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首页> 外文期刊>Case Reports in Gastroenterology >Comparison of Duodenal Mucosal Chromogranin-A Expression in Non-Alcoholic Fatty Pancreas Dyspeptic Patients with and without Endosonography-Diagnosed Early Chronic Pancreatitis: A Case Series Study
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Comparison of Duodenal Mucosal Chromogranin-A Expression in Non-Alcoholic Fatty Pancreas Dyspeptic Patients with and without Endosonography-Diagnosed Early Chronic Pancreatitis: A Case Series Study

机译：非酒精性脂肪胰腺消化不良患者（有和没有超声心动图诊断的早期慢性胰腺炎）十二指肠黏膜嗜铬粒蛋白A表达的比较：病例系列研究

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Nonalcoholic fatty pancreas (NAFP) is hypothetically related to progressive fibro-inflammation of the pancreas whose exocrine function is controlled by enteroendocrine cells (EEC). There is little evidence of pancreatic fibrosis in fatty pancreas and of whether there are quantitative differences for EEC. This study aimed to prove the coexistence of NAFP and pancreatic fibrosis or early chronic pancreatitis (ECP) using acoustic radiation force impulse (ARFI) and endosonography. Besides, the expression of duodenal mucosal chromogranin-A, a surrogate for EEC, was analyzed. Dyspeptic patients were surveyed at the digestive clinic and received abdominal sonography, endosonography, and serology tests. Cases with organic causes of dyspepsia were excluded. Pancreatic fibrosis was defined as an ARFI value ≥1.3 m/s. ECP was defined by at least 2 scores of the Japan Pancreas Society endosonographic criteria. During endosonography, 4 biopsy samples of mucosa in the duodenal first part were obtained for analysis of chromogranin-A expression by Western blot. Mucosal biopsy was also performed at the gastric antrum for surveillance of Helicobacter pylori. Between January and June 2018, a total of 24 patients with NAFP were enrolled among 48 candidates and divided into 2 groups based on whether they had pancreatic fibrosis or not. In the pancreatic fibrosis group (n = 11, pancreatic ARFI: 1.76 ± 0.34 m/s), there was a higher endosonographic criteria score (2.45 vs. 1.61, p = 0.002), increased expression of chromogranin-A (p = 0.001), and more severe fatty pancreas that was defined by pancreatic duct blurring on abdominal sonography (91 vs. 46%, p = 0.062) as compared to the non-pancreatic fibrosis group (n = 13, pancreatic ARFI: 1.11 ± 0.09 m/s). A total of 54 endosonographic abnormalities of ECP was present in these 24 patients in the head (52%), body (31%), and tail (17%), an anatomic pattern similar to pancreatic adenocarcinoma. In conclusion, among dyspeptic patients with NAFP, the duodenal mucosa chromogranin-A showed increased expression in those with pancreatic fibrosis and endosonography-diagnosed ECP.
机译：假设非酒精性脂肪胰腺（NAFP）与胰腺的进行性纤维炎症有关，其外分泌功能由肠内分泌细胞（EEC）控制。几乎没有证据表明脂肪胰腺中的胰腺纤维化以及EEC是否存在定量差异。这项研究旨在通过声辐射力脉冲（ARFI）和超声检查来证明NAFP与胰腺纤维化或早期慢性胰腺炎（ECP）并存。此外，分析了十二指肠粘膜嗜铬粒蛋白-A（EEC的替代物）的表达。在消化诊所对消化不良的患者进行了调查，并接受了腹部超声检查，内镜检查和血清学检查。排除有器质性消化不良原因的病例。胰腺纤维化定义为ARFI值≥1.3m / s。 ECP由至少2个日本胰腺协会超声内镜检查标准定义。在超声内窥镜检查中，获得了十二指肠第一部分的粘膜活检样本4份，用于通过Western blot分析嗜铬粒蛋白A的表达。还在胃窦处进行了粘膜活检，以监测幽门螺杆菌。在2018年1月至2018年6月期间，共有48名候选人入组了24例NAFP患者，根据他们是否患有胰腺纤维化分为两组。在胰腺纤维化组（n = 11，胰腺ARFI：1.76±0.34 m / s）中，超声检查标准评分较高（2.45 vs. 1.61，p = 0.002），嗜铬粒蛋白-A的表达增加（p = 0.001） ，并且与非胰腺纤维化组（n = 13，胰腺ARFI：1.11±0.09 m / s）相比，更严重的脂肪性胰腺由腹部超声检查中的胰管模糊所界定（91比46％，p = 0.062）。 ）。这24名患者的头部（52％），身体（31％）和尾巴（17％）中共出现54例ECP超声检查，其解剖结构类似于胰腺腺癌。总之，在消化不良的NAFP患者中，十二指肠粘膜嗜铬粒蛋白A在胰腺纤维化和经超声检查诊断为ECP的患者中表达增加。

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