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Part of the book series: Pathology and Laboratory Medicine ((PLM,volume 2))

Abstract

Primary neoplasms of the pancreas present with a wide variety of clinical syndromes and represent various tumors. The majority have extremely high mortalities, although prognosis is dependent on histopathological type. Early and accurate diagnosis improves survival, but is difficult. Pancreatic neoplasms may be classified as tumors of the exocrine pancreas, tumors of the endocrine pancreas, and atypical neoplasms, such as lymphomas, mesotheliomas, and sarcomas. Benign masses of the pancreas are common, especially when associated with pancreatitis, and the differentiation can be quite difficult. Traditionally, the diagnosis is based on histologic confirmation, but it is obviously advantageous to diagnose these lesions correctly prospectively or preoperatively. This chapter will focus on the relevant laboratory tests that are appropriate in the evaluation of individuals with the most common classes of pancreatic tumors.

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References

  1. Baylor SM, Berg JW (1973) Cross-classification and survival characteristics of 5,000 cases of cancer of the pancreas. J Surg Oncol 5(4):335–358.

    PubMed  CAS  Google Scholar 

  2. Warshaw AL, Swanson AS (1988) Pancreatic cancer in 1988. Possibilities and probabilities. Ann Surg 208(5):541–553.

    PubMed  CAS  Google Scholar 

  3. Go VLW. Editorial. Pancreas 1994;9(6):673.

    Google Scholar 

  4. Ho JCL, Kim YS (1992) Serological pancreatic tumor markers and the MUC1 apomucin. Pancreas 9(6):674–691.

    Google Scholar 

  5. Martin EW, James KK, Purtubise PE, et al. (1977) The use of CEA as an early indicator for gastrointestinal tumor recurrence and second look procedures. Cancer 39: 440–46.

    PubMed  Google Scholar 

  6. Steinberg WM, Gelfand R, Anderson KK, Glenn J, Kurtzman SH, Sindelar WF, et al. (1986) Comparison of the sensitivity and specificity of the CA19–9 and carcinoembryonic antigen assays in detecting cancer of the pancreas. Gastroenterology 90:343–9.

    PubMed  CAS  Google Scholar 

  7. Niederau C, Grendell, JH (1992) Diagnosis of pancreatic carcinoma: Imaging techniques and tumor markers. Pancreas 7(l):66–86.

    PubMed  CAS  Google Scholar 

  8. Yasue M, Sakamoto J, Teramukai S, Morimoto T, Yasui K, Kuno N, et al. (1994) Prognostic values of preoperative and postoperative CEA and CA19–9 levels in pancreatic cancer. Pancreas 9(6):735–740.

    PubMed  CAS  Google Scholar 

  9. Okai T, Sawabu N, Takemori Y, Ohta H, Motoo Y, Kidani H (1992) Levels of carcinoembryonic antigen and carbohydrate antigen (CA19–9) in pure pancreatic juice and sera in a patient with occult pancreatic cancer. J Clin Gastroenterol 15(2): 162–164.

    PubMed  CAS  Google Scholar 

  10. Matsumoto S, Harada H, Tanaka J, Ochi K, Seno T, Tsurumi T, et al. (1994) Evaluation of cytology and tumor markers of pure pancreatic juice for the diagnosis of pancreatic cancer at early stages. Pancreas 9(6):741–747.

    PubMed  CAS  Google Scholar 

  11. Koprowski H, Steplewski Z, Mitchell K, Herlyn D, Fuhrer JP (1979) Colorectal carcinomas detected by hybridoma antibodies. Somatic Cell Genet 5:957–972.

    PubMed  CAS  Google Scholar 

  12. Atkinson BF, Ernst CS, Herlyn M, Seplewski Z, Sears HF, Koprwoski H (1982) Gastrointestinal cancer-associated antigen in immunoperoxidase assay. Cancer Res 42: 4820–3.

    PubMed  CAS  Google Scholar 

  13. Magnani JL, Milsson M, Brockhaus D, Zopf Z, Steplewski Z, Koprowski H (1982) A monoclonal antibody-defined antigen associated with gastrointestinal cancer is a ganglioside containing sialylated lacto-N-fucopentanose II. J Biol Chem 257:14,365–14,369.

    Google Scholar 

  14. Kawa S, Tokoo M, Oguchi H, Furuta S, Homma T, Hasegawa Y, et al. (1994) Epitope analysis of Span-1 and DUPAN-2 using synthesized glycoconjugates sialyllact-Nfucopentaose II and sialyllact-N-tetraose. Pancreas 9(6):692–697.

    PubMed  CAS  Google Scholar 

  15. Koprowski H, Blaszczyk M, Steplewski Z, Brockhaus D, Magnani JL, Ginsberg V. (1982) Lewis blood-type may affect the incidence of gastrointestinal cancer. Lancet i:1332–1333.

