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Biomedical subjects

C Fabris

Publications and source records attributed to C Fabris.

At least 163 records · Page 9Linked to original sources

Ribonucleases and deoxyribonucleases in pancreatic cancer: clinical value and pathophysiological interrelationships.

In this study we evaluated some pathophysiological aspects of pancreatic and liver ribonucleases and alkaline deoxyribonuclease and their clinical usefulness in diagnosing pancreatic cancer. Pancreatic RNase was found to be a sensitive index of pancreatic malignancy; however it was not specific in distinguishing pancreatic malignancy from chronic pancreatitis or other pathologies. Liver RNase and alkaline DNase did not provide better results than pancreatic RNase. These three enzymes were found to be age-dependent and related to each other. Therefore serum nucleases are not useful for clinical purposes since they are influenced, at least in part, by different non-specific factors.

Biomarkers, Tumor↗

Limits of CEA and ferritin in the diagnosis of pancreatic cancer.

In this paper the clinical usefulness of CEA and ferritin in the diagnosis of pancreatic cancer was pointed out. CEA was found to be increased in 51% of patients with pancreatic cancer; it was also abnormal in 22% of chronic pancreatitis and 31% of extra-pancreatic diseases. In patients with metastatic pancreatic cancer CEA was found to be more elevated than in those with localized tumor. CEA correlated with the age of the subjects in all material; in liver cirrhosis with IgG and in extra-pancreatic gastro-intestinal malignancies with alkaline-phosphatase. Ferritin was found to be increased in 73% of pancreatic cancer patients; it was also abnormal in 40% of chronic pancreatitis and in 38% of extra-pancreatic diseases. Patients with chronic pancreatitis studied during a relapsing phase all had elevated serum ferritin. We can conclude that neither CEA nor ferritin are useful indices of pancreatic malignancy, due to the lack of sensitivity or specificity. Both are influenced by several factors: CEA mainly by age and liver dysfunction, ferritin by the presence of an acute inflammation with cell necrosis.

Biomarkers, Tumor↗

Cytology in the diagnosis of pancreatic cancer.

The study of cytology in duodenal and/or pure pancreatic juice has been proposed in the differential diagnosis of pancreatic cancer. In our experience the sensitivity of cytology in duodenal juice, collected during Secretin-Cholecystokinin test, in diagnosing pancreatic cancer was 66.6%. False positive results were obtained only rarely (1.4%) in patients with chronic pancreatitis and benign diseases of the gastrointestinal tract. The cytological evaluation of pure pancreatic juice, obtained by ERCP, increases sensitivity up to 80-90%, especially when the combination of the results of ERCP and cytology is performed. Cytological examination of duodenal and/or pure pancreatic juice is a useful tool in detecting pancreatic malignancy and in differential diagnosis with chronic pancreatitis.

Acute Disease↗

C reactive protein in pancreatic cancer and chronic pancreatitis.

Serum C reactive protein was determined in 30 control subjects, 32 patients with pancreatic cancer, 28 with chronic pancreatitis and 23 with extra-pancreatic diseases of the upper gastrointestinal tract. The aim was to ascertain possible alterations of this index in chronic pancreatic disease and to speculate on some influencing factors. Higher C reactive protein levels were found in pancreatic cancer as compared to controls. Pancreatic cancer patients with systemic metastases had higher levels of this index compared to those with non-metastatic disease. Raised concentrations of C reactive protein were detected in 7/28 subjects with chronic pancreatitis. In this group these higher levels were found in patients in a relapsing phase of the disease; no association was observed with pancreatic pseudocysts. Among all subjects a correlation was found, between C reactive protein and age; patients with abnormal fasting blood glucose levels or increased white blood cell count had higher levels of this protein as compared to the remaining patients. We may conclude that C reactive protein increases in pancreatic cancer, specially in relation to tumour extent; in chronic pancreatitis it reflects the inflammatory status of the gland. While acting in the context of the acute phase response, this test may provide an adjunct in evaluating patients with a chronic pancreatic disease.

