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CA19-9 lowering effect of Ayurvedic Mineral Complex in the patients of Chronic Pancreatitis

Authors:
Vaidya Prakash at VCP Cancer Research Foundation
Vaidya Prakash
  • VCP Cancer Research Foundation
Shikha Prakash at Padaav Speciality Ayurvedic Treatment Center
Shikha Prakash
  • Padaav Speciality Ayurvedic Treatment Center
Shakshi Sharma at Vcp cancer research center
Shakshi Sharma
  • Vcp cancer research center
Sneha Tiwari at VCP Cancer Research Foundation, Dehradun
Sneha Tiwari
  • VCP Cancer Research Foundation, Dehradun
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Abstract and Figures

CA19-9 is a carbohydrate antigen used as a cancer marker in pancreatic cancer. CA19-9 levels are found to be elevated in patients of pancreatic cancer along with some other gastrointestinal carcinomas. Recent studies also indicate etiological role of this antigen in pancreatitis and pancreatic cancer. The marker is widely used as an indicator to assess the efficacy of treatments given in pancreatic cancer and decreasing levels do indicate a good prognosis. However, there are no reports on auto-regression of CA19-9 levels in patients of pancreatitis or pancreatic cancer. An Ayurvedic Mineral Complex (AMC) has been found effective in lowering CA19-9 levels in Pancreatitis patients from the very beginning of the treatment. This observation can open a new thrust area for research to develop this formulation as a preventive therapy for pancreatic cancer in patients suffering from Pancreatitis. Here we report the observations made in 43 pancreatitis patients, with elevated CA 19-9 levels, who were treated using AMC.
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Cronicon
OPEN ACCESS EC GASTROENTEROLOGY AND DIGESTIVE SYSTEM
Research Article
Abstract
CA19-9 is a carbohydrate antigen used as a cancer marker in pancreatic cancer. CA19-9 levels are found to be elevated in patients
of pancreatic cancer along with some other gastrointestinal carcinomas. Recent studies also indicate etiological role of this antigen in

cancer and decreasing levels do indicate a good prognosis. However, there are no reports on auto-regression of CA19-9 levels in
patients of pancreatitis or pancreatic cancer. An Ayurvedic Mineral Complex (AMC) has been found effective in lowering CA19-9
levels in Pancreatitis patients from the very beginning of the treatment. This observation can open a new thrust area for research
to develop this formulation as a preventive therapy for pancreatic cancer in patients suffering from Pancreatitis. Here we report the
observations made in 43 pancreatitis patients, with elevated CA 19-9 levels, who were treated using AMC.
Keywords: Pancreatic Cancer; Pancreatitis; CA19-9; Marker; Prevention
Introduction
   
               
recurrent and chronic, are considered to be at a high risk to develop pancreatic cancer (2.7 to 16.5 fold) [2]. This risk is highest in the
case of hereditary pancreatitis (up to 55%) [3]. Also, chronic pancreatitis is known to promote mutant Kras-mediated development of
pancreatic cancer in experimental models [4].
CA19-9 is a known serological marker to assess progression of pancreatic cancer. It is widely used in both, diagnosis and follow-up of


[6,7]. Findings from a recent study also implicate CA 19-9 in the etiology of pancreatitis and pancreatic cancer and the need to explore
it as a therapeutic target in the treatment of pancreatic disorders [8]. There is no available information regarding the auto decrease of
CA19-9 levels. The levels are known to decrease in cancer patients who have undergone surgery or chemotherapy and are suggestive of
a good prognosis [9,10].

pancreatitis [11,12]. The compound has also shown pancreatitis protective properties in experimental studies [13]. Here, we present the

CA19-9 Lowering Effect of Ayurvedic Mineral
Complex in the Patients of Chronic Pancreatitis
Vaidya Balendu Prakash1*, Vaidya Shikha Prakash2, Shakshi Sharma2, Sneha Tiwari1 and Vaidya Pooja Jaryal2
1VCPC Research Foundation, Uttarakhand, India
2Padaav-Speciality Ayurvedic Treatment Centre, Uttarakhand, India
Citation: Vaidya Balendu Prakash., et al. “CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis”.
