J.Jpn. Surg. Soc.. 86(1): 73-83, 1985

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Original article

THE ASSOCIATION OF PANCREATIC ENDOCRINE DYSFUNCTION WITH CARCINOMA OF PANCREAS AND CHRONIC PANCREATITIS

In 20 cases with carcinoma of pancreas, 15 cases with chronic pancreatitis and 17 control cases, the levels of insulin in portal and peripheral blood after glucose infusions and the microscopical changes of pancreatic islet cells were examined, In the cases with carcinoma of pancreas, the morphological changes were the destruction and disappearance of B-cells due to the invasion of the carcinoma, the degeneration of B-cells due to the concomitant pancreatitis in the residual pancreatic tissue, and the atrophy and balooning of pancreatic islet due to a probable cause of ischemic change of circulatory dynamics and in the cases with chronic pancreatitis, the degeneration of B-cells followed by fibrosis and the increase of the number of the islet cells due to the regeneration of the pancreas tissue. In both cases, the function was more injured than the morphological changes and these findings seemed to disclose the dysfunction of insulin secretion per B-cell unit or the disturbance of the shift of insulin into portal vein caused by fibrosis. In the cases with carcinoma of pancreas, the rate of disappearance of glucose (K-index) to Σ^60’_0’IRI in portal blood was low value and the glucose tolerance per insulin unit was decreased.

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