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Expression of apoptosis markers in human chronic pancreatitis
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Abstracts / Pancreatology 15 (2015) S1eS141
positives and true negatives) comparing to the patients with incompatible results (false positives and false negatives) in terms of age of MRCP embodiment (14.2±3.6 years vs 10.5±4.2 years; p<0.05) and CP staging (Cambridge scale; median 4.0 vs 2.0). In seven children, MRCP suggested pancreas divisum (PD), which was then confirmed during ERCP only in four patients. Among the 14 patients with PD demonstrated by ERCP, MRCP revealed this anomaly only in 3 (21,4%). Conclusion: MRCP is useful in providing diagnostic information equivalent to ERCP in children with CP and should be used as the image modality of first choice, especially if the likelihood of therapeutic intervention is small. Similarly to the meta-analysis of studies among adults, it seems that MRCP is of little use if detection of PD is desired.
1208. Expression of apoptosis markers in human chronic pancreatitis Viktoryia Klopava, Inna Samsonova Vitebsk State Medical University, Belarus Introduction: Mechanisms associated with apoptosis in pancreas are elucidated deficiently. Aims: To study bcl-2, p53 (DO-7) and Granzyme B expression in pancreas at chronic pancreatitis (CP). Materials & methods: Using morphological, immunohistochemical, morphometric methods, we investigated the pancreas specimens of 45 patients with CP who underwent duodenum saving resection of the pancreas head. Control group included 7 pancreas head specimens without any pancreas pathology from people died by accidents. Statistic analysis included Mann-Whitney's and Spearman's tests. All p value 0.05 was considered statistically significant. Results: Our research showed the bcl-2 expression degree variation from 1.12 up to 38.77 points. Comparison with control group has demonstrated more than 5-fold bcl-2 expression degree increasing in pancreatic tissue of patient with CP. The p53 expression was low as in investigated as and control groups. The degree of Granzyme B expression varied from 0 up to 775.63 points and was more high in pancreas samples at CP. The results of the markers expression are displayed in Table. Table. The marks of the expression of markers (Me (LQ-UQ)). Groups
Bcl-2 expression, points
P53 expression, points
Granzyme B expression, points
Chronic pancreatitis
10.55 (7.99e14.67) 1.81 (0.6e4.57) 0.003052
0.0015 (0.00005e0.19) 0.00013 (0e0.0004) 0.085528
21.96 (5.19e92.75) 0.001 (0.00032e0.0069) 0.000005
Control group p value (Mann-Whitney)
~ Conclusion: The revealed changes of apoptosis markers (bcl-2, NV53, Granzyme B) expression at CP are suggested to play a key role in morphogenesis of disease and progressive degenerative changes in the pancreas, its structural reorganization and disturbance of regeneration processes.
1220. Liver enzymes are not reliable parameters to reveal liver fibrosis in chronic pancreatitis bor Zso tya s Czepa n, Do ri, Ma ra Ill Ga es, Mbuotidem Udongwo, lvo n Nagy, La szlo €lgyi, Istva Czako Attila Pa University of Szeged, First Department of Internal Medicine, Hungary Introduction: The coincidence of chronic pancreatitis and liver cirrhosis in alcoholic patients is rare.
Aims: To assess liver fibrosis in patients with chronic pancreatitis by measuring non-invasive fibrosis scores and liver stiffness. Patients & methods: Twenty five patients with chronic pancreatitis were enrolled in the study. Eight volunteers were recruited to serve as controls. Non-invasive fibrosis scoring systems including aspartate aminotranspherase to platelet ratio index (APRI), fibrosis-4 score (FIB-4) and non-alcoholic fatty liver disease (NAFLD) score were determined and transient elastography was performed. Results: Transient elastography was successful in all but one patients (16 male and 9 female, mean age 59,41±13 years). Mild and severe fibrosis was revealed in 5 and 2 patients by elastography, respectively. However the liver enzymes were elevated only in 3 patients The values of APRI, FIB-4 and NFALD scores did not revealed fibrosis of the liver in any patients. The duration of chronic pancreatitis was longer (10,57±5 vs. 8,05±4 years), the presence of diabetes mellitus was higher (57,14% vs. 17,64%) and regular alcohol consumption occurred more frequently (42,85% vs. 23,52%) in chronic pancreatitis patients with liver fibrosis than without liver fibrosis, respectively. There was no correlation between metavir stages and the incidence of pancreatic surgery. Conclusion: Liver fibrosis occurs in a small proportion of chronic pancreatitis patients. Liver enzymes are not reliable parameters to reveal liver fibrosis. Alcohol consumption, the duration of chronic pancreatitis and the presence of DM are the risks factors for the development of liver fibrosis.
