Expression of the cell surface antigen detected by the monoclonal antibody A7 in pancreatic carcinoma cell lines

In a previous study, we used a murine monoclonal antibody, A7, against human colon carcinoma as a drug-carrier to treat colorectal cancer.¹ In the present study, we found that MAb A7 also reacted immunohistochemically with 73% of human pancreatic carcinoma cell lines, with the A7 antigen mainly being detected on the cell surface. However, the A7 antigen was found in only 9% of the spent media of these human pancreatic carcinoma cell lines by ELISA. On the other hand, the positive incidence of CA19-9, POA, ferritin, CEA, DU-PAN-2 and SLX in those spent media was 100%, 64%, 64%, 55%, 55% and 36%, respectively. These results suggest that the A7 antigen may only rarely be shed into the sera of pancreatic cancer patients, in which case MAb A7 could be a suitable drug-carrier in targeting chemotherapy for pancreatic cancer patients.     

Primate endocrine function after pancreatico-duodenal-splenic allotransplantation

In this study the endocrine function following intraperitoneal hetero- and orthotopic pancreatico-duodenal-splenic allotransplantation (PDS) in hemipancreatectomized, non-immune-suppressed chacma baboons was assessed. Significantly reduced K-values and insulin release together with glucose intolerance during IVGTT were observed in hemipancreatectomized recipients (HPS) without grafts. Orthotopic and heterotopic PDS transplantation improved the glucose intolerance of HPS recipients; orthotopically sited grafts rendering the best curves. Normal glucose tolerance was not achieved. Both orthotopic and heterotopic PDS transplantation rendered suboptimal insulin release during IVGTT; heterotopically draining grafts released significantly more insulin than orthotopic grafts. Hyperglucagonaemia during IVGTT was a constant feature in both groups, heterotopic grafts releasing the most glucagon during stimulation. C-peptide release was significantly lower in orthotopic grafts compared to normal animals or heterotopically drained insulin. It is concluded that glucose tolerance was not directly related to insulin or glucagon release in this study as orthotopic grafts rendered near-normal IVGTT curves in the presence of hypoinsulinaemia, hyperglucagonaemia, and reduced C-peptide values. The hormonal response after PDS transplantation was variable and the advantages of portal vs systemic insulin drainage remain to be defined.     

Effects of long-term parenteral nutrition on the course of pancreatic pseudocyst

The benefit of total parenteral nutrition (TPN) for the non-operative treatment of acute pancreatic pseudocyst remains hypothetical benefit. We reviewed results for 40 patients with pancreatic pseudocyst treated with TPN who had had serial imaging studies. On presentation, mean cyst size was 7.4 cm and after non-operative treatment with TPN (mean 32.5 days) the cyst had decreased to 5.6 cm. After the non-operative period, 68% of the pseudocysts had regressed, completely in 14% and partially in 54% of the patients. Except for 1 patient with cyst-related obstructive jaundice, there were no complicated pseudocysts. Only 12 (28%) of the patients underwent cyst drainage. Fifteen patients (35%) sustained catheter-related complications, which included sepsis (26%), pneumothorax (9%), hydropneumothorax (2%), and septic right atrial thrombosis (2%), during the course of hospitalization. Most of the patients treated with TPN showed both clinical and radiographic regression of their pseudocysts. However, the risk of catheter-related complications in this group suggests that this therapy should be limited to those patients who are unable to sustain enteral nutrition.     

吉西他滨联合5-氟尿嘧啶和四氢叶酸治疗晚期胰腺癌的临床研究

目的　评价 5 氟尿嘧啶和四氢叶酸联合化疗与加用吉西他滨后治疗晚期胰腺癌的疗效和不良反应 ;以及 5 氟尿嘧啶药物代谢动力学指标的改变。方法　 43例晚期胰腺癌患者分为实验组 ( 2 2例 )和对照组 ( 2 1例 )。实验组 :吉西他滨 10 0 0mg/m2 ,第 1,8,16天静脉滴注 ,5 氟尿嘧啶 40 0mg/m2 和四氢叶酸 10 0mg/m2 于第 1～ 5天静脉滴注 ;对照组 :5 氟尿嘧啶 40 0mg/m2 和四氢叶酸 10 0mg/m2 在第 1～ 5天静脉滴注 ,均以每 4周为 1疗程 ,持续 4个疗程。结果　实验组完全缓解 (CR) 1例 ( 4 .5 %) ,部分缓解 (PR) 6例 ( 2 7.3 %) ,临床受益反应率 (CBR)为 68.2 %;对照组无CR ,PR3例 ( 14 .3 %) ,CBR有效率 3 3 .3 %。实验组出现不良反应的数量和严重程度较对照组提高且差异具有显著性。实验组 5 氟尿嘧啶血浆药物浓度、血浆峰值提高 ,血浆半衰期延长。结论　吉西他滨与 5 FU、四氢叶酸联合应用治疗晚期胰腺癌有一定的客观疗效 ,可明显改善患者的生存质量 ,但不良反应也随之提高。上述变化与吉西他滨改变 5 FU的药物代谢动力学有关     

