Pancreas最新文献

{"title":"Immune Checkpoint Inhibitor-Induced Pancreatic Injury: An Emerging Form of Immune-Mediated Pancreatitis.","authors":"Tareq Alsaleh, John George","doi":"10.1097/MPA.0000000000002582","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002582","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI) are increasingly utilized in cancer management due to their favorable outcomes. Pancreatic injury from ICIs (ICI-PI) is a heterogenous entity ranging from silent lipase elevation to clinical pancreatitis. Its distinct immunologic mechanisms and phenotype position it as a novel form of immune-mediated pancreatic injury.</p><p><strong>Methods: </strong>We performed a narrative review of the emerging literature on ICI-PI, highlighting its mechanisms, epidemiology, clinical and imaging features, histology, management, outcomes, and critical knowledge gaps.</p><p><strong>Results: </strong>ICI-PI often appears within months of starting therapy and frequently presents as isolated enzyme elevation rather than acute pancreatitis. Early imaging can be unremarkable, but later scans may show pancreatic volume loss or atrophy. Tissue examination shows neutrophil- and CD8-predominant infiltrates. Unlike other forms of autoimmune pancreatitis (AIP), storiform fibrosis, obliterative phlebitis, granulocytic epithelial lesions, or IgG4-rich plasma cells are not seen. Management focuses on supportive care, exclusion of alternative causes, and a temporary ICI hold for clinical pancreatitis. Corticosteroids are reasonable for symptomatic or radiographically confirmed disease, though evidence for long-term benefit is limited. Rechallenge with ICIs appears feasible in selected patients after recovery, with low recurrence rate observed in available data. Some patients develop delayed exocrine or endocrine insufficiency, underscoring the need for follow-up.</p><p><strong>Conclusions: </strong>ICI-PI is an uncommon yet clinically important entity that shows a distinct clinicopathologic profile from other forms of AIP. Clear diagnostic criteria, practical treatment pathways, and prospective registries are needed to guide therapy, inform rechallenge decisions, and define long-term outcomes.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Pancreatic Calcification and Pathologic Fibrosis Score: Correlation with Islet Yield and Insulin Independence after Total Pancreatectomy with Islet Autotransplantation TPIAT\".","authors":"Dhruv J Patel, William B Hyslop, Joseph Maniaci, Mu Jin, Alina Iuga, Andrew Woodward, Chris B Agala, Melissa E Chen, Chirag S Desai","doi":"10.1097/MPA.0000000000002578","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002578","url":null,"abstract":"<p><strong>Objectives: </strong>Total pancreatectomy with islet autotransplantation (TPIAT) is offered to patients with advanced chronic pancreatitis even with calcified and fibrotic glands yet rarely are these manifestations of chronic pancreatitis objectively quantified and correlated with subsequent islet yield and endocrine outcomes after surgery.</p><p><strong>Methods: </strong>All patients who underwent TPIAT at a single-institution between 2018 and 2024 were included. Preoperative computed tomography (CT) imaging was reviewed and scored for the distribution and severity of pancreatic calcification burden. All pathologic specimens were scored based on degree of fibrosis severity. Bivariate linear regression and logistic regression were performed to assess the relationship between clinical, radiographic, and pathologic variables with islet yield and insulin independence.</p><p><strong>Results: </strong>Thirty two patients met inclusion criteria. Median total fibrosis score was 9. Four patients (13%) had mild (total fibrosis score ≤6), 14 (47%) had moderate (score 7-9), and 12 (40%) had severe (score 10-12) fibrosis. On univariable analysis of factors associated with islet yield (IEQ/kg), increasing calcification burden in the pancreatic head [Linear Estimate (LE): -783 IEQ/kg, 95% Confidence Interval (CI): -1,529, -37, P=0.040] and pancreatic body/tail [LE: -1,152 IEQ/kg, 95% CI: (-1,748, -557), P<0.001] were both associated with reduced islet yield. Increasing total fibrosis score [LE: -426 IEQ/kg, 95% CI (-730, -123), P=0.008] was also associated with reduced islet yield on unadjusted analysis. After adjusting for covariates, only increasing calcification burden in the pancreatic body/tail remained a significant predictor of islet yield [Beta Coefficient: -1,511 IEQ/kg (95% CI: -2,252 - -770, P<0.001). At time of discharge, 15 patients (47%) were insulin independent, and at 1 year, 9 (28%) remained independent.</p><p><strong>Conclusion: </strong>Increasing severity of calcification burden in the pancreatic body/tail was associated with around 1500 IEQ/kg reduction in islet yield following TPIAT for chronic pancreatitis. The presence of pancreatic head calcifications may be associated with more favorable islet yield.