Volume 61 - 1998 - Fasc.4 - Original articles
Meal-related changes in plasma CCK bioactivity in patients with chronic pancreatitis
In order to clarify whether there is a negative feedback mechanism for CCK secretion, we investigated plasma CCK bioactivity in patients suffering from chronic pancreatitis (CP) according to the characteristics of their pancreatic disease. Basal, meal-stimulated, and integrated release of plasma cholecystokinin (CCK) bioactivity was measured in 24 patients with CP and in 12 healthy controls. The values obtained were compared between the healthy control group and the CP group, and between subgroups of CP patients established on the basis of the presence/ absence of several parameters : abnormal gastric emptying, abdominal pain, steatorrhea, pancreatic calcification, insunn-requiring diabetes mehitus, and iirnpairment of pancreatic exocrine functions as indicated by secretin test. A bioassay method using pancreatic ac@ was used to measure plasma CCK bioactivity. In the control group, plasma CCK bioactivity increased from a basal value of 1.6 ± 0.7 pmol/L to a maximal increase of 6.6 ± 4.1 pmol/L, and the integrated CCK release following a test meal was 37.7 ± 19.3 pmol/L - 150 min. In the CP group, plasma CCK bioactivity increased from 1.6 + 0.9 pmol/L to a maximal increase of 8.2 ± 8.7 pmol/L, and the integrated release of CCK was 43.0 ± 37.7 pmol/L - 150 min. None of the differences between them were significant. No significant differences in basal value, maximal increase, or integrated plasma CCK release were noted according to any of the parameters of the CP patients and the control group. Nor was there any correlation between impairment of pancreatic exocrine function and plasma CCK bioactivity. These results provide no evidence of a negative feedback mechanism between pancreatic exocrine dysfunction and CCK secretion.
Prolactin and colorectal cancer : is there a connection ?
The purpose of this study was to confirm the reported incidence of hyperprolactineniia in colorectal cancer and to find further evidence for an ectopic prolactin production by the tumor. Material and method. Thirty two consecutive patients with an adenocarcinoma of the colon (n = 17) or the rectum (n = 15) were included. Preoperative serum prolactin concentrations were deterntined and correlated with CEA concentrations and tumor stages. To exclude an ectopic production by the colon cancer, prolactin concentrations were determined during the operation, in the peripheral blood and in the efferent venous drainage area of the tumor. After resection, immunohistocheniical staining for prolactin was made in all resected tumors. Results. In all except two patients with a rectal cancer, preoperative plasma prolactin concentrations were normal. Peroperative serum concentrations of prolactin were high in all patients. No significant gradient was foimd between the peripheral venous concentration and the local venous concentration in the drainage area of the tumor. Immunobistochemical staining for prolactin was positive in only one rectal cancer. Finally, no correlation was found between plasma prolactin concentrations and tumor stages or CEA concentrations. Conclusion. Our results do not support the hypothesis of an ectopic prolactin production by colon adenocarcinoma. Only in a subgroup of rectal cancers, an ectopic prolactin production remains probable. At present, prolactin cannot be recommended as a tumor marker in colorectal cancer.
Incidence of inflammatory bowel disease in the area of Liège a 3 years prospective study (1993-1996)
A first prospective epidemiological study of IBD was conducted in the area of Liège. The duration of the study was short taking into account the small size of the population (1 million inhabitants). Therefore we carried out a 3 years prospective study. Method. Private and public gastroenterologists completed a questionnaire for each new case they diagnosed between 01.06.1993 and 31.05.1996. Results. During that period 270 IBD patients were identified : 137 (51%) had Crohn's disease (CD), 111 (41%) had ulcerative colitis (UC) including 32 proctitis (29% of UC) and 22 (8%) had unclassilied colitis. The mean annual incidence per 105 was 4.5 for CD and 3.6 for UC. The female/male ratio was 1,6 for CD and 0,5 for UC. The median age at the time of diagnosis was 30 years for CD and 39 years for UC. The mean time between the onset of symptoms and the diagnosis was 6,5 months for CD and only 4,8 months for UC. Family history of IBD was found in 15% of patients with CD and in 7% of UC. Conclusions. These data show a high incidence of IBD in the area of Liège. These results confirm those reported during the first year of the prospective study which were similar to those observed in North-western France. Contrary to the other countries of Northern Europe, the incidence of UC is lower than the one of CD. Belgium appears to be a privileged country to undertake a national register and to study epidemiological aspects of IBD.