Adult↗

Molecular size distribution of immunoreactive trypsin and renal tubular dysfunction: role in trypsin plasma-urine transfer.

In order to investigate the role of circulating free trypsinogen and renal tubular dysfunction in affecting trypsin plasma-urine transfer, serum immunoreactive trypsin (IRT), its urinary output, IRT molecular size distribution, filtrable immunoreactive trypsin, gamma-glutamyltransferase and alpha-glucosidase outputs were studied in 6 control subjects, 9 patients with pancreatic cancer and 15 with chronic pancreatitis. The majority of immunoreactivity was always eluted at a molecular weight of about 24,000 and might therefore be considered as free trypsinogen. Variable amounts of IRT at higher molecular weights, possibly represented by trypsin-inhibitor complexes, were also detected. Increasing IRT levels were generally accounted for by free trypsinogen, regardless of the nature of the disease. Unlike serum free trypsinogen levels, renal tubular damage, evaluated by means of the excretion of two high-molecular weight urinary enzymes, seems to play a prominent role in explaining trypsin plasma-urine transfer.

Adolescent↗

Pancreolauryl test in chronic pancreatitis.

The pancreolauryl test was performed in 30 subjects with chronic pancreatitis, in order to evaluate its behavior in relation to the duration of the clinical history and the presence of pancreatic calcifications, diabetes mellitus, jaundice, and pancreatic pseudocysts. A significant inverse linear correlation was found between the onset of symptoms and FDL test values. While calcifications and diabetes were present in patients with both normal and abnormal test results, those with pseudocysts or jaundice always had pathological results.

Adult↗

CA 19-9 and carcinoembryonic antigen in pancreatic cancer diagnosis.

CA 19-9 (Centocor, Malvern, PA) and carcinoembryonic antigen (CEA), two recently developed immunoradiometric assays utilizing monoclonal antibodies, were evaluated in the sera of 139 subjects in order to assay their individual and combined value in pancreatic cancer diagnosis and to assess the influence of jaundice. Sensitivity, specificity, and accuracy in detecting pancreatic cancer were 69%, 85%, and 54% for CA 19-9; and 28%, 78%, and 6% for CEA, respectively. Combined evaluation gave the highest specificity (95%) when both, and the highest sensitivity (79%) when at least one, gave pathologic results. The receiver-operating characteristic curves demonstrated that CA 19-9 is more discriminating than CEA, for any serum value. A correlation between serum bilirubin and CA 19-9 was demonstrated in pancreatic and extrapancreatic disease. CEA determination, performed using monoclonal antibodies, seems to be unsatisfactory as compared to CA 19-9 in pancreatic cancer diagnosis, and combined assessment does not improve the results of CA 19-9 alone. Jaundice may influence serum CA 19-9 in pancreatic and extrapancreatic diseases.

Adult↗

[The role of CEA, CA 19-9 and TPA in the diagnosis of pancreatic cancer. Evaluation by discriminant analysis].

In order to assess the relative value of CA 19-9, Tissue Polypeptide Antigen (TPA) and Carcinoembryonic Antigen (CEA), evaluated alone and in combination, in diagnosing pancreatic malignancy, serum CA 19-9, TPA and CEA were determined in 25 control subjects (CS), 26 pancreatic cancer (PC), 23 chronic pancreatitis (CP) and 21 benign extra-pancreatic diseases (EPD). The three markers were able to allocate the subjects correctly in 56.8% of the cases (CS 100%, PC 73.1%, CP 17.4%, EPD 28.6%). Sensitivity, specificity and diagnostic accuracy in detecting pancreatic cancer were respectively: 77%, 91% and 68% for CA 19-9; 92%, 75% and 67% for TPA; 50%, 84% and 34% for CEA; 73%, 91% and 64% for the three parameters evaluated simultaneously. CA 19-9 and TPA appear to be useful indices of pancreatic cancer with a satisfactory specificity when related to chronic pancreatitis; their diagnostic value seems to be comparable and better than that of CEA; the combination of these markers does not improve the results obtained by CA 19-9 or TPA alone.

