Noh Kyung W, Pungpapong Surakit, Wallace Michael B, Woodward Timothy A, Raimondo Massimo
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
Clin Gastroenterol Hepatol. 2006 Jun;4(6):782-9. doi: 10.1016/j.cgh.2006.03.026. Epub 2006 May 19.
BACKGROUND & AIMS: Cytokine concentration in pancreatic juice of patients with pancreatic disease is unknown. Secretin stimulation allows endoscopic collection of pancreatic juice secreted into the duodenum. We aimed to evaluate the cytokine concentrations in pancreatic juice of patients with abdominal pain to discriminate presence from absence of pancreatic disease.
From January 2003-December 2004, consecutive patients with abdominal pain compatible with pancreatic origin were enrolled. Patients underwent upper endoscopy. Intravenous secretin (0.2 mug/kg) was given immediately before scope intubation. Pancreatic juice collected from the duodenum was immediately snap-frozen in liquid nitrogen until assays were performed. Pancreatic juice levels of interleukin-8, interleukin-6, intercellular adhesion molecule 1, and transforming growth factor-beta 1 were measured by modified enzyme-linked immunosorbent assays. The final diagnosis was made by the primary gastroenterologist on the basis of medical history; laboratory, endoscopic, and imaging studies; and clinical follow-up. Fisher exact test and Kruskal-Wallis rank sum test were used for statistical analysis.
Of 130 patients screened, 118 met the inclusion criteria. Multivariate analysis revealed that only interleukin-8 was able to discriminate between normal pancreas and chronic pancreatitis (P = .011), pancreatic cancer (P = .044), and the presence of pancreatic diseases (P = .007). Individual cytokine concentrations were not significantly different in chronic pancreatitis compared with pancreatic cancer.
Cytokine levels can be measured in pancreatic juice obtained from the duodenum without direct cannulation of the pancreatic duct. Interleukin-8 concentration in pancreatic juice can be used to discriminate between normal pancreas and patients with pancreatic disease. This is a relatively simple and noninvasive method to aid in the diagnosis of pancreatic diseases.
胰腺疾病患者胰液中的细胞因子浓度尚不清楚。促胰液素刺激可通过内镜收集分泌到十二指肠的胰液。我们旨在评估腹痛患者胰液中的细胞因子浓度，以鉴别是否存在胰腺疾病。
纳入2003年1月至2004年12月期间连续的、腹痛症状与胰腺疾病相符的患者。患者接受上消化道内镜检查。在插入内镜前立即静脉注射促胰液素（0.2μg/kg）。从十二指肠收集的胰液立即在液氮中速冻，直至进行检测。采用改良酶联免疫吸附测定法测量白细胞介素-8、白细胞介素-6、细胞间黏附分子1和转化生长因子-β1在胰液中的水平。最终诊断由初级胃肠病学家根据病史、实验室检查、内镜检查、影像学检查及临床随访结果做出。采用Fisher精确检验和Kruskal-Wallis秩和检验进行统计分析。
在筛查的130例患者中，118例符合纳入标准。多变量分析显示，只有白细胞介素-8能够区分正常胰腺与慢性胰腺炎（P = 0.011）、胰腺癌（P = 0.044）以及是否存在胰腺疾病（P = ）。与胰腺癌相比，慢性胰腺炎患者的单个细胞因子浓度无显著差异。
无需直接穿刺胰管即可测量从十二指肠获取的胰液中的细胞因子水平。胰液中白细胞介素-8的浓度可用于区分正常胰腺与胰腺疾病患者。这是一种相对简单且无创的辅助诊断胰腺疾病的方法。
