Morphometric study on islet of Langerhans in relation to glucose tolerance in chronic obstructive pancreatitis due to pancreatoduodenal cancer]

Twenty one specimens of the pancreas in the patients who underwent pancreatoduodenectomy or total pancreatectomy for pancreatoduodenal cancer were divided into 4 groups according to the extent of fibrosis (Grade 0-Grade III). Islet cells of serial sections were stained immunohistochemically with calculation of the proportion of B-cells, A-cells, D-cells and PP-cells in the islets of Langerhans. In the pancreatic tissue with the most severe fibrosis (Grade III), B-cell ratio was significantly decreased (p less than 0.01), whereas A-cell ratio was significantly increased (p less than 0.01). Based on the data of oral glucose tolerance test (OGTT) and insulin response test, some indices were calculated (delta IRI/delta BS, sigma IRI/sigma BS, sigma delta IRI/sigma delta BS). In Grade III, sigma delta IRI/sigma delta BS was significantly decreased. A significant positive correlation was observed between B-cell ratio and both delta IRI/delta BS or sigma delta IRI/sigma delta BS, whereas a significant negative correlation was seen between A-cell ratio and sigma delta IRI/sigma delta BS. The present study first demonstrates the significant correlation between the endocrine secretory function of the islets and quantitative changes of the endocrine cells of islets in chronic obstructive pancreatitis due to pancreatoduodenal cancer. The present data strongly suggest that it is possible to estimate the degree of fibrosis and quantitative changes of the islet cells in the patients with pancreatoduodenal cancer by means of calculating the above mentioned indices, especially sigma delta IRI/sigma delta BS.