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Studies on exfoliative cytology of the pancreatic-duodenal juice in the diagnosis of pancreas neoplasia are not numerous and the data reported are not uniform. The present study examines 176 patients, 18 of them suffering from carcinoma of the pancreas. In these latter patients there were no advanced signs of the disease. Cytology gave a correctly negative result in 46.8% of the normal subjects and in those with non-neoplastic pancreatic or digestive conditions, correctly positive in 66.6% of the pancreas neoplasias, falsely negative in 2,2% of the total series and in 33.3% of the pancreatic cancers, and falsely positive in 1,1% of the series. In 47.7% of cases, the study proved useless owing to the absence of material in the collected juice.

In order to ascertain the clinical usefulness of CA 19-9 in detecting pancreatic cancer in comparison with CEA, and to verify the influence of age and liver dysfunction on serum levels of these two antigens, serum CA 19-9 and CEA were assessed in 32 control subjects, 32 patients with pancreatic cancer, 26 with chronic pancreatitis and 43 with gastrointestinal extra-pancreatic diseases. Sensitivity, specificity and diagnostic accuracy of CA 19-9 and CEA in detecting pancreatic cancer were: 69% and 44%, 91% and 75%, 60% and 19% respectively. Linear correlations were observed between the age of the subjects on the one hand and CA 19-9 or CEA on the other. Significant relationships were also noticed between alanine-amino-transferase or bilirubin serum levels and CA 19-9 values. Serum CA 19-9 seems to be a better diagnostic tool than CEA in the assessment of pancreatic cancer; nevertheless the influence of liver dysfunction and age to some extent limits the diagnostic value of CA 19-9.

CA 19-9 and tissue polypeptide antigen (TPA) were determined in the sera of 28 control subjects, 29 patients with pancreatic cancer, 26 with chronic pancreatitis and 62 with benign and malignant extra pancreatic diseases in order to compare their usefulness in diagnosing pancreatic cancer, to verify whether the combined assessment of the two indices could improve the results given by a single parameter and to speculate on the role of liver dysfunction in increasing their serum levels. The sensitivity, specificity and accuracy of CA 19-9 and TPA in diagnosing pancreatic malignancy were: 76, 85 and 61% for CA 19-9 and 79, 52 and 32% for TPA. The receiver-operating characteristic curves showed that CA 19-9 and TPA similarly discriminate pancreatic cancer from controls and chronic pancreatitis, while CA 19-9 is more useful than TPA in differentiating pancreatic malignancy from benign and malignant extra pancreatic abdominal diseases. TPA did not seem to add further information as compared to CA 19-9 alone when both markers were combined. Liver dysfunction may contribute to increasing serum levels of both markers.

The authors compare by gravimetric analysis the quantity of dentin by four different types of endodontic instruments, with the sonic technique. The results show File-Diamond are the most efficient instruments, followed by Rispi-Sonic, File-K and Shaper.