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Silent Surge: Why Pancreatic Cancer Demands an Early Detection Revolution.","authors":"Manas Pustake","doi":"10.1097/MPA.0000000000002579","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002579","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single vs Dual Drainage of Walled Off Pancreatic Necrosis.","authors":"Jake G Herbert, Patricia Carney, Gregory Cote, Jessica X Yu, Kaveh Sharzehi, Saad Jazrawi, Erin Gilbert, Keith Quencer, Emily Jonica","doi":"10.1097/MPA.0000000000002514","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002514","url":null,"abstract":"<p><strong>Objectives: </strong>Walled off pancreatic necrosis (WOPN) management has shifted towards greater emphasis on endoscopic methods, though practice variation persists. Percutaneous drains are still widely utilized, with or without transmural endoscopic stents, though the clinical impact of either single or combined approach has not been clarified. We aimed to assess efficacy of first-line endoscopic drainage of WOPN, and define characteristics associated with need for step-up to additional percutaneous drain, i.e. dual modality drainage (DMD).</p><p><strong>Methods: </strong>A single-center retrospective review was performed among patients who received endoscopic ultrasound (EUS)-guided transmural drainage for WOPN as index therapy. Patient characteristics, WOPN morphology and clinical course were assessed. The primary outcome was need for step-up to DMD.</p><p><strong>Results: </strong>Fifty-six patients (32.1% women; median 54.5 years) were included, all who received initial EUS-drainage, with similar rates of LAMS usage and disconnected tail between groups. Thirty-seven patients (66.1%) were managed by endoscopic approach only (EAO). DMD patients had larger collection(s): 16.4 cm vs 11. 5 cm (P=0.013) and more frequent pericolic extension (42.1% vs 13.5%, P=0.043). Despite additional route of drainage, DMD patients required more total endoscopy sessions (4.7 vs 3.3, P=0.010).</p><p><strong>Conclusions: </strong>In patients receiving initial EUS drainage, the rate of step-up to DMD was 33.9%, highlighting that 2/3 of those with WOPN can be successfully managed by endoscopic means alone. Large size and pericolic extension were identified as predictors for need for step-up, and such features may be useful in identifying patients who may benefit from early dual approach.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant Retention in a Prospective Multicenter Cohort of Participants With Pancreatitis and Factors Associated With Attrition.","authors":"Radmila Choate, Jun Xu, Jeffrey J Easler, Samuel Han, Anna E Phillips, Melena D Bellin, William E Fisher, Evan L Fogel, Chris Forsmark, Phil A Hart, Stephen J Pandol, Walter G Park, Jose Serrano, Stephen K Van Den Eeden, Santhi Swaroop Vege, Liang Li, Darwin L Conwell, Dhiraj Yadav","doi":"10.1097/MPA.0000000000002550","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002550","url":null,"abstract":"<p><strong>Objectives: </strong>Participant retention is essential in prospective studies to minimize bias and maintain validity. This study aimed to estimate retention rates and identify factors influencing attrition in a multicenter cohort (PROCEED) of U.S. adults with acute/recurrent acute pancreatitis (AP/RAP) and chronic pancreatitis (CP).</p><p><strong>Methods: </strong>Participants from the PROCEED study with AP/RAP or CP eligible for follow-up within the designated visit window were included. Retention was defined as completing at least one follow-up visit during the observation period. Retention was analyzed by follow-up mode (in-person and/or medical record review) and disease type (AP/RAP and CP). Retention factors were assessed using univariate analyses (Wilcoxon rank-sum for continuous variables, Chi-square/Fisher's exact for categorical) and multivariable logistic regression. Missing data were adjusted using multiple imputations in statistical modeling.</p><p><strong>Results: </strong>Among 1,279 participants (AP/RAP: n=632, median age 47, 48.9% female; CP: n=647, median age 54, 46.5% female), we observed high cumulative and annualized retention rates, with improved retention when incorporating medical record reviews. In multivariable regression analyses, older age was statistically significantly associated with in-person retention in the AP/RAP group (P=0.0001), while a higher self-reported physical health (assessed with PROMIS Global Health Physical Health T-score) was a key predictor of retention in CP (P=0.034).</p><p><strong>Conclusions: </strong>Integrating medical records review substantially enhanced retention rates, enabling robust analyses of pancreatitis outcomes and disease progression. Older age and better self-reported physical health were key predictors of retention, highlighting the need for targeted strategies to enhance engagement among younger participants and those with poorer health in long-term studies.