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T Meggiato

Publications and source records attributed to T Meggiato.

At least 37 records · Page 2Linked to original sources
PubMed1991

Serum DU-PAN-2 in the differential diagnosis of pancreatic cancer: influence of jaundice and liver dysfunction.

The usefulness of serum DU-PAN-2 in diagnosing pancreatic cancer and in distinguishing between this cancer and other benign and malignant diseases, and to assess the role of liver dysfunction in altering the serum levels of this marker were investigated. DU-PAN-2 was measured in the sera of 31 patients with pancreatic cancer, 32 with chronic pancreatitis, 20 with benign and 21 with malignant extra-pancreatic diseases. DU-PAN-2 was found to be above 300 U ml-1 in 21/31 patients with pancreatic cancer (sensitivity 68%). Only 3/32 patients with chronic pancreatitis had abnormal values. A substantial number of patients with both benign and malignant extra-pancreatic diseases had an elevated serum DU-PAN-2 (9/20 and 15/21, respectively). Correlations were found between DU-PAN-2 and (1) total bilirubin, (2) alanine-amino-transferase and (3) alkaline phosphatase. Of the patients with high DU-PAN-2 values, jaundice was found in: 2/3 with chronic pancreatitis, 9/10 with benign and 12/14 with malignant extra-pancreatic diseases. In conclusion, the serum DU-PAN-2 test for pancreatic malignancy is not completely satisfactory, because it is not sensitive enough. While the test for chronic pancreatitis has an acceptable specificity, the assay cannot distinguish between pancreatic cancer and other extra-pancreatic diseases, mainly of the liver and biliary tract. Liver dysfunction as well as jaundice seem to considerable affect the levels of this marker, as reported elsewhere for CA 19-9.

Adult↗
PubMed1991

Urinary kallikrein excretion in chronic pancreatic diseases.

Variations in urinary kallikrein in pancreatic diseases were ascertained, and possible influencing factors were investigated. Serum amylase and urinary excretion of glandular kallikrein, pancreatic ribonuclease (RNase), gamma-glutamyltransferase (GGT) and amylase were measured in 24 control subjects, 39 patients with pancreatic cancer, 49 with pancreatitis and 63 with extra-pancreatic diseases. Urinary kallikrein was found to be elevated in a substantial number of patients with pancreatitis. Higher levels were detected in patients with a relapse, which was diagnosed using clinical and biochemical examinations. RNase was also increased in a high number of patients with pancreatic diseases, but was not correlated with pancreatic damage. In patients with pancreatitis, a correlation was found between urinary kallikrein and RNase excretions. No correlations were found between kallikrein and serum or urinary amylase and GGT. We can conclude that urinary kallikrein excretion increases in pancreatitis, especially when a phlogistic involvement of the pancreas is present; this condition may lead to a release of this ultrafiltrable enzyme in the circulation. Renal tubular damage, which determines a reduced reabsorption of this enzyme, seems to play a concomitant but minor role in this process.

Adult↗
PubMed1991

Does serum CAR-3 play a role in pancreatic cancer diagnosis?

A new tumour marker, CAR-3, was isolated using the monoclonal antibody technique and measured in the sera of 27 patients with pancreatic cancer, 25 chronic pancreatitis, 30 extra-pancreatic diseases and in that of 18 healthy controls in order (1) to evaluate the diagnostic role of CAR-3 in patients with pancreatic cancer and (2) to ascertain whether liver dysfunction influences CAR-3 serum levels. The increased levels were found in 12/27 patients with pancreatic cancer (sensitivity 44.4%). No increase was found in patients with chronic pancreatitis, whereas abnormal levels were found in patients with other gastrointestinal diseases, especially those of the liver and biliary tract. Correlations were found between serum CAR-3 and (1) total bilirubin and (2) alkaline phosphatase. In conclusion, CAR-3, an antigen structurally related to CA 19-9, does not appear to be accurate enough to be considered a tumour marker. Cholestasis seems to increase CAR-3 levels as well as those of other glycoproteic tumour markers, probably by interfering with the hepatic clearance of these substances.

Adult↗
PubMed1991

Hepatic changes and serum ferritin in pancreatic cancer and other gastrointestinal diseases: the role of cholestasis.

Serum ferritin, prealbumin, pseudocholinesterase, alpha-1-antitrypsin and caeruloplasmin were determined in control subjects and patients with pancreatic cancer, chronic pancreatitis or extra-pancreatic disease mainly of gastrointestinal origin, in order to investigate the different hepatic changes which influence serum ferritin in chronic pancreatic and other digestive diseases. Increased circulating ferritin was found in pancreatic cancer and extra-pancreatic disease when compared to controls. Correlations were detected between ferritin and the other proteins investigated and between ferritin and total bilirubin, alkaline phosphatase and alanine aminotransferase. Multiple regression analysis demonstrated that cholestasis accounts for 45% of circulating ferritin, the acute-phase response accounted for 18% and decreased liver function accounted for 11%. We conclude that the increase in serum ferritin in chronic pancreatic and other gastrointestinal diseases largely depends on liver changes, with cholestasis probably playing a primary role.