    Google Scholar 

  16. Von Rosen A, Linder S, Harmenberg U, Pegert S (1993) Serum levels of CA19–9 and CA 50 in relation to Lewis blood cell status in patients with malignant and benign pancreatic disease. Pancreas 8(2): 160–165.

    Google Scholar 

  17. Schmeigel W (1989) Tumor markers in pancreatic cancer—current concepts. Hepatogastroenterology 36:446–449.

    Google Scholar 

  18. Safi F, Beger HG, Bittner R, Buchler M, Krautzberger W (1986) CA19–9 and pancreatic adenocarcinoma. Cancer 57:779–783.

    PubMed  CAS  Google Scholar 

  19. Farini R, Fabris C, Bonvicini P, Piccoli A, DelFavero G, Venturini R, et al. (1985) CA19–9 in the differential diagnosis between pancreatic cancer and chronic pancreatitis. Eur J Cancer Clin Oncol 21(4):429–432.

    PubMed  CAS  Google Scholar 

  20. Safi F, Roscher R, Bittner R, Schenkluhn B, Dopfer HP, Beger HG (1987) High sensitivity and specificity of CA19–9 for pancreatic carcinoma in comparison to chronic pancreatitis. Serological and immunohistochemical findings. Pancreas 2(4):398–403.

    PubMed  CAS  Google Scholar 

  21. Malesci A, Montorsi M, Mariani A, Santambrogio R, Bonato C, Bissi O, et al. (1992) Clinical utility of the serum CA19–9 test for diagnosing pancreatic carcinoma in symptomatic patients: A prospective study. Pancreas 7(4):497–502.

    PubMed  CAS  Google Scholar 

  22. Malesci A, Tommasini M, Bocchia P, et al. (1984) Differential diagnosis of pancreatic cancer and chronic pancreatitis by a monoclonal antibody detecting a new cancer associated antigen (CA19–9). Ric Clin Lab 14:303–306.

    PubMed  CAS  Google Scholar 

  23. Ritts RE, Nagorney DM, Jacobsen DJ, Talbot RW, Zurawski VR (1994) Comparison of serum CA19–9 levels with results of diagnostic imaging modalities in patients undergoing laparotomy for suspected pancreatic or gallbladder disease. Pancreas 9(6): 707–716.

    PubMed  Google Scholar 

  24. Satake K, Chung Y, Umeyama K, Takeuchi T, Kim YS (1991) The possibility of diagnosing small pancreatic cancer (less than 4.0 cm) by measuring various serum tumor markers. Cancer 68:149–152.

    PubMed  CAS  Google Scholar 

  25. Satake K, Takeuchi T, Homma T, Ozaki H (1994) CA19–9 as a screening and diagnostic tool in symptomatic patients: The Japanese experience. Pancreas 6:703–6.

    Google Scholar 

  26. Glenn J, Steinberg WM, Kurtzman SH, Steinberg SM, Sindelar WF (1988) Evaluation of the utility of a radioimmunoassay for serum CA19–9 levels in patients before and after treatment of carcinoma of the pancreas. J Clin Oncol 6(3):462–468.

    PubMed  CAS  Google Scholar 

  27. Forsmark CE, Lambaise L, Vogel SB (1994) Diagnosis of pancreatic cancer and prediction of unresectability using the tumor-associated antigen CA19–9. Pancreas 9(6): 731–734.

    PubMed  CAS  Google Scholar 

  28. Sperti C, Pasquali C, Catalini C, Cappellazzo F, Bonadimani B, Behboo R, et al. (1993) CA19–9 as a prognostic index after resection for pancreatic cancer. J Surg Oncol 52:137–141.

    PubMed  CAS  Google Scholar 

  29. Lundin J, Roberts PJ, Kuusela P, Haglund C (1994) The prognostic value of preoperative serum levels of CA19–9 and CEA in patients with pancreatic cancer. Br J Cancer 69:515–519.

    PubMed  CAS  Google Scholar 

  30. Berretta E, Malesci A, Zerbi A, Mariani A, Carlucci M, Bonato C, et al. (1987) Serum CA19–9 in the postsurgical follow-up of patients with pancreatic cancer. Cancer 60: 2428–2431.

    Google Scholar 

  31. Malesci A, Tommasini MA, Bonato C, Bocchia P, Bersani M, Zerbi A, et al. (1987) Determination of CA19–9 antigen in serum and pancreatic juice for differential diagnosis of pancreatic adenocarcinoma from chronic pancreatitis. Gastroenterology 92:60–67.

    PubMed  CAS  Google Scholar 

  32. Yuan-fang C, Can-rong M, Zhen-jun T, Zi-tan F, Jie Z, Xing-hua L, et al. (1989) The diagnostic significance of carbohydrate antigen CA19–9 in serum and pancreatic juice in pancreatic carcinoma. Chinese Med J 102(5):333–337.