EC Gastroenterology and Digestive System 7.1 (2020): 01-05.
*Corresponding Author: 
Received: November 08, 2019; Published: December 10, 2019
CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis
02
Methodology
The enrolled patients were diagnosed for different variants of Pancreatitis by expert gastroenterologists using modern diagnostic tools
(Figure 1). These patients were in the age group of 6 to 67 years (mean age = 30 years) with 34 males and 9 females. They had a history


lifestyle and moderate rest. Ayurvedic treatment for Pancreatitis is a one year long protocol. These patients were asked to get Serum
CA19-9 levels checked periodically.
Figure 1: Different variants of pancreatitis diagnosed (n = 43).
Results
An analysis of periodical results of CA19-9 showed a lowering trend after the commencement of treatment (Figure 2). Detailed sheet
with CA19-9 levels of these patients is shown in table 1. The levels were seen to decrease in all patients with time. One patient (number
43) showed increase at Day 120 as compared to Day 0 when the level was at borderline. The patient is under treatment and continuous
follow up.
Figure 2: 
Citation: Vaidya Balendu Prakash., et al. “CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis”.
EC Gastroenterology and Digestive System 7.1 (2020): 01-05.
CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis
03
Pt.
No.Age Sex Days
0 10 20 30 40 60 120 200 360 480 600
1 19 M 157.94 40.2 33.55
2 32 M 75.19 14.07
3 18 F 55.07 65.6 50.88 37.9 47.22
4 38 M 123.36 28.5
5 21 M 87.27 37.41
6 28 M 85.84 50.2 39.62
7 47 M 633.3 93.8 86.36
8 52 M 48.85 30.4
9 6 F 71.46 35.3
10 23 M 136.03 33.34
11 19 M 213.22 27.8
12 23 F 473.8 458 398.4 394.24
13 38 M 102.79 83.2 87.52 67.23 45.3
14 28 M 53.89 42.89
15 27 M 114.93 13.8
16 36 M 49.91 39.3 28.19
17 32 M 136.58 45.8
18 38 M 242.76 66.7
19 67 M 348.15 188.02 202.88
20 29 M 109.6 253.81 160.21 47.2
21 26 M 70.84 21.7
22 10 M 80.78 37.21
23 22 M 55.75 4.87
24 32 M 240.65 106 18.89
25 25 M 328.52 34.8
26 24 M 287.03 13.8
27 23 M 73.73 18.9
28 19 M 56.05 48.69
29 26 F 318.41 38.2
30 27 M 104.42 103 53.8
31 33 M 59.23 52.8
32 50 F 1234.4 1060
33 46 M 52.14 14.23 63.1 30.9
34 46 M 65.86 38.55
35 30 M 39.11 56.5 26.38
36 32 F 159.31 284 182.88 70.97
37 16 F 76.53 54.9 64.5
38 53 M 1200 1098 4293.10 2764 1439.2 1030.1
39 29 M 39.78 16
40 27 F 114.82 22.5
41 17 M 54.6 60.3
42 31 M 268.96 225 140.53 70.1
43 10 F 36.85 59.9
Table 1: Individual CA19-9 levels of patients (n = 43).
Citation: Vaidya Balendu Prakash., et al. “CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis”.
EC Gastroenterology and Digestive System 7.1 (2020): 01-05.
CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis
04
Discussion
CA19-9 is embarked as a biomarker for keeping a check on progression or regression of pancreatic diseases [9]. It is more used in the
evaluation of the success or failure of any therapy in curbing or treating pancreatic cancer. Increase in CA 19-9 levels is considered to be
a sign of disease progression while decreasing levels indicate regression of cancer following the therapy. Although levels more than 300

study were at a high risk for developing pancreatic cancer. Chemotherapy and radiation therapy is known to lower the levels in cancer
patients. Post-operative decreases in CA 19-9 levels in patients with pancreatic tumors and masses have also been reported. However,
there are no reports on auto lowering of CA19-9 levels to normal limit.
