, Volume 44, Issue 6, pp 1142-1147

Serum Levels of Pancreatitis-Associated Protein in Digestive Diseases with Special Reference to Gastrointestinal Cancers

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The serum levels of pancreatitis-associatedprotein (PAP) were measured in 196 patients withdigestive diseases and 15 healthy subjects by anenzyme-linked immunosorbent assay. The serum PAP levelswere significantly elevated in the patients withgastric, colorectal, biliary tract, hepatocellular, orpancreatic cancers compared with the healthy subjects.After curative resection of the tumor, serum PAP levels were significantly decreased. The serumPAP levels were not related to clinicopathologicalfactors except for the tumor size of pancreatic cancer.There were some cases of PAP-positive andcarcinoembryonic antigen (CEA) or carbohydrate antigen (CA)19-9-negative gastric and colorectal cancers. The serumPAP levels were also significantly elevated in thepatients with acute pancreatitis compared with those in not only the healthy subjects but also thepatients with chronic pancreatitis. The peak PAP levelswere significantly correlated with the severity of acutepancreatitis and reflected the clinical healing of the disease. The peak of serum PAP wassignificantly delayed compared with those of otherpancreatic enzymes. These results suggest that theincrease of serum PAP levels in patients withgastrointestinal cancers reflects an ectopic expression of PAPin cancer cells and that increased serum levels of PAPin acute pancreatitis are correlated with the diseaseseverity and are prolonged than those of other pancreatic markers.