    Google Scholar 

  33. Matsumoto A, Tommasini MA, Bonato C, Bocchia P, Bersani M, Zerbi A, et al. (1987) Determination of CA19–9 antigen in serum and pancreatic juice for differential diagnosis of pancreatic adenocarcinoma from chronic pancreatitis. Gastroenterology 92:60–67.

    Google Scholar 

  34. Masson P, Palsson B, Andren-Sandberg A (1991) Evaluation of CEA, CA19–9, CA-50, CA-195, and TATI with special reference to pancreatic disorders. Int J Pancreatol 8: 333–344.

    PubMed  CAS  Google Scholar 

  35. Satake K, Takeuchi T (1994) Comparison of CA19–9 with other tumor markers in the diagnosis of cancer of the pancreas. Pancreas 9(6):720–724.

    PubMed  CAS  Google Scholar 

  36. Pasanen PA, Eskelinen M, Partanen K, Pikkarainen P, Pentilla I, Alhava E. (1994) A prospective study of serum tumor markers carcinoembryonic antigen, carbohydrate antigens 50 and 242, tissue polypeptide antigen and tissue polypeptide specific antigen in the diagnosis of pancreatic cancer with special reference to multivariate diagnostic score. Br J Cancer 69:562–565.

    PubMed  CAS  Google Scholar 

  37. Von Rosen A, Linder S, Harmenberg U, Pegert S (1993) Serum levels of CA19–9 and CA 50 in relation to Lewis blood cell status in patients with malignant and benign pancreatic disease. Pancreas 8(2): 160–165.

    Google Scholar 

  38. Banfi G, Zerbi A, Pastori S, Parolini D, DiCarlo V, Bonini P (1993) Behavior of tumor markers CA19–9, CA195, CAM43,CA242, and TPS in the diagnosis and follow-up of pancreatic cancer. Clin Chem 39(3):420–423.

    PubMed  CAS  Google Scholar 

  39. Kiriyama S, Hayakawa T, Kondo T, Shibata T, Kitagawa M, Ono H, et al. (1990) Usefulness of a new tumor marker, Span-1, for the diagnosis of pancreatic cancer. Cancer 65:1557–1561.

    PubMed  CAS  Google Scholar 

  40. Takeda S, Nakao A, Ichihara T, Suzuki Y, Nonami T, Harada A, et al. (1991) Serum concentration and immunohistochemical localization of Span-1 antigen in pancreatic cancer. A comparison with CA19–9 antigen. Hepato-Gastroenterology 38:143–148.

    PubMed  CAS  Google Scholar 

  41. Ferrara C, Basso D, Fabris C, Malesci A, Fogar P, Meggiato T, et al. (1991) Comparison of two newly identified tumor markers (CAR-3 and DU-PAN-2) with CA19–9 in patients with pancreatic cancer. Tumori 77:56–60.

    PubMed  CAS  Google Scholar 

  42. Plebani M, Basso D, Navaglia F (1995) Is CA 242 really a new tumour marker for pancreatic adenocarcinoma? Oncology 52:19–23.

    PubMed  CAS  Google Scholar 

  43. Haglund C, Lindgren J, Roberts PJ, Kuusela P, Nordling S (1989) Tissue expression of the tumor associated antigen CA242 in benign and malignant pancreatic lesions. A comparison with CA50 and CA19–9. Br J Cancer 60:845–51.

    PubMed  CAS  Google Scholar 

  44. Banfi G, Parolini D, Murone M, Bonini PA (1990) CAM43 in the diagnosis of pancreatic cancer: preliminary results. J Nucleic Med Allied Sci 34(Suppl 3):203.

    Google Scholar 

  45. Buchler M, Friess H, Schultheiss KH, Gebhardt C, Kubel R, Muhrer KH, et al. (1991) A randomized controlled trial of adjuvant immunotherapy (murine monoclonal antibody 494/32) in resectable pancreatic cancer. Cancer 68:1507–1512.

    PubMed  CAS  Google Scholar 

  46. Friess H, Buchler M, Auerbach B, Weber A, Malfertheiner P, Hammer K, et al. (1993) CA 494–A new tumor marker for the diagnosis of pancreatic cancer. Int J Cancer 53:759–763.

    PubMed  CAS  Google Scholar 

  47. Stenman UH, Huhtala ML, Koistinen R, Steppala M (1982) Immunochemical demonstration of a ovarian cancer associated urinary peptide. Int J Cancer 30:53–57.

    PubMed  CAS  Google Scholar 

  48. Haglund C, Huhtala ML, Halila H, Nordling S, Roberts P, Scheinin T, et al. (1986) Tumour-associated trypsin inhibitor, TATI, in patients with pancreatic cancer, pancreatitis and benign biliary disease. B J Cancer 54:297–303.

