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Pancreatic polypeptide is increased in patients with advanced malignant disease
Audhild Hjalmarsen1, Roy M Bremnes, Ulf Aasebø
1Division of Pulmonary Medicine, Department of Medicine, University Hospital of Northern Norway, N-9038 Tromsø, Norway. audhild.hjalmarsen@unn.no
Background:
Augmented secretion of pancreatic polypeptide (PP) has been demonstrated in patients with severe systemic diseases or endocrine tumors. The aim of this study was to evaluate PP and autonomic neuropathy in patients with advanced malignant disease.
Materials And Methods:
Basal PP assessments and five cardiovascular tests for autonomic function were used. Twenty patients, including 11 patients with lung cancer (69 yrs +/- 11, mean +/- SD) and 10 healthy age-matched controls, were studied.
Results:
PP levels were significantly higher in the patients than in the controls (pmol/L 107.0 +/- 111.4 versus 28.2 +/- 13.4, p<0.05). In the parasympathetical tests, the patients showed significantly decreased heart rate response to the Valsalva manoeuvre (ratio 1.20 +/- 0.19 versus 1.46 +/- 0.23, p<0.005). Also, in the sympathetical tests, the blood pressure response to standing up was significantly decreased (mmHg -3.84 +/- 17.53 versus 10.80 +/- 8.89, p<0.05). The heart rate response to standing up and deep breathing as well as the blood pressure response to sustained handgrip, did not differ significantly between the groups. In spite of the apparent autonomic dysfunction among cancer patients with advanced malignant disease, PP levels were significantly higher in these patients when compared with healthy controls.
Conclusion:
PP levels were significantly higher in patients with advanced cancer than controls, regardless of autonomic dysfunction in the cancer patients. This finding supports the hypothesis that PP may, in some cancer patients, be a marker of advanced malignant disease.