967. Chronic Pancreatitis in patients without an adequate follow-up: Nutritional consequences and quality of life, preliminary results of the PANCREVOL study pez Valenciano 1, Eva Marin Serrano 2, Carlos Marra-Lo Federico Bolado Concejo 3, Maria Francisco Gonzalez 4, Emma Martínez Moneo 5, Judith Millastre Bocos 6, Fidencio Bao Perez 7, Andres Del Pozo-Garcia 8, Esperanza Perez Garcia 9, ~ a 10, Enrique De-Madaria 11 Elena Labrador Barba 10, M. Luisa Orera Pen 1
Pancreatic Unit, Araba University Hospital, Spain Gastroenterology, H. La Paz, Spain 3 Gastroenterology, Complejo Universitario de Navarra, Spain 4 Gastroenterology, Complejo Hospitalario Universitario de Orense, Spain 5 Gastroenterology, H. Universitario Cruces, Spain 6 Gastroenterology, H. Universitario Miguel Servet, Spain 7 Gastroenterology, H. San Eloy, Spain 8 Gastroenterology, H. Universitario 12 Octubre, Spain 9 Gastroenterology, H. Universitario Reina Sofia, Spain 10 Medical Department Mylan EPD, Spain 11 Pancreatic Unit, H. General Universitario de Alicante, Spain 2
Introduction: Chronic pancreatitis (CP) can lead to development of pancreatic exocrine insufficiency (PEI). Some CP patients are not adequately monitored. Consequently diagnosis of complications such as PEI may be delayed, resulting in postponement of specific treatment. Aims: To evaluate nutritional status, quality of life (QoL) and PEI in CP patients without adequate follow-up. Materials & methods: Cross-sectional multicenter study involving 11 hospitals. CP patients without follow-up by gastroenterologist in the last two years were included. A complete medical exam including laboratory and EORTC-QoL-c30 questionnaire were performed to evaluate CP and complications. PEI status was determined by fecal elastase-1 concentration in stools (FE). Results: In this preliminary analysis 50 patients were included (80% males, mean age 59.8 years, 56% smokers, 52% regular alcohol consumers). Mean time (95%CI) from diagnosis to the inclusion in the study was 7.2(5.3-9.3) years. 25.5% of the patients indicated their overall health and their QoL was 12 (7 points scales, 1-very poor, 7-excellent). FE analysis was available in 37 patients: 20(54.0%) had FE<200 mcg/g, and 17(45.9 %) were considered to suffer from severe PEI (FE<100mcg//g).
Abstracts / Pancreatology 15 (2015) S1eS141
positives and true negatives) comparing to the patients with incompatible results (false positives and false negatives) in terms of age of MRCP embodiment (14.2±3.6 years vs 10.5±4.2 years; p<0.05) and CP staging (Cambridge scale; median 4.0 vs 2.0). In seven children, MRCP suggested pancreas divisum (PD), which was then confirmed during ERCP only in four patients. Among the 14 patients with PD demonstrated by ERCP, MRCP revealed this anomaly only in 3 (21,4%). Conclusion: MRCP is useful in providing diagnostic information equivalent to ERCP in children with CP and should be used as the image modality of first choice, especially if the likelihood of therapeutic intervention is small. Similarly to the meta-analysis of studies among adults, it seems that MRCP is of little use if detection of PD is desired.
1208. Expression of apoptosis markers in human chronic pancreatitis Viktoryia Klopava, Inna Samsonova Vitebsk State Medical University, Belarus Introduction: Mechanisms associated with apoptosis in pancreas are elucidated deficiently. Aims: To study bcl-2, p53 (DO-7) and Granzyme B expression in pancreas at chronic pancreatitis (CP). Materials & methods: Using morphological, immunohistochemical, morphometric methods, we investigated the pancreas specimens of 45 patients with CP who underwent duodenum saving resection of the pancreas head. Control group included 7 pancreas head specimens without any pancreas pathology from people died by accidents. Statistic analysis included Mann-Whitney's and Spearman's tests. All p value 0.05 was considered statistically significant. Results: Our research showed the bcl-2 expression degree variation from 1.12 up to 38.77 points. Comparison with control group has demonstrated more than 5-fold bcl-2 expression degree increasing in pancreatic tissue of patient with CP. The p53 expression was low as in investigated as and control groups. The degree of Granzyme B expression varied from 0 up to 775.63 points and was more high in pancreas samples at CP. The results of the markers expression are displayed in Table. Table. The marks of the expression of markers (Me (LQ-UQ)). Groups
Bcl-2 expression, points
P53 expression, points
Granzyme B expression, points
Chronic pancreatitis
10.55 (7.99e14.67) 1.81 (0.6e4.57) 0.003052
0.0015 (0.00005e0.19) 0.00013 (0e0.0004) 0.085528
21.96 (5.19e92.75) 0.001 (0.00032e0.0069) 0.000005
Control group p value (Mann-Whitney)
~ Conclusion: The revealed changes of apoptosis markers (bcl-2, NV53, Granzyme B) expression at CP are suggested to play a key role in morphogenesis of disease and progressive degenerative changes in the pancreas, its structural reorganization and disturbance of regeneration processes.