    CAS  Google Scholar 

  49. Aroasio E, Piantino P (1991) tumor-associated trypsin inhibitor in pancreatic diseases. Scand J Clin Lab Invest 51(Suppl 207):71–73.

    Google Scholar 

  50. Bjorkland B, Bjorkland V (1957) Antigenicity of pooled human malignant and normal tissues by cyto-immunological techniques: presence of an insoluble, heatlabile tumor antigen. Int Arch Allergy 10:153–184.

    Google Scholar 

  51. Meduri F, Doni MG, Merenda R, Bizzarini M, Neri D, Gerunda GE, et al. (1989) The role of the leukocyte adherence inhibition (LAI), CA19–9, and tissue polypeptide antigen (TPA) tests in the diagnosis of pancreatic cancer. Cancer 64:1103–1106.

    PubMed  CAS  Google Scholar 

  52. Pasanen PA, Eskelinen M, Partanen K, Pikkarainen P, Pentillla I (1993) Clinical evaluation of tissue polypeptide antigen (TPA) in the diagnosis of pancreatic carcinoma. Anticancer Res 13:1883–1888.

    PubMed  CAS  Google Scholar 

  53. Chang JM, Takeuchi T (1990) Clinical significance of measurement of serum Spar-1 antigen in the diagnosis of pancreatic cancer. J. Jpn Pancreas Soc 5:80–88.

    Google Scholar 

  54. Hayakawa T, Kondo T, Shibata T, Hamano H, Kitagawa M, Sakai Y, et al. (1988) Sensitive serum markers for detecting pancreatic cancer. Cancer 61:1827–1831.

    PubMed  CAS  Google Scholar 

  55. Nakaizumi A, Tatsuta M, Uehara H, Iishi H, Yamamura H, Okuda S, et al. (1992) A prospective trial of early detection of pancreatic cancer by ultrasonographic examination combined with measurement of serum elastase 1. Cancer 69:936–940

    PubMed  CAS  Google Scholar 

  56. Basso D, Fabris C, Panucci A, Del Favero G, Agonese C, Plebani M, et al. (1988) Tissue polypeptide antigen, galactosyltransferase isoenzyme II and pancreatic oncofetal antigen serum determination: role in pancreatic cancer diagnosis. Int J Pancreatol 3: S95–S100.

    PubMed  Google Scholar 

  57. Podolsky DK, McPhee MS, Alpert E, Warshaw AL, Isselbacher KJ (1981) Galactosyltransferase isoenzyme II in the detection of pancreatic cancer: comparison with radiologic, endoscopic and serologic tests. N Engl J Med 304:1313–1318.

    PubMed  CAS  Google Scholar 

  58. Podolsky DK, Isselbacher KJ (1984) Characterization of monoclonal antibodies to serum galactosyltransferase. Proc Natl Acad Sci USA 81:2529–2533.

    PubMed  CAS  Google Scholar 

  59. Kemmer TP, Malfertheiner P, Buchler M, Kemmer ML, Ditschuneit H (1991) Serum ribonuclease asctivity in the diagnosis of pancreatic cancer. Int J Pancreatol 8(1):23–33.

    PubMed  CAS  Google Scholar 

  60. Pezzilli R, Billi P, Fiocchi M, Beltrandi E, Cappelletti O, Sprovieri G, et al. (1995) Serum ß-2 microglobulin in chronic disease of the pancreas. Int J Pancreatol 17(2): 161–166.

    PubMed  CAS  Google Scholar 

  61. Kawamoto S, Hiraoka T, Kanemitsu K, Kimura M, Miyauchi Y, Takeya M (1992) Alphafetoprotein-producing pancreatic cancer—a case report and review of 28 cases. Hepato-Gastroenterology 39:282–286.

    PubMed  CAS  Google Scholar 

  62. Alfthan H, Haglund C, Roberts P, Ulf-Hakan S (1992) Elevation of free ß subunit of human choriogonadotropin and core ß fragment of human choriogonadotropin in the serum and urine of patients with malignant pancreatic and biliary disease. Cancer Res 52:4628–4633.

    PubMed  CAS  Google Scholar 

  63. Kuno N, Kurimoto K, Fukushima M, Hayakawa T, Shibata T, Suzuki T, et al. (1994) Effectiveness of multivariate analysis of tumor markers in diagnosis of pancreatic carcinoma: a prospective study in multiinstitutions. Pancreas 9(6):725–730.

    PubMed  CAS  Google Scholar 

  64. Norton J (1994) Neuroendocrine tumors of the pancreas and duodenum. Curr Probl Surg 31(2):79–156.

    Google Scholar 

  65. Buchanan KD, Johnston CF, O’Hare MMT, et al. (1986) Neuroendocrine tumors: A European view. Am J Med 86 (Suppl 6B):14–23.