AMC has been bringing complete and sustainable relief in patients suffering from Pancreatitis and is also able to cease disease
progression in treated cases [11,12]. The formulation also exhibits pancreatitis protective properties and is absolutely safe [13]. CA 19-9
lowering effect is a recently made observation using AMC in Pancreatitis patients.
Though the number of patients in the study is small and the study is retrospective, preliminary trend does indicate that AMC could
be explored further for its CA 19-9 lowering properties by designing prospective controlled studies in experimental and clinical models.
Conclusion
                    
preventive model for pancreatic cancer in pancreatitis patients.
Acknowledgment
Authors would like to thank the patients and their families for consenting to share their medical records. We are grateful to Ms Jyoti
Tewari and Ms Meenakshi Joshi for assisting in data collection and compilation.


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6. Bedi MMS., et alIndian Journal
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7. Nouts A., et al. “Diagnostic value of serum Ca 19-9 antigen in chronic pancreatitis and pancreatic adenocarcinoma”. Gastroenterologie
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Citation: Vaidya Balendu Prakash., et al. “CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis”.
EC Gastroenterology and Digestive System 7.1 (2020): 01-05.
CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis
05
Volume 7 Issue 1 January 2020
©All rights reserved by Vaidya Balendu Prakash., et al.
8. Engle DD., et al. “The glycan CA19-9 promotes pancreatitis and pancreatic cancer in mice”. Science 364.6446 (2019): 1156-1162.
9. Koom WS., et al. “CA 19-9 as a Predictor for Response and Survival in Advanced Pancreatic Cancer Patients Treated With
Chemoradiotherapy”. International Journal of Radiation Oncology 73.4 (2009): 1148-1154.
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11. Prakash VB., et al
TANG [Humanitas Medicine] 7.2 (2017): e9.
12. Prakash VB., et al. “Impact evaluation of Ayurvedic Treatment Protocol on three hundred nineteen cases of different variants of
Pancreatitis”. Pancreatic Disorders and Therapy 8 (2018): 2.
13. Prakash VB., et al             
Experimental Studies”. EC Gastroenterology and Digestive System 6.7 (2019): 519-524.
Citation: Vaidya Balendu Prakash., et al. “CA19-9 Lowering Effect of Ayurvedic Mineral Complex in the Patients of Chronic Pancreatitis”.
EC Gastroenterology and Digestive System 7.1 (2020): 01-05.
Significant Reduction of Carbohydrate 19-9 Antigen Levels in a Patient of Acute on Chronic Pancreatitis through Ayurvedic Treatment Protocol
Article
Full-text available
  • Jul 2023
Pancreatitis is an inflammatory and irreversible disorder of Pancreas, though unpredictable in nature. It's broadly categorized in acute and chronic pancreatitis depending upon the diagnostic parameters. Both types of pancreatitis are managed by using tools of conventional treatment; however natural course of progression of the diseases process remains unbeatable. Pancreatitis may also lead to pancreatic cancer and a tumor marker called Carbohydrate 19-9 antigen (CA 19-9) is being used routinely to accesses the progression of the disease. The normal value of CA 19-9 in the serum is<37 U/mL, whereas, levels more than 300 U/mL are considered definite indicators of pancreatic cancer. Here, we report a case of 52 years old male form Eastern Uttar Pradesh in India who was initially diagnosed for Acute Necrotizing pancreatitis and was treated conservatively by subject experts. Later he suffered with seven more episodes within three years of initial diagnosis and was dealt in emergencies. His clinical condition continued to deteriorate and he lost 15 kg body weight during the course of disease. At this juncture, he opted to a north India based specialty Ayurvedic treatment centre and was treated with metal based Ayurvedic formulations, daily diet of 2000 to 2200 calories and complete mental and physical rest. He responded well to Ayurvedic treatment protocol (ATP) and showed overall improvement. There was also remarkable improvement in his rising CA 19-9 levels, that turned to normal in the first hundred eight days of ATP, which needs to be explored further for its path making therapeutic values.