Adult↗
PubMed1991

Role of local and systemic factors in increasing serum glycoprotein markers of pancreatic cancer.

This study was performed in order to evaluate the role of various local and systemic alterations in influencing serum glycoproteic markers in patients with pancreatic cancer, and in healthy and diseased controls. Cancer antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and ferritin were determined in the sera of 23 control subjects, 30 patients with pancreatic cancer, 27 with chronic pancreatitis, and 27 with extra-pancreatic diseases mainly of gastrointestinal origin. A number of acute-phase proteins and indices of liver function and cholestasis were also assayed. The three antigens increased only in patients with pancreatic cancer. Higher CA 19-9 and CEA, but not ferritin, levels were found only in patients with hepatic metastases. Acute-phase proteins and synthetic functional indices were found to be higher and lower, respectively, in patients with pancreatic malignancy when compared with controls. Multiple regression analysis documented the dependence of circulating ferritin, but not of CA 19-9 and CEA, on the systemic indices. Canonical correlation showed a similar trend for CA 19-9 and CEA, which differed from that of ferritin. Ferritin was found to depend on the presence of systemic and hepatic alterations, especially of cholestasis. We can conclude that the variations of serum glycoprotein markers in patients with pancreatic cancer depend on various regional and systemic factors. CA 19-9 and CEA are related mainly to the extent of the neoplasia. The influence of a decreased liver function capacity associated or not to cholestasis and the interrelation with the acute-phase response may also be suggested. Ferritin, on the other hand, is related to a higher degree than CA 19-9 and CEA to hepatic dysfunction and also behaves similar to an acute-phase protein.

Adult↗
PubMed1991

[Value and limitations of neoplasm markers in the diagnosis of pancreatic carcinoma].

In the last decades several markers of pancreatic neoplasia have been proposed to obtain a diagnosis as earlier as possible. Prerequisites of a good tumor marker are high sensitivity and specificity. Among the various substances, serum determination of pancreatic enzymes has been found of no utility in early diagnosis of pancreatic cancer, due to its lack in sensitivity and specificity. Similar results with ribonuclease and deoxyribonuclease. Oncofetal antigens (CEA and POA) have been initially considered promising indices; however, further studies showed their limits. In particular CEA is greatly influenced by the presence of hepatic metastases; therefore, serum levels are detectable only in advanced stages. TPA is characterized by a high sensitivity, but lacks in specificity and its use is now avoided. A real progress in the field of tumor markers has been made in the last years with the monoclonal antibody technique: among them CA 19-9 showed a good sensitivity and a satisfactory specificity as regards the diagnosis of pancreatic cancer. However, it cannot be considered as absolute aid, since it is influenced by several factors, as tumor spread, jaundice and liver dysfunction.

Antigens, Neoplasm↗
PubMed1990

Serum phospholipase A2 activity in chronic pancreatic diseases.

This study was performed to investigate the phospholipase A2 (PLA2) serum activity in patients with chronic pancreatic disease. PLA2, elastase-1, total, and pancreatic isoamylase were evaluated in 40 control subjects, 28 patients with pancreatic cancer, 51 with chronic pancreatitis, and 36 with extrapancreatic diseases, mainly of gastrointestinal origin. Elastase-1, PLA2, and pancreatic isoamylase were increased in 56%, 25%, and 15% of patients with pancreatic cancer, and in 40%, 31%, and 41% of subjects with chronic pancreatitis. All four enzymes gave pathological values in a number of patients with extrapancreatic diseases. We conclude that the diagnostic efficacy of phospholipase A2 in chronic pancreatic disease is similar to that of other well known pancreatic enzymes, with an unsatisfactory sensitivity and specificity.

Adult↗
PubMed1990

Oxygen derived free radicals in patients with chronic pancreatic and other digestive diseases.

To ascertain modifications in the activation products derived from oxygen free radicals in patients with chronic pancreatic and extra-pancreatic diseases, lipid peroxide activity was measured in the sera of 40 control subjects, 28 patients with pancreatic cancer, 49 with chronic pancreatitis, and 53 with extra-pancreatic diseases. In 142 of the subjects, elastase 1, amylase, and pancreatic isoamylase activities were also determined. Increased lipid peroxide activities were found in some patients with both chronic pancreatic and extra-pancreatic diseases. Patients with chronic pancreatitis studied during relapse had higher activities of lipid peroxides than those without active disease. No difference was found between the values in patients with pancreatic cancer with liver metastases and those without. Correlations were found between lipid peroxides and both amylase and pancreatic isoamylase activities; no correlation was detected between lipid peroxides and elastase 1. In benign biliary tract disease a correlation was detected between lipid peroxides and alanine aminotransferase and alkaline phosphatase activities. In all patients, however, a correlation was found between alkaline phosphatase and lipid peroxide activities. It is concluded that activation of oxygen derived free radicals occurs in chronic pancreatic as well as in extra-pancreatic disease; it seems to reflect the degree of inflammation.