    Google Scholar 

  66. Wilder RM, Allan FN, Power, MH, Robertson HE (1927) Carcinoma of the islets of the pancreas: hyperinsulinism and hypoglycemia. JAMA 89:348–355.

    CAS  Google Scholar 

  67. Whipple AO, Frantz VK (1935) Adenoma of islet cells with hyperinsulinism: A review. Ann Surg 101:1299.

    PubMed  CAS  Google Scholar 

  68. Fajans SS, Vinik AI (1989) Insulin-producing islet cell tumors. Endocrinol Metab Clin North Am 18:45–74.

    PubMed  CAS  Google Scholar 

  69. Grama D, Eriksson B, Martensson H, et al. (1992) Clinical characteristics, treatment and survival in patients with pancreatic tumors causing hormonal syndromes. World J Surg 16:632–639.

    PubMed  CAS  Google Scholar 

  70. Shimizu T, Sasakuma F, Ishikawa O, et al. (1994) Assessment of immunoassays for insulin in diagnostic tests for insulinoma. Diabetes Res and Clin Prac 26:149–154.

    CAS  Google Scholar 

  71. Field JB (1993) Insulinoma. In: Endocrine tumors, Mazzaferi EL, Samaan NA, eds, Boston: Blackwell Scientific, pp. 504–506.

    Google Scholar 

  72. Lebowitz MR, Blumenthal SA (1993) The molar ratio of insulin to C-peptide. An aid to the diagnosis of hypoglycemia due to surreptitious (or inadvertant) insulin administration. Arch Intern Med 153:650–655.

    PubMed  CAS  Google Scholar 

  73. Doppman JL, Miller DL, Chang R, et al. (1993) Intraarterial calcium stimulation test for detection of insulinomas. World J Surg 17:439–443.

    PubMed  CAS  Google Scholar 

  74. Rothmund M, Stinner B, Arnold R (1991) Endocrine pancreatic carcinoma. Eur J Surg Oncol 17:191–199.

    PubMed  CAS  Google Scholar 

  75. Stabile BE, Morrow DJ, Passaro E Jr (1984) The gastrinoma triangle operative implications. Am J Surg 147:25–31.

    PubMed  CAS  Google Scholar 

  76. Zollinger RM, Ellison EH (1955) Primary peptic ulcerations of the jejunum associated with islet cell tumors of the pancreas. Ann Surg 142:709–728.

    PubMed  CAS  Google Scholar 

  77. Gregory RA, Tracy HJ, French JM, et al. (1960) Extraction of a gastrin-like substance from a pancreatic tumor in a case of Zollinger-Ellison syndrome. Lancet 1:1045–1048.

    PubMed  CAS  Google Scholar 

  78. Stabile BE, Morrow DJ, Passaro E Jr (1980) Serum gastrin and human chorionic gonadotropin in the Zollinger-Ellison syndrome. Arch Surg 115:1090–1095.

    PubMed  CAS  Google Scholar 

  79. Passaro E Jr. Basso N, Walsh JH (1972) Calcium challenge in the Zollinger-Ellison syndrome. Surgery 72:60–67.

    PubMed  Google Scholar 

  80. Norton JA, Doppman JL, Collen MJ, et al. (1986) Prospective study of gastrinoma localization and resection in patients with Zollinger-Ellison syndrome. Ann Surg 204:468–479.

    PubMed  CAS  Google Scholar 

  81. Schirmer WJ, Melvin WS, Rush RM, O’Dorisio TM, Pozderac RV, Olsen JO, Ellison EC. (1995) Indium-111–pentetreotide scanning versus conventional imaging techniques for the localization of gastrinoma. Surgery 118(6): 1105–13.

    PubMed  CAS  Google Scholar 

  82. John M, Meyerhof W, Richter D, Waser B, Schaer JC, Scherubl H, et al. (1996) Positive somatostatin receptor scintigraphy correlates with the presence of somatostatin receptor subtype two. Gut 38(l):33–9.

    PubMed  CAS  Google Scholar 

  83. Ellison EC (1995) Forty-year appraisal of gastrinoma. Back to the future. Ann Surg 222(4):511–24.

    PubMed  CAS  Google Scholar 

  84. Go wer WR and Fabri PJ (1990) Endocrine neoplasms (non-gastrin) of the pancreas. Semin Surg Oncol 6:98–109.

    Google Scholar 

  85. Verner JV, Morrison AB (1958) Islet cell tumor and a syndrome of refractory watery diarrhea and hypokalemia. Am J Med 29:529.