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Anti-Inflammatory Properties of a Processed Copper Complex in L-Arginine Induced Pancreatitis -Two Experimental Studies
Article
Full-text available
  • Jul 2019
Background: Recurrent Acute/Chronic Pancreatitis (RA/CP) is an inflammatory disorder of the pancreas. The disease is progressive in nature and may turn fatal in due course. The aetiology of this inflammatory condition majorly remains mysterious, especially in Indian context, where majority of the patients of RA/CP are non-alcoholics and non-tobacco users with no family history of the disease. An Ayurvedic Mineral Complex (AMC) has shown significant improvement in the clinical conditions of pancreatitis patients and significantly reduced acute exacerbations and emergency hospitalizations in a number of cases. The present set of studies was carried to understand the mechanism of AMC. Methodology: AMC was evaluated for its pancreatitis protective properties at different doses in an existing model of L-Arginine induced pancreatitis in albino male wistar rats and compared to Methylprednisolone, a known anti-inflammatory agent. The study was carried in two phases, with three different doses of AMC used in each phase. Results: The studies indicate that AMC was well tolerated. It did not cause mortality or any clinical signs of toxicity in male wistar rats, who were given a daily dose of AMC for twenty-one days. There was no change in body weight and food consumption pattern. It also decreased the oxidative stress, inflammatory cytokines and severity of inflammatory condition in pancreas by reducing structural changes. The best pancreatitis protective effect of AMC was observed at doses of 25 mg/kg and 19 mg/kg body weight. Conclusion: The results of the aforesaid studies validate the stated clinical efficacy of AMC by showing its strong pancreatitis protective properties. AMC might be developed as a potential anti-inflammatory agent.
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impact-evaluation-of-ayurvedic-treatment-protocol-on-three-hundred-nineteen-cases-of-different-variants-of-pancreatitis-2165-7092-1000196
Article
Full-text available
  • Dec 2018
Pancreatitis is an inflammatory disorder of the pancreas, affecting its endocrine and exocrine function. It is mainly associated with abdominal pain, vomiting, nausea, indigestion, steatorrhea, weight loss and diabetes. There are many variants of pancreatitis that have been broadly divided into acute and chronic pancreatitis. In both the conditions, patients may suffer with recurring episodes of the aforesaid symptoms with progression of the disease. Pancreatitis is conservatively managed by emergency hospitalizations, lifelong pancreatic enzymes and supplements with modifications in diet and lifestyle. Advance surgical intervention is also being used in some cases to provide long term solution. However, the benefits of such procedures are limited to certain pockets of the world. Owing to unpredictable nature of the disease and limitations of treatment possibilities, pancreatitis adversely affects psychological, physical and financial status of the patients. In this scenario, many patients opt for alternate medicines. A North India based Ayurvedic clinic has earned reputation in bringing complete and sustainable relief in significant number of cases of Recurrent Acute/ Chronic Pancreatitis (RA/CP). A data on 319 well diagnosed cases demonstrates that Ayurvedic Treatment Protocol (ATP) has been able to bring complete relief in significant number of patients, without causing any side effect. Statistical analysis of the data shows that the treatment brought significant improvement in weight and reduction in frequency of attacks. ATP comprises of a few Ayurvedic formulations that are prescribed for a period of one year, along with regulated diet and lifestyle as well as complete physical and mental rest. The main Ayurvedic formulation used in the treatment is Amar. Experimental studies conducted using Amar have demonstrated its protective properties against pancreatitis. Further research is being conducted for the systematic and scientific development of this specialized ATP.