1220. Liver enzymes are not reliable parameters to reveal liver fibrosis in chronic pancreatitis bor Zso tya s Czepa n, Do ri, Ma ra Ill Ga es, Mbuotidem Udongwo, lvo n Nagy, La szlo €lgyi, Istva Czako Attila Pa University of Szeged, First Department of Internal Medicine, Hungary Introduction: The coincidence of chronic pancreatitis and liver cirrhosis in alcoholic patients is rare.
Aims: To assess liver fibrosis in patients with chronic pancreatitis by measuring non-invasive fibrosis scores and liver stiffness. Patients & methods: Twenty five patients with chronic pancreatitis were enrolled in the study. Eight volunteers were recruited to serve as controls. Non-invasive fibrosis scoring systems including aspartate aminotranspherase to platelet ratio index (APRI), fibrosis-4 score (FIB-4) and non-alcoholic fatty liver disease (NAFLD) score were determined and transient elastography was performed. Results: Transient elastography was successful in all but one patients (16 male and 9 female, mean age 59,41±13 years). Mild and severe fibrosis was revealed in 5 and 2 patients by elastography, respectively. However the liver enzymes were elevated only in 3 patients The values of APRI, FIB-4 and NFALD scores did not revealed fibrosis of the liver in any patients. The duration of chronic pancreatitis was longer (10,57±5 vs. 8,05±4 years), the presence of diabetes mellitus was higher (57,14% vs. 17,64%) and regular alcohol consumption occurred more frequently (42,85% vs. 23,52%) in chronic pancreatitis patients with liver fibrosis than without liver fibrosis, respectively. There was no correlation between metavir stages and the incidence of pancreatic surgery. Conclusion: Liver fibrosis occurs in a small proportion of chronic pancreatitis patients. Liver enzymes are not reliable parameters to reveal liver fibrosis. Alcohol consumption, the duration of chronic pancreatitis and the presence of DM are the risks factors for the development of liver fibrosis.
967. Chronic Pancreatitis in patients without an adequate follow-up: Nutritional consequences and quality of life, preliminary results of the PANCREVOL study pez Valenciano 1, Eva Marin Serrano 2, Carlos Marra-Lo Federico Bolado Concejo 3, Maria Francisco Gonzalez 4, Emma Martínez Moneo 5, Judith Millastre Bocos 6, Fidencio Bao Perez 7, Andres Del Pozo-Garcia 8, Esperanza Perez Garcia 9, ~ a 10, Enrique De-Madaria 11 Elena Labrador Barba 10, M. Luisa Orera Pen 1
Pancreatic Unit, Araba University Hospital, Spain Gastroenterology, H. La Paz, Spain 3 Gastroenterology, Complejo Universitario de Navarra, Spain 4 Gastroenterology, Complejo Hospitalario Universitario de Orense, Spain 5 Gastroenterology, H. Universitario Cruces, Spain 6 Gastroenterology, H. Universitario Miguel Servet, Spain 7 Gastroenterology, H. San Eloy, Spain 8 Gastroenterology, H. Universitario 12 Octubre, Spain 9 Gastroenterology, H. Universitario Reina Sofia, Spain 10 Medical Department Mylan EPD, Spain 11 Pancreatic Unit, H. General Universitario de Alicante, Spain 2
Introduction: Chronic pancreatitis (CP) can lead to development of pancreatic exocrine insufficiency (PEI). Some CP patients are not adequately monitored. Consequently diagnosis of complications such as PEI may be delayed, resulting in postponement of specific treatment. Aims: To evaluate nutritional status, quality of life (QoL) and PEI in CP patients without adequate follow-up. Materials & methods: Cross-sectional multicenter study involving 11 hospitals. CP patients without follow-up by gastroenterologist in the last two years were included. A complete medical exam including laboratory and EORTC-QoL-c30 questionnaire were performed to evaluate CP and complications. PEI status was determined by fecal elastase-1 concentration in stools (FE). Results: In this preliminary analysis 50 patients were included (80% males, mean age 59.8 years, 56% smokers, 52% regular alcohol consumers). Mean time (95%CI) from diagnosis to the inclusion in the study was 7.2(5.3-9.3) years. 25.5% of the patients indicated their overall health and their QoL was 12 (7 points scales, 1-very poor, 7-excellent). FE analysis was available in 37 patients: 20(54.0%) had FE<200 mcg/g, and 17(45.9 %) were considered to suffer from severe PEI (FE<100mcg//g).