Premium
Discriminant analysis in diagnosing carcinoma of the pancreas and of the papilla of Vater
Author(s) -
Montalto Giuseppe,
Ficano Leonardo,
Carroccio Antonio,
D'arpa Francesco,
Greco Luigi,
Soresi Maurizio,
Salvo Pasquale
Publication year - 1994
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf01211923
Subject(s) - gastroenterology , anorexia , medicine , constipation , vomiting , nausea , weight loss , major duodenal papilla , aspartate transaminase , bilirubin , alkaline phosphatase , biology , biochemistry , enzyme , obesity
The clinical and biochemical presentation of carcinoma of the pancreas (PC) and of the papilla of Vater (CPV) are very similar, and, consequently, detailed investigations are required to correctly distinguish between them. The aim of the present study was to select the clinical and biochemical variables that would most efficiently discriminate the precise site of tumor origin. The study group consisted of 72 patients with PC and 22 patients with CPV consecutively hospitalized in our department. The following clinical parameters were considered: age, asthenia, anorexia, vomiting, weight loss, pain, fever, pruritis, and constipation; the biochemical parameters considered were total, direct, and indirect bilirubin, glucose, alkaline phosphatase, gamma glutamy transferase, transaminase, total protein, amylase, and occult blood in stools. The results indicated that in the initial phase of PC the most frequent clinical parameters were weight loss ( P < 0.0001), anorexia ( P < 0.02), constipation ( P < 0.001), and pruritus ( P < 0.01). In contrast, in CPV, fever ( P < 0.003) was most frequent in the same phase. There was a statistically significant difference in occult blood in stools ( P < 0.0001), total ( P < 0.03) and direct bilirubin ( P < 0.02), alkaline phosphatase ( P < 0.05), and transaminase ( P < 0.002) values in the two groups. On discriminant analysis, weight loss, constipation, pruritus, nausea, anorexia, and fever were the variables which best discriminated between the two types of tumors. In fact, the presence of weight loss, anorexia, asthenia, constipation, and pruritus correctly classified 87.5% of the patients with PC, while the presence of fever and nausea correctly classified 72.7% of the patients with CPV.