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Relevance of metal based Ayurvedic formulations in the management of recurrent acute/ chronic pancreatitis
Article
Full-text available
  • May 2017
Recurrent Acute Pancreatitis/ Chronic Pancreatitis (RAP/ CP) is generally marked by sudden onset of symptoms like severe abdominal pain, vomiting and weight loss that needs emergency hospitalization. Owing to irreversible and progressive nature of the disease and limitations of conventional treatment, many patients look for an alternative solution. Here, we report data of 250 well diagnosed cases of acute recurring/ chronic pancreatitis, enrolled in between January 1997 to August 2016, in our Ayurvedic clinical practice in Northern part of India. Ayurveda is well recognized as an independent medical system parallel to conventional medicines in India and a subject is free to opt for any system of medicine for the prevention and treatment of any ailment. The subjects were treated with a complex herbo-mineral formulation based on the principles of Rasa Shastra in Ayurveda that deals with the therapeutics of processed metals in the prevention and treatment of diseases. They were also prescribed a regulated balanced diet and lifestyle. Significant improvement has been noted in subjects who have completed the treatment.
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CA 19-9 to differentiate benign and malignant masses in chronic pancreatitis: Is there any benefit?
Article
Full-text available
  • Jan 2009
  • Indian J Gastroenterol
The role of the tumor marker CA 19-9 in differentiating benign from malignant masses in chronic pancreatitis has not been extensively studied. This study aims at assessing the accuracy of CA 19-9 in differentiating inflammatory head masses in chronic pancreatitis from superimposed carcinomas on chronic pancreatitis. The data of 84 consecutive patients who had mass lesions in chronic pancreatitis were analyzed to determine the sensitivity, specificity and predictive values at cut-off values of 37, 100, 200 and 300 U/mL. Receiver operating characteristic (ROC) curves were used to assess the sensitivity and specificity. There were 50 benign masses and 34 malignancies. The overall sensitivity and specificity of CA 19-9 for cancer was 68% and 70%, respectively. There was a higher positivity of CA 19-9 in cancers than in benign masses (23/34; 68% versus 15/50; 30%, P<0.01) with cut-off values of 37 U/mL. Higher positivity rates were obtained in cancers using other cut-off values such as 100, 200 and 300 U/mL. Values over 300 U/mL were 100% specific for malignancy, but occurred in only 5 (of whom had distant metastases) of 34 patients. CA 19-9 level in excess of 300 U/mL in mass lesions in chronic pancreatitis was always indicative of malignancy.
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CA 19-9 as a Predictor for Response and Survival in Advanced Pancreatic Cancer Patients Treated With Chemoradiotherapy
Article
Full-text available
  • Sep 2008
To investigate the significance of carbohydrate antigen 19-9 (CA 19-9) levels for predicting response and survival in pancreatic cancer (PC) treated with concurrent chemoradiotherapy. We retrospectively reviewed data from 69 patients with PC between 1999 and 2005. All patients had elevated CA 19-9 levels before treatment. CA 19-9 levels (pre- and posttreatment CA 19-9) and their decline were analyzed for radiologic response and overall survival. Seventeen patients (25%) had a 50% or greater reduction in tumor size within 3 months of chemoradiotherapy (1 complete response, 16 partial responses). CA 19-9 decline was significantly correlated with radiologic response (p = 0.03). The median survival time (MST) was 12 months (range, 4-48 months), and 1-year survival rate was 44%. Pretreatment CA 19-9 > 1,200 U/mL (MST, 13 vs. 8 months; p = 0.002), posttreatment CA 19-9 >100 U/mL (MST, 17 vs. 10 months; p = 0.0003), and CA 19-9 decline <or=40% (MST, 13 vs. 10 months; p = 0.005) were the strongest and most unfavorable prognostic factors. In addition, patients with multiple unfavorable CA 19-9 levels had significantly worse outcomes than those without. CA 19-9 decline shows a correlation with radiologic response. The combination of pretreatment CA 19-9 >1,200 U/mL, posttreatment CA 19-9 >100 U/mL, and CA 19-9 decline <or=40% may possibly serve as a surrogate marker for poor survival in advanced PC receiving chemoradiotherapy.