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative Splicing of Secretin Receptor (SCTR) and its low Expression Drive the Occurrence of Pancreatic Ductal Adenocarcinoma.","authors":"Yanqi Ke, Ling Wang, Qicai Liu, Feng Gao","doi":"10.1097/MPA.0000000000002569","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002569","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aim to elucidate the mechanistic role of secretin receptor (SCTR) in pancreatic ductal adenocarcinoma (PDAC) pathogenesis by systematically characterizing its alternative splicing (AS) landscape.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study systematically investigated the specific gene expression profiles of PDAC by integrating multi-omics data from TCGA and GTEx public databases. We collected formalin-fixed paraffin-embedded (FFPE) specimens and clinicopathological data from 65 PDAC patients. Immunohistochemical (IHC) analysis was performed to determine the differential expression of secretin receptor (SCTR) between PDAC and adjacent non-tumor (ATN) tissues, along with its clinicopathological correlations. RNA sequencing (RNA-seq) was conducted on 9 paired PDAC and ATN samples, followed by alternative splicing (AS) analysis using rMATs software to identify prognostic-related splicing events. IHC validation confirmed the protein-level expression patterns. Notably, through RT-qPCR and cloning/sequencing approaches, we unexpectedly discovered an intron 2-retained alternative splicing variant of SCTR, which may represent a novel PDAC-specific isoform.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Public data shows that compared with other tissues, SCTR expression in pancreatic tissue and pancreatic cancer is higher, and SCTR expression in pancreatic cancer is lower (P&lt;0.001). In pancreatic cancer, the high expression of SCTR is associated with better overall survival (P&lt;0.01). IHC expression analysis of 65 PDAC retrospective samples showed that：the expression of SCTR protein in PDAC was significantly lower than that of ATN (P&lt;0.001), and the expression of SCTR protein was correlated with distant metastasis (P&lt;0.05), tumor stage (P&lt;0.001) and Ki67 expression (P&lt;0.05) in PDAC.The RNA-seq results of this study showed that in 6 groups of samples, the expression of SCTR in PDAC was lower than that in ATN, with 5 groups significantly down regulated (P&lt;0.05). RNA-seq sequencing revealed 18 alternative splicing patterns of SCTR in PDAC and ATN, among which the number of three high-frequency alternative splicing events, namely exon 9 skipping, fragments of intron 2 retention, and alternative 3' splice site of exon 3, were differed among multiple pairs of PDAC and ATN samples(P&lt;0.05) (≥3 groups). Simultaneously, it was found that SNP rs2587682 (c.194-1804 T&gt;C) and the fragments of intron 2 retention of SCTR were associated with the occurrence of this alternative splicing event (P&lt;0.01).RT-qPCR and cloning sequencing results verified the existence of alternative splicing, the retained fragment is located in intron 2 between exons 2 and 3 of SCTR, and the sequence is 114bp.The expression of intron 2 of SCTR in ATN (2.58±4.41) was higher than that in PDAC (0.16±0.12) (P&lt;0.001).Moreover, the expression of intron 2 of SCTR in samples with genotype GG of rs2587682 (2.42±1.61) was significantly higher than that in samples with genotype AA ","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dana K. Andersen, MD Leader, Visionary, Colleague and Friend for the Pancreas Community.","authors":"Stephen Pandol, Chris E Forsmark, Melena Bellin, Phil A Hart, Dhiraj Yadav","doi":"10.1097/MPA.0000000000002570","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002570","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Perfusion Computed Tomography in Early Prediction of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis.","authors":"Shunichiro Nozawa, Masaki Kuwatani, Ryosuke Shimura, Ryo Sugiura, Kazumichi Kawakubo, Kosuke Nagai, Kazuma Kishi, Hiroki Yonemura, Yusuke Sakuhara, Kohsuke Kudo, Naoya Sakamoto","doi":"10.1097/MPA.0000000000002568","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002568","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is essential for diagnosing and treating pancreaticobiliary diseases, but post-ERCP pancreatitis (PEP) is a common and potentially severe complication. Perfusion computed tomography (CT) is a method for analyzing blood flow by capturing sequential images after rapid intravenous contrast injection, however, its usefulness in the early detection of PEP is unclear. This study aimed to assess whether ERCP followed by perfusion CT could predict PEP at an early phase.</p><p><strong>Methods: </strong>This single-center prospective study included 49 patients (25 women, 24 men; median age, 70 y) who underwent ERCP, who were at high risk for PEP, and who underwent perfusion CT within 2 hours after ERCP. All patients underwent perfusion assessment of blood volume (BV), blood flow (BF), mean transit time (MTT), and time to peak (TTP).