|Budget Amount *help
¥3,200,000 (Direct Cost : ¥3,200,000)
Fiscal Year 1998 : ¥700,000 (Direct Cost : ¥700,000)
Fiscal Year 1997 : ¥2,500,000 (Direct Cost : ¥2,500,000)
It has been reported that cathepsin E (CTSE) is a non-secretory and intracellular aspartic proteinase found in the superficial epithelial cells of the stomach, and is also expressed in ductal cell carcinoma of the pancreas. We evaluated the diagnostic value of CTSE in pancreatic juice in comparison with those of CA19-9, CEA, K-ras mutation and cytology. Pancreatic juice was examined in 111 patients ; 29 with ductal cell carcinoma of the pancreas and 82 with chronic pancreatitis. Pancreatic juice was collected during ERCP after secretin stimulation for 10 min. Half amount of the collected juice was applied to cytology. The supernatant and sediment ultracentrifuged from the remaining juice were applied to the analysis of CTSE, CA19-9, CEA, and K-ras mutation. In patients with ductal cell carcinoma the positive rates of CTSE was 63%, that of CA19-9 was 33%, that of CEA was 17%, that of K-ras mutation was 41% and that of cytology was 69%. In patients with chronic pancreatitis the positive rate of CTSE was 8%, that of CA19-9 was 10%, that of CEA was 1%, that of K-ms mutation was 17% and that of cytology was 0%. The detection frequency of CTSE in pancreatic juice was significantly higher in patients with ductal cell carcinoma than in patients with chronic pancreatitis as well as cytology. The accuracy of the combination of CTSE and cytology in detecting ductal cell carcinoma of the pancreas was 92%, it is the highest of various combinations of these diagnostic marker for the definitive diagnosis of ductal cell carcinoma of the pancreas.