Adult↗

Development of thyroid function between VI-IX month of fetal life in humans.

Well-preserved thyroid glands from 28 fetuses 22-34 weeks of gestational age and from 4 term newborns who survived at most 12 days were examined to study thyroid development in late intrauterine life. Total iodine thyroglobulin (Tg), T4, T3 and rT3 were assayed before and after hydrolysis with pronase. In the same maternity unit the cord-serum of 25 healthy term newborns was also assayed and the urine iodine on the day of delivery was tested in 52 newborns and their mothers. Results are expressed as mean values +/- SD. The thyroid gland weight ratio to body weight for the preterms was 0.063 +/- 0.024; thyroid Tg content 5.9 +/- 4.0 mg/g; total thyroid iodine 41.7 +/- 35.1 micrograms/g; Tg iodination 0.72 +/- 0.37%; hormone quota of Tg iodine 39.9 +/- 12.4. Molar ratios were: T4/Tg 3.3 +/- 1.6, T3/Tg 0.25 +/- 0.14, rT3/Tg 0.072 +/- 0.059. Considerable differences in thyroid iodine content and Tg iodination were observed although the availability of iodine was presumably the same. The high Tg iodination reflects the enhanced uptake of the fetal thyroid. The quantity of iodine involved in hormonogenesis varied greatly among fetuses of the same gestational age, this being in the third term as active as in fully mature thyroids. Hormonogenesis seemed preferentially directed to production of T4 and rT3, which, in the latter case, is higher peripherically. Four preterms with a particularly low level of hormonogenesis were not seen to have deficient levels of thyroid iodine or Tg iodination and the most compromised step was the iodine utilization in the production of hormones.(ABSTRACT TRUNCATED AT 250 WORDS)

Congenital Hypothyroidism↗

Is tissue polypeptide antigen more accurate than serum CEA for diagnosing pancreatic cancer?

Tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) were determined in the sera of 36 control subjects, 30 patients with pancreatic cancer, 35 with chronic pancreatitis and 25 with non-pancreatic digestive disease to evaluate their role in detecting pancreatic malignancy. Abnormal values of TPA and CEA were found in 28 and 19 of 30 patients with pancreatic cancer, and in four and seven of 35 patients with chronic pancreatitis, respectively. Raised titres of TPA were observed more often than equivalent serum CEA in simulated pancreatic diseases. The receiver-operating (ROC) characteristic curves showed that TPA was more discriminating than CEA in detecting pancreatic cancer. Specificity was enhanced when both titres were abnormally high and sensitivity when one titre was raised, but the diagnostic accuracy of TPA alone has not improved, which satisfactorily discriminates pancreatic cancer from chronic pancreatitis.

Adult↗

Serum elastase 1 and immunoreactive trypsin in chronic pancreatic disease: is there any relationship with trypsin inhibitors?

In order to investigate modifications of serum levels of elastase 1, immunoreactive trypsin, alpha 1-antitrypsin and alpha 2-macroglobulin in chronic pancreatic disease, and to speculate on the possible relationships among these parameters, the enzymes and inhibitors were assayed in the sera of 33 control subjects, 34 pancreatic cancer, 28 chronic pancreatitis and 36 extra-pancreatic diseases. An increase of elastase 1, alpha 1-antitrypsin and alpha 2-macroglobulin was detected in pancreatic cancer, chronic pancreatitis and extra-pancreatic diseases; no changes were found for serum immunoreactive trypsin. Multiple regression analyses showed that only 7% of elastase 1 was explained by inhibitors with alpha 1-antitrypsin playing a major role. Inhibitors did not influence immunoreactive trypsin. Our data indicate that the variations of the serum levels of proteases and antiproteases in chronic pancreatic disease are probably independent of each other.

Adult↗