胰腺实性-假乳头状瘤影像与病理诊断分析

目的 探讨胰腺实性-假乳头状瘤的影像及病理学的诊断要点。资料与方法 回顾分析11例经手术切除、病理学和免疫组织化学证实的胰腺实性一假乳头状瘤患者的临床资料，以比较其影像和病理学特点。结果 (1)本病多发于30岁以下女性，临床主要表现为腹痛。(2)CT、MRI表现为肿瘤内有实性和囊性结构，可分为3型；特征性表现为“浮云征”。(3)肿瘤大部分位于胰腺，多有完整包膜，不伴有胆总管扩张。(4)病理学特点为肿瘤实性部分由实性区、假乳头区及两者过渡区以不同比例混合而成。囊性区由坏死、液化、陈旧性出血组成。(5)肿瘤的囊实性结构是形成“浮云征”的病理基础。结论 胰腺实性-假乳头状瘤有相对特征性的影像和病理学表现，术后预后较好。     

思他宁对人胰腺癌细胞株ASPC-1的生长调控

目的:观察思他宁对人胰腺癌细胞ASPC-1的生长作用.方法:细胞培养,分别加入不同浓度的思他宁.应用MTT法来观察细胞增殖程度;放免法测定细胞内cAMP含量;荧光法测定[Ca2 ]i.结果:不同浓度的思他宁(10-11～10-6mol/L)均能有效地抑制ASPC-1的生长,能抑制ASPC-1细胞内cAMP生成和细胞内钙离子水平,cAMP生成量和细胞内钙离子水平与思他宁浓度呈负相关.结论:思他宁能抑制ASPC-1细胞的生长,经过特异性受体调节.     

EUS AND PANCREATIC CYST DRAINAGE: AN UPDATE

Endoscopic drainage has become the primary therapy for pancreatic pseudocysts. Diagnostic endoscopic ultrasound (EUS) has added safety to the procedure and interventional EUS has broadened the indications to non‐bulging lesions. At the same time, more aggressive endoscopic treatment has also made it possible to treat infected pseudocysts and organized pancreatic necrosis. The indications and technique are reviewed in this paper.     

烟酰胺对高糖介导胰岛细胞bax及bcl-2表达的影响

目的 探讨烟酰胺对高糖环境下胰岛细胞bax及bel-2蛋白表达的影响。方法 体外培养大鼠胰岛细胞，应用免疫组化方法检测培养液中葡萄糖终浓度为22．2mmol／L及加入烟酰胺后胰岛细胞bax及bcl-2蛋白表达。结果 培养液中葡萄糖终浓度为22．2mmol／L时，胰岛细胞bax表达阳性，bcl-2表达较对照组降低。加入烟酰胺后bax表达降低，bcl-2表达增强。结论 烟酰胺能够上调bcl-2表达，下调bax表达，在高糖介导的胰岛细胞损伤中起一定作用。     

反义核苷酸抑制人高迁移率族蛋白1表达对胰腺癌细胞的影响

目的　构建高迁移率族蛋白 1(HMGB1)基因的反义真核表达载体 ,寻找胰腺癌基因治疗新途径。方法应用分子克隆技术构建HMGB1基因反义真核表达载体 pcDNA3 1/antisense HMGB1,转染胰腺癌细胞株PANC 1,通过逆转录 聚合酶链反应 (RT PCR)、免疫印迹法 (Westernblot)、噻唑蓝 (MTT)比色法检测转染 4 8h后胰腺癌细胞HMGB1基因表达和体外增殖活性的变化。结果　成功构建 pcDNA3 1/antisense HMGB1反义真核表达载体。所获反义表达载体 pcDNA3 1/antisense HMGB1转染可使PANC 1细胞HMGB1mRNA和蛋白表达水平显著降低 (P <0 0 1)。反义 pcDNA3 1/antisense HMGB1的导入能有效抑制PANC 1增殖活性 (P <0 0 1)。 结论　应用反义RNA技术阻断HMGB1基因的表达 ,能有效抑制癌细胞的体外增殖活性 ,为基因治疗提供了新思路     

VALUE OF COMPUTED TOMOGRAPHY FOR EVALUATING THE INJECTION SITE IN ENDOSONOGRAPHY‐GUIDED CELIAC PLEXUS NEUROLYSIS

Endosonography‐guided celiac plexus neurolysis (EUS‐CPN) safely and effectively relieves pain associated with intra‐abdominal malignancies when the neurolytic is accurately injected. We applied contrast medium to evaluate the ethanol injection sites in patients who received EUS‐CPN due to abdominal pain caused by malignancies. We injected, under the guidance of endoscopic ultrasonography (EUS), ethanol containing 10% contrast medium into the celiac plexus of patients with intra‐abdominal pain due to malignancies. Immediately after the endoscopic therapy, patients underwent computed tomography (CT) to confirm the injection site. Images of distribution of injected solutions were classified into three groups. Injected solution dispersed in unilateral and bilateral anterocrural space was defined as ‘unilateral injection’ or ‘bilateral injection’, respectively. Injected solution located out of the anterocrural space was defined as ‘inappropriate injection’. Pre‐ and postprocedure pain was assessed using a standard analog scale. Before and 2, 4, 8, 12, and 16 weeks after the procedure, pain scores were evaluated. From April 2003 to May 2005, 13 patients were enrolled in this study. Improvement of pain score in the ‘bilateral injection’ and ‘unilateral injection’ groups was significantly superior to the change in the ‘inappropriate injection’ group. Although EUS‐CPN was effective in eight of 13 patients (61.5%), additional EUS‐CPN to the ‘inappropriate injection group’ increased the response rate to 84.6%. Injection of ethanol to the anterocrural space by EUS‐CPN produced adequate pain relief. Immediate examination by CT for confirmation of injection sites after EUS‐CPN would increase the likelihood of induction of pain relief.