Abstract
Background: Faecal elastase 1 (E1) is an indirect test of pancreatic function. Few study investigated the role of E1 in pancreatic cancer. Aim: 1) To evaluate fecal elastase levels in normal healthy subject in comparison to patients with pancreatic cancer 2) To assess the relationship between faecal elatase 1 and tumor topography in patients with pancreatic cancer. Methods: 26 consecutive patients (15 male, 11 female, mean age 72±21.3) admitted in our G.I. unit between January 2003 and February 2004 with first diagnosis of pancreatic cancer were enrolled in the study. Clinical, laboratory, histologic and imaging data were prospectively collected. Cancer topography was as follow: 14 patients had head cancer; 5 patients had body-tail cancer; 7 patients had head-body cancer. The head-body group of patients was removed from the study when we analized the relationship between fecal elastase levels and pancreatic cancer topography. Control group was composed from 165 normal healthy subject (70 male, 95 female, mean age 68±27.1). All patients and control gave their informed consent. Stool elastase level was measured by an immunoenzymatic method (Meridian Bioscience Europe). According to our normal control group, we considered abnormal E1 values lower than 200 μg/g. Mann-Whitney rank-sum test was used to data analysis. Results: Faecal elastase 1 levels were significantly decreased in pancreatic cancer patients (276.2±234.4) in comparison to normal subjects (504.5±145.3) (p<0.0001). A correlation between E1 levels and cancer topography was found: patients with pancreatic head cancer showed lower E1 levels (189.4±180.7) in comparison to patients with pancreatic body-tail cancer (421.2±229.1) but did not achieve significant level of p (p=0.078) because of low power of the test. Conclusions: Faecal elastase 1 is significantly decreased in patients with pancreatic cancer in comparison to normal healthy subject. Moreover, fecal elastase 1 could have a significant correlation with pancreatic cancer localization.
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