CLINICAL STUDY FOR EARLY DIAGNOSIS OF MINIMAL PANCREATIC DAMAGE

Amylase Isoenzyme and Electron Microscopic Findings

Abstract

Pancreozymin-Secretin test (PS test), endoscopic retrograde pancreatography (ERP) and quantitative measurement of serum amylase isoenzyme-P were performed in 101 patients suspected to have chronic pancreatitis. These data were compared with light and electron microscopic findings of biopsy specimens from 12 cases out of 101 patients.
The mean value of amylase isoenzyme-P was 97 IU/l in normal subjects (n=25) and its value did not change before and after PS test. In the cases of minimal pancreatitis diagnosed by ERP (MIP), the value of amylase isoenzyme-P increased from 127 IU/l to 201 IU/l by the stimulation of pancreozymin and secretin (n=47).
Light microscopic examination revealed only mild fibrosis and cell infiltration. Electron micrograph showed ruptured basement membrane, secretory granule fluxing into the stroma (SG), markedly dilated rough endoplasmic reticulum (RER) and swelling of mitochondria (M).
Furthermore, filamentous materials were found in the lumen of acinal cells and intercalated portion and the obstruction of lumen by the plug of these materials played a role in the progression of the pancreatic damage.
Measurement of serum amylase isoenzyme-P was thought to be useful for early diagnosis of the minimal pancreatic damage.