Adult↗
PubMed1990

Renal handling of amylase and immunoreactive trypsin in pancreatic cancer and chronic pancreatitis.

In order to evaluate the renal metabolism of amylase and immunoreactive trypsin (IRT) in chronic pancreatic disease, we assayed amylase, IRT and creatinine in serum and urine and gamma-glutamyl transferase (GGT) in dialyzed urine as well as alpha-glucosidase (AGL) and ribonuclease (RNase) in 24 control subjects, 34 patients with pancreatic cancer, 52 with chronic pancreatitis and 32 with extra-pancreatic diseases. Urinary amylase and IRT outputs were found to be more elevated in chronic pancreatitis than in control subjects. The levels of serum amylase, its renal inputs and outputs were correlated with the corresponding IRT values. Multiple regression analyses (dependent on amylase or IRT urinary outputs, circulating levels of the two enzymes, creatinine clearance and the excretion of GGT, AGL and RNase predictor variables) showed significant correlations. The standardized partial regression coefficients found to be significant were: GGT, RNase and serum amylase for amylase, and GGT and RNase for IRT. No difference was found between amylase and IRT outputs in patients with chronic pancreatitis, taking the presence or the absence of alcohol abuse, exocrine insufficiency and pancreatic pseudocysts into consideration. Urinary GGT excretion correlated with serum amylase and IRT levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Diagnostic utility of a new monoclonal antibody pancreatic isoamylase assay in chronic pancreatic diseases.

In order to evaluate the efficacy of a monoclonal pancreatic (P) isoamylase assay in the diagnosis of chronic pancreatic disease and to compare the behavior of this test with that of amylase and elastase 1, these three enzymes were measured in the sera of 39 healthy controls, 28 patients with pancreatic cancer, 50 with chronic pancreatitis and 60 with extra-pancreatic diseases. In patients with chronic relapsing pancreatitis, increased P-isoamylase and elastase 1 values were found in similar percentages (about 70%), whereas the percentage for elevated amylase values was lower (52%). Elastase 1 was increased in 52% of patients with pancreatic cancer, while the other two enzymes were only occasionally elevated. The levels for all three enzymes were abnormal in some patients with extra-pancreatic diseases. It may be concluded that this assay for P-isoamylase determination is sufficiently sensitive and reliable in detecting pancreatic inflammation, even though some limitations concerning its specificity should be born in mind.

Adolescent↗
PubMed1990

Deoxyribonuclease I serum activity in pancreatic cancer.

In patients with pancreatic cancer deoxyribonuclease I (DNase I) serum levels were compared with those of other known pancreatic enzymes. Serum deoxyribonuclease I, elastase 1, immunoreactive trypsin, amylase and phospholipase A2 were determined in 40 healthy controls, 28 patients with pancreatic cancer, 49 with chronic pancreatitis and 40 with extra-pancreatic diseases. The analysis of variance showed a significant difference among groups for serum DNase I values. However, none of the 3 groups of patients had a mean deoxyribonuclease I value higher than that of the healthy controls. In pancreatic cancer and chronic pancreatitis patients, increases in the 4 pancreatic enzymes values were found in percentages that were higher than those for DNase I. A significant correlation was found between DNase I and phospholipase A2, but not between DNase I and elastase 1, immunoreactive trypsin and amylase serum activities. The findings indicate that deoxyribonuclease I serum determination is an even less satisfactory index of pancreatic malignancy than the other pancreatic enzymes. Rather than expressing pancreatic damage, any variations in this enzyme appear more likely to reflect an aspecific phenomenon.

Adult↗
PubMed1990

[X-ray diffraction study of biliary calculi. Morphological and composition correlations of calculi].

In this study, we examined the composition of crystallographic structure of biliary stones in 106 patients (27 male, 79 female). The material has been obtained following cholecystectomy. In 70 cases (66%), the monohydrate cholesterol was the main constituent, alone (33%) or in combination with calcium salts (32%). In 52% of the cases, we found presence of vaterite, aragonite and calcite. The anhydrous cholesterol was determined in 28 subjects (26%), alone (9.4%) or associated with calcium salts (16%). Cholesterol was completely absent in 8 cases: of them, 4 presented an aspecific diffrattografic picture and 4 revealed presence of calcium carbonate. Finally, no correlation was found between epidemiological data (sex or age) and macroscopic feature of biliary stones (chemical and morphological structure).

