Acute phase proteins in chronic pancreatic disease.

In order to evaluate the behaviour of some acute phase proteins in chronic pancreatic disease and to correlate these reactants with different factors, C-reactive protein, ceruloplasmin and alpha-1-antitrypsin were assayed in the sera of 24 control subjects, 26 patients with pancreatic cancer, 22 patients with chronic pancreatitis and 22 patients with a variety of diseases not of pancreatic origin. Alpha-1-antitrypsin, C-reactive protein and ceruloplasmin concentrations were found to be increased in 63%, 50% and 42% of patients with chronic pancreatic disease, respectively. In patients with pancreatic cancer no difference was found between the values of each protein considering the presence or otherwise the absence of liver metastases. Patients with chronic pancreatitis had higher C-reactive protein or alpha-1-antitrypsin values when increased serum amylase or pseudocysts were present. Significant correlations were found between the three acute-phase proteins considering the subjects as a whole; however in the single subjects they were not found to be concomitantly abnormal. Correlations were detected between these proteins and liver function test values. Alpha-1-antitrypsin is probably the most sensitive index in chronic pancreatic disease, while C-reactive protein seems better to reflect the stage of the disease. The variations of the levels of these proteins seem to be, at least in part, independent of each other; they are all partially influenced by the presence of liver damage.