</p><p><strong>Results: </strong>PEP occurred in 13 patients (26.5%). The PEP group had higher BF and shorter MTT and TTP than the non-PEP group (P<0.01). Receiver operating characteristic analysis identified BV, BF, MTT, and TTP as good predictive markers for PEP (with areas under the curve of 0.624, 0.739, 0.735, and 0.748, respectively). The respective sensitivity and specificity for the diagnosis of PEP were as follows: BV, 84.6% and 50.0%; BF, 61.5% and 91.7%; MTT, 84.6% and 66.7%; TTP, 84.6% and 69.4%; serum amylase, 61.5% and 86.1%. The sensitivity and specificity of TTP combined with serum amylase increased to 76.9% and 88.9%, respectively.</p><p><strong>Conclusions: </strong>Early perfusion CT findings after ERCP could predict PEP development in high-risk patients.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Acute and Chronic Pancreatitis in Children and Impact of Obesity.","authors":"In Sook Jeong, Yeoun Joo Lee, Soon Chul Kim, Yoo Min Lee, Dae Yong Yi, So Yoon Choi, Ju Young Kim, Eun Hye Lee, Eun Sil Kim, You Jin Choi, Hyun Jin Kim","doi":"10.1097/MPA.0000000000002572","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002572","url":null,"abstract":"<p><strong>Objectives: </strong>In the contest of increasing rates of obesity in children, through this study, we aimed to evaluate the impact of obesity on Asian pediatric acute pancreatitis (AP) and chronic pancreatitis (CP).</p><p><strong>Methods: </strong>The medical records of patients aged<18 years with AP and CP across 11 Korean centers were reviewed retrospectively. To stratify the severity of acute pancreatitis, Ranson score, modified Glasgow score and revised Atlanta severity classification were used. Patients were categorized by body mass index percentile for the analysis. We also evaluated blood parameters to predict severe AP.</p><p><strong>Results: </strong>We enrolled 301 patients (obesity: n= 61; overweight: n=40; normal-weight: n=200) with AP and 19 patients (obesity: n=5; overweight: n=4; normal-weight: n=10) with CP. The rate of moderately severe/severe AP was significantly higher in the obesity group than that in the overweight and normal-weight groups (41.0% vs. 17.5% vs. 4.5%). The obesity group demonstrated a significantly higher incidence of organ failure (16.4% vs. 1.5%) and pancreatic necrosis (41.0% vs. 4.0%) that the normal-weight group. According to multivariate analysis, obesity and overweight were predictors of moderately severe/severe AP. Among the various blood parameters, glucose was found to be most highly correlated with AP severity in receiver operating characteristic analysis. In CP, the mean number of hospital admission was 5.2 times and the times computed tomography was performed was 3. Genetic and imaging abnormalities occurred in 12 (63.2%) and 12 (63.2%) patients, respectively. Exocrine and endocrine pancreatic insufficiencies occurred in two (10.5%) and five (26.3%) patients, respectively.</p><p><strong>Conclusions: </strong>Obesity significantly impacted both length of hospital stay and AP severity in Asian children.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndecan-1 is a Key Mediator of Entosis and Cellular Competition in Pancreatic Cancer.","authors":"Kara Li, Chenyang Li, Shigeaki Umeda, Rajya L Kappagantula, Masakatsu Paku, Yue Zeng, Christine Iacobuzio-Donahue, Wantong Yao","doi":"10.1097/MPA.0000000000002542","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002542","url":null,"abstract":"<p><p>Entosis, a form of cell-in-cell (CIC) structure formation where one cell invades and becomes internalized by another, has long been observed in various malignancies and is considered a critical cellular process in cancer progression, with potential impacts on tumor heterogeneity, survival, and metastasis. Syndecan-1 (SDC1), a transmembrane proteoglycan involved in cell adhesion and communication, plays a pivotal role in these processes, yet its specific function in entosis within pancreatic ductal adenocarcinoma (PDAC) remains underexplored. This study aimed to investigate whether SDC1 facilitates entosis in PDAC cells and to assess its impact on tumor aggressiveness and patient outcomes. Using immunohistochemistry, flow cytometry, and entosis assays, our findings reveal that SDC1 prominently localizes at cell-cell contact points, facilitating stable intercellular adhesion and promoting entotic activity. Knockdown experiments reveal that reduced SDC1 expression significantly diminishes CIC formation, implicating SDC1 as a critical mediator of this process. Analysis of clinical samples revealed that high SDC1 expression correlates with increased entotic activity in PDAC tumors and is associated with decreased patient survival. These results suggest that SDC1-mediated entosis enhances tumor aggressiveness by contributing to cellular competition and heterogeneity. Our study sheds light on the critical role of SDC1 in promoting CIC formation and cancer progression, highlighting its potential as a therapeutic target to disrupt entotic mechanisms in PDAC.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}