P83

Background

To evaluate the clinical symptoms in pancreatic cancer patients (PCa) and compare some biochemical blood serum parameters in patients with different pathology of the pancreas (PCa, acute (OP) and chronic pancreatitis (CP)).

Materials and methods

During a one-time clinical research on the type of “series of cases” 130 patients were examined (42 patients with OP, 81 – CP and 7 patients with PCa). The diagnosis of PCa, OP, CP was verified by clinical and instrumental methods. Glucose, cholesterol, triglyceride and bilirubin serum levels were determined by ELISA.

Results

The mean age of patients with PCa was 63.6 ± 4.9 years, morbidity duration of PCa – 3.5 ± 1.1 months. Among patients with PCa, 83.3% of people – smoked, 16.7% – smoked every day. Half of the respondents PCa patients noted that over the last year they did not drink alcohol; 16.7% of people – drank alcohol several times a year, and 33.3% of patients consumed alcohol 1–2 times a month. BMI of PCa patients was equal to 26.3 ± 3.5 kg/m², in OP patients – 23.8 ± 1.0 kg/m², in CP patients – 26.3 ± 0.6 kg/m², p > 0.05. In this case, 85.7% of PCa patients noted a significant decrease in body weight (11.7 ± 6.0 kg) for 3–4 months after the onset of symptoms. There was no pain in 42.8% of PCa patients, and frequent pain noted only in 28.6% of persons. Among CP patients, frequent and persistent pain noted in 65.5% of patients and among OP patients in 48.6% of cases. All PCa patients experienced pain in the right upper quadrant. Pain was of low intensity in 75% of cases and moderate in 25% of cases. Elimination of pain was observed in half of the PCa patients, and 1/4 of patients continued to experience pain. Episodes of nausea and vomiting noted in 25% of PCa patients. Bloated feeling in the stomach and overflow were noted in 42.8% of the all surveyed PCa persons. The level of glucose in PCa patients exceeded the normal limits and was significantly higher compared to that in OP and CP patients (8.5 ± 1.4 mmol/L, 5.4 ± 0.3 and 5.1 ± 0.1 mmol/L, respectively, p < 0.05). Hyperbilirubinemia was detected in PCa patients – 89.9 ± 27.5 μmol/L; in OP and CP patients bilirubin levels were 32.2 ± 11.0 and 13.4 ± 1.8 μmol/L, respectively, which were significantly lower than those in patients with PCa, p < 0.05. Triglyceride levels did not differ in patients with different pancreas diseases (PCa – 1.7 ± 0.3, CP – 1.86 ± 0.1 and OP –1.88 ± 0.11 mmol/L, p > 0.05). However, the total cholesterol in CP patients was significantly higher than that in PCa and OP patients (5.8 ± 0.1, 5.0 ± 0.6 and 4.1 ± 0.2 mmol/L, p < 0.05). In PCa patients, the elevated levels of some markers of cholestasis and hepatocyte injury were also found: ALP – 185.0 ± 12.7 IU/L, ALT – 108.4 ± 33.5 IU/L, AST – 85.3 ± 31.5 IU/L, amylase – 44.9 ± 14.9 IU/L, fibrinogen – 2696.6 ± 398.6 g/L.

Conclusion

The combination of nonspecific clinical signs (pain, dyspepsia) with biochemical markers of biliary pathology and endocrine pancreatic insufficiency – of PCa patients demonstrates the obligatoriness of differential diagnostic pancreatic and biliary pathology in their earlier stages.