Which of the following laboratory values would be the most important to monitor for a patient with pancreatic cancer?
A. Serum glucose
B. Radioimmunoassay (RIA)
C. Creatine phosphokinase (CPK)
D. Carcinoembryonic antigen (CEA)
Correct Answer: A. Serum glucose
In pancreatitis, hypersecretion of the insulin from a tumor may affect the islets of Langerhans, resulting in hyperinsulinemia, a complication of pancreatic cancer. Pancreatitis damages the cells that produce insulin and glucagon, which are the hormones that control the amount of glucose in the blood. This can lead to an increase in blood glucose levels.
Option B: RIA should also be monitored to measure the effects of therapy, but hypoglycemia may be life-threatening. Determination of serum pancreatic enzymes remains the gold standard for the diagnosis of acute pancreatitis. More expensive and cumbersome methods such as RIA or ELISA for pancreatic elastase are useful only in special clinical circumstances.
Option C: Creatine phosphokinase is an enzyme that reflects normal tissue catabolism. Elevated serum levels indicate trauma to cells with high CPK content. CPK and CPK-isoenzymes are used to detect myocardial infarction. Serum CPK is elevated in most alcoholics including patients with delirium tremens (6, 9) or acute pancreatitis, a finding which possibly reflects a certain degree of myopathy known to occur in patients with acute alcohol intoxication as well as with chronic alcoholism
Option D: Carcinoembryonic antigen (CEA) is one of the most widely used tumor markers and is increased in 30%–60% of patients with pancreatic cancer. Although carbohydrate antigen 19-9 (CA19-9) is the most important serum biomarker in pancreatic cancer, the diagnostic and prognostic value of CEA is gradually being recognized.
No comments:
Post a Comment