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Evaluation of CA 19?9 as a serum tumor marker in pancreatic cancer
Article
Full-text available
  • Mar 1986
Serum concentrations of the CA 19-9 antigen were determined in 91 patients with pancreatic cancer and in 111 patients with benign pancreatic, biliary and hepatocellular diseases. The CA 19-9 concentration was above the cut-off limit (37 U ml-1) in 78% of the patients with pancreatic cancer and high levels (greater than 500 U ml-1) were seen in 56% of these patients. Elevated levels were also seen in benign diseases (22%), especially in patients with extrahepatic cholestasis (up to 440 U ml-1). Hepatocellular jaundice and pancreatitis were associated with normal values (84% of the patients), or with only slightly elevated CA 19-9 levels (up to 88 U ml-1). The CA 19-9 test can be useful as an additional diagnostic tool for the detection of pancreatic cancer. Preliminary results suggest that the CA 19-9 assay can be used in the monitoring of surgically treated patients.
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Hereditary Pancreatitis and the Risk of Pancreatic Cancer
Article
Full-text available
  • Apr 1997
Hereditary pancreatitis is an autosomal-dominant disease, with a variable expression and an estimated penetrance of 80%. The gene for this disease has recently been mapped to chromosome 7q35, and the defect is believed to be caused by a mutation in the cationic trypsinogen gene. Acute attacks of abdominal pain begin early in life and the disease often progresses to chronic pancreatitis. Although the risk of pancreatic cancer is thought to be increased in more common types of chronic pancreatitis, the frequency of pancreatic cancer in the inherited type of pancreatitis is uncertain. The aim of this study was to assess the frequency of pancreatic cancer and other tumors in patients with hereditary form of pancreatitis. To determine the natural history of hereditary pancreatitis, we invited all members of the American Pancreatic Association and the International Association of Pancreatology to participate in a longitudinal study of this rare form of pancreatitis. The initial criteria for patient eligibility were as follows: early age (< or = 30 years) at onset of symptoms, positive family history, and absence of other causes. From April 1995 through February 1996, 37 physicians from 10 countries contributed medical records of 246 (125 males and 121 females) patients thought to have hereditary pancreatitis as the most likely diagnosis. This group included 218 patients where the diagnosis appeared to be highly probable and 28 additional patients where the diagnosis of hereditary pancreatitis was less certain: 25 patients who had relatively late onset of disease and a positive family history and three patients with onset of disease before age 30 years but with an uncertain family history. We reviewed all causes of death and compared the observed to the expected frequency of cancer in this historical cohort of patients with hereditary pancreatitis. The strength of the association between pancreatitis and pancreatic cancer was estimated by the standardized incidence ratio (SIR), which is the ratio of observed pancreatic cancer cases in the cohort to the expected pancreatic cancers in the background population, adjusted for age, sex, and country. The mean age (+/- standard deviation [SD]) at onset of symptoms of pancreatitis was 13.9 +/- 12.2 years. Compared with an expected number of 0.150, eight pancreatic adenocarcinomas developed (mean age +/- SD at diagnosis of pancreatic cancer: 56.9 +/- 11.2 years) during 8531 person-years of follow-up, yielding an SIR of 53 (95% confidence interval [CI] = 23-105). The frequency of other tumors was not increased: SIR = 0.7 (95% CI = 0.3-1.6). Eight of 20 reported deaths in the cohort were from pancreatic cancer. Thirty members of the cohort have already been tested for the defective hereditary pancreatitis gene: all 30 carry a mutated copy of the trypsinogen gene. The transmission pattern of hereditary pancreatitis was known for 168 of 238 patients without pancreatic cancer and six of eight with pancreatic cancer. Ninety-nine of the 238 patients without pancreatic cancer and six of the patients with pancreatic cancer inherited the disease through the paternal side of the family. The estimated cumulative risk of pancreatic cancer to age 70 years in patients with hereditary pancreatitis approaches 40%. For patients with a paternal inheritance pattern, the cumulative risk of pancreatic cancer is approximately 75%. Patients with hereditary pancreatitis have a high risk of pancreatic cancer several decades after the initial onset of pancreatitis. A paternal inheritance pattern increases the probability of developing pancreatic cancer.
