BACKGROUND/AIMS: This study addresses the possibility of very difficult differential diagnosis of pancreatic cancer and chronic pancreatitis, especially in cases where pancreatic cancer appears in the course of chronic pancreatitis. A combination of graphical methods and pancreatic biopsy targeted with endosonography seems to be the most precise diagnostic technique. Even negative findings for this procedure cannot exclude the risk of existing tumor and is additionally an invasive technique. Therefore there are different conditions that have to be fulfilled to allow use of both endoscopic and bioptic instruments (biopsy with biopsy needle). Tumor markers of blood serum are used in the practice, but this use seems to be limited by the sensitivity, which is on the level of 60-70% in average. METHODOLOGY: The authors examined M2-pyruvate-kinase concentration in their group, which included patients with chronic pancreatitis, different grading of pancreatic cancer as well as patients with pancreatic cancer which appeared in the course of chronic pancreatitis. M2-pyruvate-kinase was used as a marker of tumor hyperplasia as it is present in higher concentration in tumors of gastrointestinal tract. RESULTS: The authors observed important growth in advanced forms of pancreatic tumor compared to patients with chronic pancreatitis. M2-PK was increased in a similar way in patients with pancreatic cancer in the course of chronic pancreatitis. The results led to the conclusion that evaluation of M2-PK concentration helps differentiating between pancreatic cancer and chronic pancreatitis, especially in cases where morphological changes of the gland have focal character and are imitating pancreatic cancer.

Internal Hepatic gastroenterology Clinic UH Brno Czech Republic

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