Serum levels of pancreatitis-associated protein in digestive diseases withspecial reference to gastrointestinal cancers

The serum levels of pancreatitis-associated protein (PAP) were measured in 196 patients with digestive diseases and 15 healthy subjects by an enzyme-l inked immunosorbant assay. The serum PAP levels were significantly elevated in the patients with gastric, colorectal, biliary tract, hepatocellular, o r pancreatic cancers compared with the healthy subjects. After curative res ection of the tumor, serum PAP levels were significantly decreased. The ser um PAP levels were not related to clinicopathological factors except for th e tumor size of pancreatic cancer, There were some cases of PAP-positive an d carcinoembryonic antigen (CEA) or carbohydrate antigen (CA) 19-9 -negativ e gastric and colorectal cancers. The serum PAP levels were also significan tly elevated in the patients with acute pancreatitis compared with those in not only the healthy subjects but also the patients with chronic pancreati tis. The peak PAP levels were significantly correlated with the severity of acute pancreatitis and reflected the clinical healing of the disease. The peak of serum PAP was significantly delayed compared with those of other pa ncreatic enzymes These results suggest that the increase of serum PAP level s in patients with gastrointestinal cancers reflects an ectopic expression of PAP in cancer cells and that increased serum levels of PAP in acute panc reatitis are correlated with the disease severity and are prolonged than th ose of other pancreatic markers.