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The glycan CA19-9 promotes pancreatitis and pancreatic cancer in mice
Article
  • Jun 2019
Sweet bystander becomes a villain Patients with pancreatic cancer often have elevated blood levels of CA19-9, a carbohydrate antigen present on many proteins. CA19-9 is thus commonly used as a biomarker for diagnosing and monitoring disease progression. In a study of mice, Engle et al. found that CA19-9 may be more than an innocent bystander that marks the presence of pancreatic disease; it may play a causal role in disease (see the Perspective by Halbrook and Crawford). Transgenic mice expressing the human enzymes that add CA19-9 to proteins developed severe pancreatitis that could be reversed by treatment with CA19-9 antibodies. When the transgenic mice also harbored a Kras oncogene, they went on to develop pancreatic cancer. These unexpected observations suggest new avenues for the treatment of pancreatic disease. Science , this issue p. 1156 ; see also p. 1132
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The Epidemiology of Pancreatitis and Pancreatic Cancer
Article
  • Jun 2013
Acute pancreatitis is one of the most frequent gastrointestinal causes of hospital admission in the United States. Chronic pancreatitis, although lower in incidence, significantly reduces patients' quality of life. Pancreatic cancer is associated with a high mortality rate and is one of the top 5 causes of death from cancer. The burden of pancreatic disorders is expected to increase over time. The risk and etiology of pancreatitis differ with age and sex, and all pancreatic disorders affect the black population more than any other race. Gallstones are the most common cause of acute pancreatitis, and early cholecystectomy eliminates the risk of future attacks. Alcohol continues to be the single most important risk factor for chronic pancreatitis. Smoking is an independent risk factor for acute and chronic pancreatitis, and its effects could synergize with those of alcohol. Significant risk factors for pancreatic cancer include smoking and non-O blood groups. Alcohol abstinence and smoking cessation can alter the progression of pancreatitis and reduce recurrence; smoking cessation is the most effective strategy to reduce the risk of pancreatic cancer.
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[Diagnostic value of serum Ca 19-9 antigen in chronic pancreatitis and pancreatic adenocarcinoma]
Article
  • Mar 1998
  • GASTROEN CLIN BIOL
The value of serum Ca 19-9 dosage for pancreatic carcinoma diagnosis has been studied in heterogeneous series. The effect of the complications of chronic pancreatitis and pancreatic carcinoma on serum Ca 19-9 value has not been assessed precisely. The aims of this study were to assess: a) the value of Ca 19-9 to differentiate benign from malignant pancreatic disease; b) the influence of complications (particularly, cholestasis). The studied population included 179 patients: 126 with chronic pancreatitis (25 females, 101 males, 45 with cholestasis) and 53 with pancreatic carcinoma (27 females, 26 males, 37 with cholestasis). At 37 UI/mL threshold, the specificity and sensitivity of Ca 19-9 were 53 and 95%, respectively. Cholestasis was associated with a significant increase of Ca 19-9 in patients with chronic pancreatitis but not in those with pancreatic carcinoma. At 300 UI/mL threshold, the specificity and sensitivity of Ca 19-9 were 95 and 81% in patients without cholestasis and 87 and 81% in those with cholestasis, respectively. Diabetes mellitus was associated with a significant increase of Ca 19-9 only in patients with chronic pancreatitis without cholestasis. Pancreatic calcifications, pseudocysts, cirrhosis, pleural effusion or ascites were not associated with significant variation of Ca 19-9. In patients with pancreatic disease, 300 UI/mL threshold is the most accurate to differentiate benign from malignant disease, whatever the presence of cholestasis.
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