    Google Scholar 

  86. O’Dorisio TM, Mehkjian HS, Gaginella TS (1989) Medical therapy of VIPomas. Endocrinol Metab Clin North Am 18:545.

    PubMed  Google Scholar 

  87. Brunt LM, Mazoujian G, O’Dorisio TM, Wells SA, Jr (1994) Stimulation of vasoactive intestinal peptide and neurotensin secretion by pentagastrin in a patient with VIPoma syndrome. Surgery 115:362–369.

    PubMed  CAS  Google Scholar 

  88. Maton PN, Gardner JK, Jensen TR (1989) The use of the long acting somatostatin analogue 201–995 in patients with pancreatic endocrine tumors. Dig Dis Sci 34:29–37S.

    Google Scholar 

  89. Delcore R, Friesen S (1994) Gastrointestinal neuroendocrine tumors. J Am Coll Surg 178:187–211

    PubMed  CAS  Google Scholar 

  90. Bloom SR, Long RG, Bryant MG, et al. (1980) Clinical, biochemical and pathological studies on 62 VIPomas. Gastroenterology 78:1143A.

    Google Scholar 

  91. Nagorney D, Bloom S, Polak J, et al. (1983) Resolution of recurrent Verner-Morrison syndrome by resection of metastatic vipoma. Surgery 93:348–353.

    PubMed  CAS  Google Scholar 

  92. Mozell E, Stenzel P, Woltering E, et al. (1990) Functional endocrine tumors of the pancreas: Clinical presentation, diagnosis, and treatment. Curr Probl Surg 27:303–386.

    Google Scholar 

  93. Norton JA, Kahn CR, Schiebinger R, et al. (1979) Amino acid deficiency and the skin rash associated with glucagonoma. Ann Intern Med 91:213–215.

    PubMed  CAS  Google Scholar 

  94. Bloom SR, Polak JM (1987) Glucagonoma syndrome. Am J Med 82(5B):25–36.

    PubMed  CAS  Google Scholar 

  95. Stacpoole PW (1981) The glucagonoma syndrome: clinical features, diagnosis and treatment. Endocr Rev 2:347.

    PubMed  CAS  Google Scholar 

  96. Krejs GJ, Collins SM, McCarthy D, et al. (1986) Follow-up of a patient with somatostatinoma [Letter]. N Engl J Med 315:1295.

    PubMed  CAS  Google Scholar 

  97. Ganda OP, Weis GC, Soeldner A (1977) Somatostatinoma: A somatostatin-containing tumor of the endocrine pancreas. N Engl J Med 296:963.

    PubMed  CAS  Google Scholar 

  98. Dayal Y, Ganda OP (1991) Somatostatin-producing tumors. In: Endocrine pathology of the gut and pancreas, Dayal Y, ed., Boca Raton, FL: CRC, pp. 241–277.

    Google Scholar 

  99. Vinik AJ, Strodel WE, Eckhauser FE, et al. (1987) Somatostatinomas, PPomas, neurotensinomas. Semin Oncol 14:263–281.

    PubMed  CAS  Google Scholar 

  100. Vinik AI and Moattari AR (1989) Treatment of endocrine tumors of the pancreas. Endocrinol Metab Clin North Am 18:45–74.

    PubMed  Google Scholar 

  101. Pipleers D, Couturier E, Gepts W, Somers G (1983) Five cases of somatostatinomas: clinical heterogeneity and diagnostic usefulness of basal and tolbutamide-induced hypersomatostatinemia. J Clin Endocrinol Metab 56:1236–1242.

    Google Scholar 

  102. Hazelwood RL (1989) Biosynthesis, chemistry and storage of islet (endocrine) products. In: The Endocrine Pancreas, Hadley ME, ed. Englewood Cliffs, NJ: Prentice Hall, Chapter 3, pp. 27–48.

    Google Scholar 

  103. Grossman MI, Brown JC, Said S, et al. (1974) Candidate hormones of the gut. Gastroenterology 67:730–755.

    PubMed  CAS  Google Scholar 

  104. Adrian T, Uttenthal LO, Williams SJ, et al. (1986) Secretion of pancreatic polypeptide in patients with pancreatic endocrine tumors. N Engl J Med 315:287–291.

    PubMed  CAS  Google Scholar 

  105. Schwartz TW (1978) Atropine suppression test for pancreatic polypeptide. Lancet 2: 43–44.

    PubMed  CAS  Google Scholar 

  106. Solcia E. Sessa F, Rindi G, et al. (1991) Pancreatic endocrine tumors: general concepts; nonfunctioning tumors and tumors with uncommon function. In: Endocrine pathology of the gut and pancreas, Dayal Y, ed., Boca Raton, FL, CRC, pp. 105–132.

    Google Scholar 

  107. Prinz RA, Marangos PJ (1983) Serum neuron specific enolase: a serum marker for nonfunctioning pancreatic islet cell carcinoma. Am J Surg 145:77–81.