Calcium↗
PubMed1989

Tumor-associated trypsin inhibitor in patients with chronic pancreatic diseases.

Serum TATI (tumor-associated trypsin inhibitor) was measured in 41 control subjects, 30 patients with pancreatic cancer, 53 with chronic pancreatitis, and 47 with extrapancreatic diseases, mainly of gastrointestinal origin. TATI was found to be elevated in some subjects in all groups of patients; patients with chronic pancreatitis studied during an acute exacerbation of the disease had the highest percentage (68%) of pathological values. TATI was found to be correlated with elastase 1, tissue polypeptide antigen, and total and pancreatic isoamylase. A significant relationship was also found between TATI and serum creatinine levels.

Adult↗
PubMed1989

Alpha-fetoprotein, tissue polypeptide antigen and ferritin in diagnosing primary hepatocellular carcinoma in patients with liver cirrhosis.

This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum alpha-fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver/cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but no in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.

Adult↗
PubMed1989

Do CA 19-9 and TPA play a minor role as compared to AFP in diagnosing primary hepatocellular carcinoma?

This study was undertaken in order to compare the ability of 4 tumour markers to discriminate between liver cirrhosis patients with or without hepatocellular carcinoma (HCC). Serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 19-9 and tissue polypeptide antigen (TPA) were determined in 63 patients with liver cirrhosis and in 25 patients with HCC in liver cirrhosis. All 4 serum markers were found to be increased in a number of liver cirrhosis patients, regardless of the presence of HCC. AFP was found to be more elevated in HCC patients as compared to the other group; no difference was observed for CA 19-9, CEA and TPA. A significant correlation was detected in HCC patients between AFP and TPA. Significant correlation were detected in all except HCC patients between liver function tests and TPA. We can conclude that AFP determination remains as yet the only suitable marker able to detect HCC in liver cirrhosis. The newly introduced serum marker CA 19-9 is, as previously reported, unhelpful for CEA. TPA can in some instances (i.e. in the absence of an important hepatic cell necrosis or cholestasis) provide a clue to neoplastic growth.

Adult↗
PubMed1989

Urinary elastase 1 in chronic pancreatic disease.

Serum and urine elastase 1, its renal output and clearance and urinary gamma-glutamyltransferase and ribonuclease excretions were measured in 16 patients with pancreatic cancer, 23 with chronic pancreatitis and in 22 healthy controls in order to evaluate elastase 1 plasma-urine transfer in chronic pancreatic disease and to investigate any factors that might influence the clearance of this enzyme. In an additional group of 17 patients with different pancreatic diseases the serum molecular size distribution of elastase 1 after chromatography was ascertained. An increased urinary elastase 1 output was found in 4/16 patients with pancreatic cancer and in 6/23 with chronic pancreatitis. No correlation was found between circulating elastase 1 and its urinary output; a negative correlation was detected between the serum levels of this enzyme and its clearance. The excretion of ribonuclease and gamma-glutamyltransferase was correlated with elastase 1 output and clearance. While the majority of elastase 1 in serum was accounted for by high molecular forms, probably the expression of complexes with serum inhibitors, free circulating enzyme was present in all patients with high serum elastase 1. Our findings suggest that elastase 1 urinary excretion increases in some patients with chronic pancreatic disease regardless of the neoplastic or inflammatory nature of the illness. Although the availability of different amounts of ultrafiltrable enzyme may play a role in influencing elastase 1 plasma-urine transfer, renal tubular damage appears to be the most important factor influencing the increase in the urinary output of elastase 1.

Adult↗
PubMed1989

[Ca 19-9 in the diagnosis of pancreatic carcinoma].

This study was undertaken in order to ascertain the role of CA 19-9 in pancreatic cancer diagnosis. Therefore CA 19-9 was determined in the sera of 83 control subjects, 108 patients with pancreatic cancer, 112 with chronic pancreatitis and 126 with extrapancreatic diseases. Sensitivity, specificity and accuracy in detecting pancreatic cancer were: 75%, 86% and 61% respectively. The receiver-operating characteristic curves showed that CA 19-9 is able to well discriminate pancreatic cancer from controls; satisfactorily it differentiated pancreatic malignancy from chronic pancreatitis and other benign extrapancreatic diseases. Extrapancreatic neoplasms were not accurately separated. No difference was detected in CA 19-9 levels between pancreatic cancer patients with or without hepatic metastases. We can conclude that CA 19-9 is a test for pancreatic malignancy with a satisfactory sensitivity and specificity in respect of other pancreatic and extrapancreatic benign pathologies; the presence of hepatic metastases is only one of the factors which may increase its serum levels.

Adult↗