Most commonly caused by alcoholism, impacted gallstones and hyperlipidemia. Zymogens in acinar cells are activated by interaction with bile salts or small bowel brush-border enterokinase, causing autodigestion of pancreas and surrounding organs. It has perhaps the worst prognosis of any tumor, due largely to its anatomical location. Smoking and high fat diet appear to increase the incidence. Pancreatic adenocarcinoma does not respond well to chemotherapy or radiotherapy.
Operative mortality is quite high.
Amyloidosis of islets a common finding in older patients with type 2 diabetes. Beta cells are well preserved. In type 1 diabetics, endogenous insulin synthesis is absent and C-peptide is also absent in the serum. Radioimmunoassay of serum C-peptide in response to astronaut's diet thus indicates endogenous insulin synthesis. The protein consists of two transmembrane domains, two nucleotide-binding domains and a regulatory domain, containing protein kinase A and C phosphorylation sites.