    PubMed  CAS  Google Scholar 

  108. Iguchi H, Yasuda D, Yamada Y, et al. (1991) 7B2, a possible marker for nonfunctioning pancreatic islet cell tumor. Horm Metab Res 23:486–489.

    PubMed  Google Scholar 

  109. American Cancer Society (1996) Cancer facts and figures-1996. New York, American Cancer Society.

    Google Scholar 

  110. Gordis L, Gold EB (1986) Epidemiology and etiology of pancreatic cancer. In: Go VLW, et al., eds. The exocrine pancreas: Biology, pathobiology and diseases, New York: Raven, pp. 621–35.

    Google Scholar 

  111. Gudjonsson B, Livstone EM, Spiro HM (1978) Cancer of the pancreas: Diagnostic accuracy and survival statistics. Cancer 42:2494–2506.

    PubMed  CAS  Google Scholar 

  112. Gordis L, Gold EB(1984) Epidemiology of pancreatic cancer. World J Surg 8:808–821.

    PubMed  Google Scholar 

  113. Haenszel W, Kurihara M (1968) Studies of Japanese migrants I. Mortality from cancer and other diseases among Japanese in the United States. J Nat Cancer Inst 40:43.

    PubMed  CAS  Google Scholar 

  114. Levin DL, Connelly RR, Devesa SS (1981) Demographic characteristics of cancer of the pancreas: Mortality, incidence and survival. Cancer 47:1456–1468.

    PubMed  CAS  Google Scholar 

  115. Grieve DC (1973) Adenocarcinoma of the pancreas (a review of 100 cases). J R Coll Surg 18:221.

    CAS  Google Scholar 

  116. Fraumeni JF (1975) Cancers of the pancreas and biliary tract: Epidemiological considerations. Cancer Res 35:3437.

    PubMed  Google Scholar 

  117. Moynan RW, Neerhour RC, Johnson TS (1964) Pancreatic carcinoma in children: Case report and review. J Pediatr 65:711.

    PubMed  CAS  Google Scholar 

  118. Tsukimoto I, Watanabe K, Lin JB, Nakajima T (1973) Pancreatic carcinoma in children in Japan. Cancer 31:1203.

    PubMed  CAS  Google Scholar 

  119. Taxy JB (1976) Adenocarcinoma of the pancreas in childhood. Cancer 37:1508.

    PubMed  CAS  Google Scholar 

  120. Everhart, J, Wright D (1995) Diabetes mellitus as a risk factor for pancreatic cancer. A meta-analysis. JAMA 273:1605–1609.

    PubMed  CAS  Google Scholar 

  121. Hammond EC (1966) Smoking in relation to the death rates of one million men and women. In: Epidemiological approaches to the study of cancer and other chronic diseases, Haenszel W, ed. US Public Health Service, National Cancer Institute Monograph 19, Bethesda, MD: U.S. Government Printing Office, p. 126.

    Google Scholar 

  122. MacMahon BY, Trichopoulos D, Warren K, Nardi G (1981) Coffee and cancer of the pancreas. N Engl J Med 304:630.

    PubMed  CAS  Google Scholar 

  123. Wynder EL, Mabuchi K, Maruchi N, Fortner JG (1973) Epidemiology of cancer of the pancreas. J Natl Cancer Inst 50:645.

    PubMed  CAS  Google Scholar 

  124. Gross JB, Bambill EE, Ulrich JA (1962) Hereditary pancreatitis. Description of a fifth kindred and summary of clinical features. Am J Med 33:358.

    PubMed  CAS  Google Scholar 

  125. Whitten DM, Feingold M, Eisenklam EJ (1968) Hereditary pancreatitis. Am J Dis Child 116:426.

    PubMed  CAS  Google Scholar 

  126. Davidson P, Costanza D, Swieconeck JA, Harris JB (1968) Hereditary pancreatitis. A kindred without gross aminoaciduria. Ann Intern Med 68:88.

    PubMed  CAS  Google Scholar 

  127. Lapey A, Kattwinkel J, DiSant Angese PA, Laster L (1971) Hereditary pancreatitis (HP) without aminoaciduria: Two new kindred. Pediat Res 5:389.

    Google Scholar 

  128. Appel MF (1974) Hereditary Pancreatitis: Review and presentation of an additional kindred. Arch Surg 108:63.

    PubMed  CAS  Google Scholar 

  129. Longnecker DS, Memoli V, Pettengill OS (1992) Recent results in animal models of pancreatic carcinoma: Histogenesis of tumors. Yale J Biol Med 65:457–464.

