© Borgis - Postępy Nauk Medycznych 5/2015, s. 353-354
Chronic pancreatitis (CP) is a progressive inflammatory disease of the gland characterized with non-reversible morphologic changes, like progressive destruction of exocrine and endocrine parenchyma, as well as ductular structures, followed with fibrosis and pancreatic exocrine and endocrine function impairment. The correlation between structural and functional changes is often poor. Pancreatogenic diabetes is often recognized late in the course od the disease, often when it’s complications are already present.
Advanced stages of CP are easily diagnosed with imaging techniques, as ultrasound, computed tomography or endosonography (EUS). On the other hand, despite the significant progress in the knowledge on chronic CP pathogenesis, an early detection of the disease is rarely possible.
Pancreatic cancer (PC) accounts for 3% of all malignant neoplasms diagnosed each year in the world and is the 4th most common cause of cancer deaths. The aggressive course, late diagnosis and resistance to treatment result in 5 year survival lower than 5% and very high mortality in the 6 months period after diagnosis. At the diagnosis 80-90% patients have an advanced disease and the tumor is non-operable. Numerous studies concentrate on developing specific and sensitive diagnostic and prognostic marker of PC, but the results are unsatisfactory yet.
In this issue of „Postępy Nauk Medycznych” the important and not clearly elucidated problem of coexisting diabetes in CP and PC is being analysed in the article titled „The emergence of carbohydrate metabolism disorders in the course of pancreatic adenocarcinoma (PC) and chronic pancreatitis (CP) – assessment of insulin level and insulin resistance” by Wlodarczyk et al. It shows that the oral glucose tolerance test allows the early detection of endocrine pancreatic disorders in patients with CP and PC in absence of clinical symptoms of diabetes. In addition, hyperinsulinemia was detected more often in PC patients, and reduced insulin secretion – CP, which may provide the additional tool in the difficult task of CP and PC differentiation.
In the article „Usefulness and limitations of core biopsy in pancreatic tumors diagnostics – retrospective analysis„ by Gwożdziewicz et al. the significant number od pancreatic core biopsy is reported. As opposite to fine-needle biopsy cytology, the final diagnosis was obtained in the majority of patients with relatively low number of procedure complications. It should be stressed that this method is highly operator-dependent and requires very close cooperation with experienced pathologist.
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