Rapid endoscopic secretin stimulation test and discrimination of chronic pancreatitis and pancreatic cancer from disease controls Massimo Raimondo, Mami.

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Rapid endoscopic secretin stimulation test and discrimination of chronic pancreatitis and pancreatic cancer from disease controls Massimo Raimondo, Mami Imoto, Eugene P Dimagno Clinical Gastroenterology and Hepatology Volume 1, Issue 5, Pages 397-403 (September 2003) DOI: 10.1053/S1542-3565(03)00182-4

Figure 1 Trypsin concentration in response to secretin. Significantly less trypsin concentration was detected in patients with chronic pancreatitis, pancreatic adenocarcinoma, and islet cell tumors when compared with patients with normal pancreas. NP, normal pancreas; AP, acute pancreatitis; CP, chronic pancreatitis; PC, pancreatic ductal adenocarcinoma; MT, malignant pancreatic tumors; BT, benign pancreatic tumors; ICT, islet cell tumors; ADBT, ampullary, duodenal, biliary tumors; SC, simple pancreatic cysts. Clinical Gastroenterology and Hepatology 2003 1, 397-403DOI: (10.1053/S1542-3565(03)00182-4)

Figure 2 Lipase concentration in response to secretin. Significantly less lipolytic activity was detected in patients with chronic pancreatitis, pancreatic adenocarcinoma, other malignant pancreatic tumors, and islet cell tumors when compared with patients with a normal pancreas. NP, normal pancreas; AP, acute pancreatitis; CP, chronic pancreatitis; PC, pancreatic ductal adenocarcinoma; MT, malignant pancreatic tumors; BT, benign pancreatic tumors; ICT, islet cell tumors; ADBT, ampullary, duodenal, biliary tumors; SC, simple pancreatic cysts. Clinical Gastroenterology and Hepatology 2003 1, 397-403DOI: (10.1053/S1542-3565(03)00182-4)

Figure 3 Receiver operating characteristics curve for lipase and trypsin concentration in patients with chronic pancreatitis (CP) and pancreatic adenocarcinoma (PC). The best sensitivity and specificity values for lipase (100 U/mL) and trypsin (30 U/mL) concentrations were 70% and 60%, respectively. Clinical Gastroenterology and Hepatology 2003 1, 397-403DOI: (10.1053/S1542-3565(03)00182-4)

Figure 4 Distribution of lipase concentration in response to secretin. The horizontal line is the lipase concentration of 104 U/mL, which is the concentration for the best sensitivity and specificity of 70% to discriminate pancreatic adenocarcinoma from no pancreatic disease. There was substantial overlap of lipase concentration among patients with chronic pancreatitis and pancreatic adenocarcinoma when compared with patients without pancreatic disease. NP, normal pancreas; AP, acute pancreatitis; CP, chronic pancreatitis; PC, pancreatic ductal adenocarcinoma; MT, malignant pancreatic tumors; BT, benign pancreatic tumors; ICT, islet cell tumors; ADBT, ampullary, duodenal, biliary tumors; SC, simple pancreatic cysts. Clinical Gastroenterology and Hepatology 2003 1, 397-403DOI: (10.1053/S1542-3565(03)00182-4)

Figure 5 Comparison between CCK (output) and secretin test (concentration) in 28 patients. The observed lipase compared favorably with the predicted one (P < 0.03, r = 0.41). Clinical Gastroenterology and Hepatology 2003 1, 397-403DOI: (10.1053/S1542-3565(03)00182-4)