    PubMed  CAS  Google Scholar 

  130. Kohler H, Lankisch PG (1987) Acute Pancreatitis and hyperamylasemia in pancreatic carcinoma. Pancreas 2:117–119.

    PubMed  CAS  Google Scholar 

  131. Campbell JP, Wilson SR (1988) Pancreatic neoplasms: how useful is evaluation with US? Radiology 167:341–4.

    PubMed  CAS  Google Scholar 

  132. Freeny PC, Ball TJ (1981) Endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic disease: a comparative study. Cancer 47:1666–78.

    PubMed  CAS  Google Scholar 

  133. Moossa AR, Levin B (1981) The diagnosis of “early” pancreatic cancer: The University of Chicago experience. Cancer 47:1688–1697.

    PubMed  CAS  Google Scholar 

  134. Glenner GG, Mallory GK (1956) The cystadenoma and related nonfunctional tumors of the pancreas. Cancer 9:980–986.

    PubMed  CAS  Google Scholar 

  135. Lack EE (1989) Primary tumors of the exocrine pancreas: Classification, overview and recent contributions by immunohistochemistry and electron microscopy. The Am J Surg Pathol 13(Suppl l):66–88.

    Google Scholar 

  136. Sperti C, Cappellazzo F, Pasquale C, Militello C, Catalini S, Bonadimani B, et al. (1993) Cystic neoplasms of the pancreas: Problems in differential diagnosis. The Am Surg 59(ll):740–5.

    CAS  Google Scholar 

  137. Taft DA, Freeny PC (1981) Cystic neoplasms of the pancreas. Am J Surg 142:30–5.

    PubMed  CAS  Google Scholar 

  138. Lewandroski KB, Southern JF, Pins MR, Compton CC, Warshaw AL (1993) Cyst fluid analysis in the differential diagnosis of pancreatic cysts. A comparison of pseudocysts, serous cystadenomas, mucinous cystic neoplasms, and mucinous cystadenocarcinomas. Ann Surg 217:41–47.

    Google Scholar 

  139. Pinto MM, Meriano FV (1991) Diagnosis of cystic pancreatic lesions by cytologic examination and carcinoembryonic antigen and amylase assays of cyst contents. Acta Cytologica 35(4):456–463.

    PubMed  CAS  Google Scholar 

  140. Cubilla AL, Fitzgerald PJ (1984) Tumors of the exocrine pancreas. In: Atlas of tumor pathology, 2nd ser, fasc 19, Washington, DC: Armed Forces Institute of Pathology, pp. 1–287.

    Google Scholar 

  141. Cubilla AL, Fitzgerald PJ (1980) Cancer (non-endocrine) of the pancreas. A suggested classification. In: The pancreas, Fitzgerald PJ, Morrison AB, eds., Baltimore: Williams and Wilkins, pp. 82–110.

    Google Scholar 

  142. Webb JN (1977) Acinar cell neoplasms of the exocrine pancreas. J Clin Pathol 30:103–112.

    PubMed  CAS  Google Scholar 

  143. Lack EE, Levey R, Cassady JR, Vawter GF (1983) Tumors of the exocrine pancreas in children and adolescents. A clinical and pathological study of eight cases. Am J Surg Pathol 7:319–327.

    PubMed  CAS  Google Scholar 

  144. Oertel JE, Mendelsohn G, Compagno J (1982) Solid and papillary epithelial neoplasm of the pancreas. In: Pancreatic tumors in children, Humphrey GB, Grindley GB, Dehner LP, Acton RT, Pysher TJ, eds. The Hague: Martinus Nijhoff, pp. 161–71.

    Google Scholar 

  145. Horie A, Yano Y, Kotoo Y, Miwa A (1977) Morphogenesis of pancreatoblastoma, infantile carcinoma of the pancreas. Report of two cases. Cancer 39:247–54.

    PubMed  CAS  Google Scholar 

  146. Beazley RM, Cohn I (1991) Tumors of the pancreas, gallbladder, and pancreatic ducts. In: American Cancer Society textbook of clinical oncology. Holleb AI, Fink DJ, Murphy GP, eds., Atlanta, The American Cancer Society, pp. 219–236.

    Google Scholar 

  147. Eli Lilly and Company (1994) Treatment IND of gemzar (gemcitabine) for patients with pancreatic cancer.

    Google Scholar 

  148. Fisher WE, Muscarella P, O’Dorisio TM, O’Dorisio MS, Kim JA, Doran TA, Sabourin CL, Schirmer WJ (1996) Differential expression of the somatostatin receptor subtype-2 gene predicts response of human pancreatic cancer to somatostatin. Surgery 120(2):234–241.

    PubMed  CAS  Google Scholar 

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Muscarella, P., Fisher, W., Johnson, J.A., Melvin, W.S. (1997). Neoplastic Disorders of the Pancreas. In: Lott, J.A. (eds) Clinical Pathology of Pancreatic Disorders. Pathology and Laboratory Medicine, vol 2. Humana Press. https://doi.org/10.1007/978-1-4612-3964-2_4

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