Endocrine pancreas in chronic pancreatitis. A qualitative and quantitative study

Abstract

This study includes nine patients with diabetes mellitus (DM) and chronic pancreatitis (CP) (group I); 11 patients without DM and with CP (group II); and a control group (group III) consisting of five autopsy cases with neither DM nor CP. These groups were evaluated by routine histologic stains and immunocytochemical stains for insulin, glucagon, and somatostatin. Semiquantitative assessment of the degree of exocrine pancreatic atrophy and of two endocrine features (diffuse endocrine proliferation and ductoendocrine proliferation) was performed for each pancreas. Quantitative determination of the cell composition was carried out in three kinds of islets (parenchymal, sclerosis, and newly formed). The mean percentages of the insulin-producing B cells were significantly lower in the parenchymal (44.5%) and new (34.3%) islets of diabetic patients than in the controls (67.8%) and parenchymal (59.4%) islets of nondiabetic patients. The mean percentages of glucagon-producing A cells revealed significant increases in the parenchymal (43.0%) and new (55.7%) islets of diabetic patients as compared with the controls (24.3%) and parenchymal (32.2%) islets of nondiabetic patients. The mean percentage of somatostatin-producing D cells was significantly increased in the parenchymal islets (12.4%) of diabetic patients as compared with the parenchymal islets (8.2%) of nondiabetic patients and controls (7.5%). These findings correlate with clinical data of frequent DM in CP, but are partly in contrast with previous immunohistochemical analysis findings in CP.