible chronic pancreatitis progresses to probable or definite chronic pancreatitis, and to pancreatic cancer, is an important research goal. Because even chronic pancreatitis defined as irreversible appears to be reversible for some time in its clinical course, there is an urgent need to develop methods for diagnosing reversible chronic pancreatitis, and to prevent the transition from chronic pancreatitis to pancreatic cancer.

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“…63,64 Other older comparisons with histologic findings found a similarly modest sensitivity. 65,66 Fecal elastase has a sensitivity of 45% to 63% for mild disease but 73% to 100% for severe 67-69 disease compared with ERCP 67 or invasive pancreatic function tests. 68,69 Studies of MRCP have shown that the main pancreatic duct is seen well, especially with secretin, although resolution of side branches is inferior compared with ERCP.…”

Section: Reference Standards and Competing Technologiesmentioning

confidence: 99%

EUS in Inflammatory Diseases of the Pancreas

Romagnuolo¹

2011

Endosonography

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

Cited by 21 publications

References 16 publications

Can measurement of chemokines become useful biological and functional markers of early-stage chronic pancreatitis?

Can measurement of chemokines become useful biological and functional markers of early-stage chronic pancreatitis?

Chronic pancreatitis in Japan: epidemiology, prognosis, diagnostic criteria, and future problems

EUS in Inflammatory Diseases of the Pancreas

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