Pancreas最新文献

{"title":"N-acetyltransferase 10 Promotes Pancreatic Cancer Progression Through ZEB1/MT1-MMP Axis.","authors":"Fangxia Wang, Yumeng Hu, Shaobo Zhang, Yuxin Ye, Haoran Qi, Yan Xu, Hui Zhang, Mingyang Liu","doi":"10.1097/MPA.0000000000002492","DOIUrl":"10.1097/MPA.0000000000002492","url":null,"abstract":"<p><strong>Objectives: </strong>To elucidate the role of N-acetyltransferase 10 (NAT10) in pancreatic cancer (PC) progression and its epigenetic mechanisms, particularly in relation to metastasis.</p><p><strong>Methods: </strong>TCGA and GTEx databases were used to analyze the expression and roles of NAT10 in pancreatic cancer. We constructed stable cell lines with NAT10 knockdown in PC cell lines, AsPC-1 and KPC. CCK-8, EdU assay, and colony formation assay were conducted to evaluate the capability of cell proliferation and clonogenesis in vitro. Meanwhile, a transwell assay was performed to assess the impact on invasion and metastasis abilities. The correlation between NAT10 and ZEB1 expression was verified by correlation analysis. The underlying mechanisms through which NAT10 regulates ZEB1 were confirmed by qPCR, western blot, RIP-qPCR, dot plot, and mRNA stability assay. Furthermore, the interplay among NAT10, ZEB1, and MT1-MMP was confirmed using similar experimental approaches. Rescue experiments involving ZEB1 overexpression further verified the role of NAT10/ZEB1/MT1-MMP axis in PC metastasis. In addition, the NAT10 inhibitor Remodelin was employed in a nude orthotopic PC model to investigate its effects on metastasis in vivo.</p><p><strong>Results: </strong>NAT10 was found to be upregulated in PC and was significantly associated with poor prognosis. After NAT10 knockdown, the ability of proliferation and metastasis of AsPC-1 and KPC was remarkably impaired, the degree of ac4C modification was decreased, and the mRNA stability of ZEB1 declined. Correlation analysis indicated a positive correlation among NAT10, ZEB1, and MT1-MMP, and the results of qPCR and western blot also verified this conclusion. Moreover, ZEB1 overexpression could significantly reverse the inhibition of migration and invasion induced by NAT10 depletion in AsPC-1. NAT10 inhibitor Remodelin treatment could reduce the degree of peritoneal and liver metastases in vivo.</p><p><strong>Conclusions: </strong>Our study highlights the pivotal functions of NAT10 in the progression of PC and reveals the underlying epigenetic mechanism that NAT10 promotes metastasis via ZEB1/MT1-MMP axis.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":"54 8","pages":"e674-e683"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883396","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":"Serum 25-Hydroxyvitamin D and Vitamin D Receptor Genetic Polymorphisms are Associated With Prognosis of Acute Pancreatitis.","authors":"Yu Liu, Yangxi Chen, Lei Guo, Chen Yang, Haiyang Jiang, Xiang Yang, Zhihui Tong, Xinghu Zhang, Fang Huang, Lei Lv, Wenhui Wan","doi":"10.1097/MPA.0000000000002496","DOIUrl":"10.1097/MPA.0000000000002496","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the relationship between serum 25-Hydroxyvitamin D [25(OH)D] levels, vitamin D receptor (VDR) gene polymorphisms, and the prognosis of acute pancreatitis (AP).</p><p><strong>Methods: </strong>This prospective observation study included patients with AP admitted to the Jinling Hospital between January 2018 and December 2019. Clinical information, laboratory tests, and single-nucleotide polymorphisms (SNPs) of the VDR gene were collected.</p><p><strong>Results: </strong>A total of 508 AP patients were included, with a mean age of 44.81 ± 13.80 years. Among them, 158 (31.10%) cases developed sepsis, 211 (41.54%) cases had serious AP, and 47 (9.25%) patients died before discharge. The multivariate regression analysis showed that VD deficiency was an independent risk factor for the occurrence of sepsis (OR=3.768, 95% CI: 2.368-5.997, P <0.001), progression of AP patients to serious AP (OR=4.297, 95% CI: 2.806-6.582, P <0.001), and in-hospital mortality in AP patients (OR=2.406, 95% CI: 1.162-4.984, P =0.018). SNPs of VDR associated with sepsis, serious AP, or in-hospital death were identified, including rs12721375, rs2853559, rs11168287, rs2853559, and rs11168283 (all P <0.05). The Generalized Multifactor Dimensionality Reduction model analysis revealed that a 4-order model (rs11168283, rs11168287, rs2853559, and 25(OH)D) was the best model for predicting death ( P <0.01).</p><p><strong>Conclusions: </strong>VD deficiency and VDR genetic polymorphisms are associated with AP prognosis in Chinese Han patients with AP. VDR genetic polymorphism may influence the outcomes of AP patients by affecting the levels of inflammatory cytokines.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e698-e704"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019258","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":"Endoscopic and Surgical Treatments for Painful Chronic Pancreatitis: A Scoping Review of Pain Assessment Tools and Meta-analysis of Outcomes.","authors":"Mahya Faghih, Mitchell L Ramsey, Misbah Unnisa, Anna E Phillips, Katie Lobner, Samuel Han, Phil A Hart, Elham Afghani, Benjamin L Bick, Dhiraj Yadav, John A Windsor, Søren S Olesen, Vikesh K Singh, Asbjørn M Drewes","doi":"10.1097/MPA.0000000000002495","DOIUrl":"10.1097/MPA.0000000000002495","url":null,"abstract":"<p><strong>Objective: </strong>Managing painful chronic pancreatitis (CP) often involves invasive treatments, but success rates are variable. We aimed to describe the pain assessment tools used to measure the efficacy of endotherapy and surgery for painful CP and perform a meta-analysis of outcomes.</p><p><strong>Design: </strong>PubMed, Embase, and Scopus databases were searched for published studies through April 1, 2023. Full papers in English that assessed pain outcomes among adults with painful CP undergoing invasive interventions were included.</p><p><strong>Results: </strong>There were 413 out of 1,282 studies that underwent full-text review, and 279 studies were selected for the scoping review. Most commonly used pain assessment tools included symptom description (n=68 studies), numeric pain rating scales (NRS) or visual analog scales (VAS) (n=52), binary pain relief (yes or no) (n=27), and the pancreatitis-specific 4-item Izbicki score (n=28). In a meta-analysis of studies reporting preintervention and postintervention NRS or VAS (0-100), the mean decrease in pain after endoscopic intervention (n=9 studies) was 40.3 (95% CI: 27-53.6, P <0.001) and after surgical intervention (n=12 studies) it was 43.2 (95% CI: 31.5-54.9, P <0.001). A separate meta-analysis of studies reporting the preintervention and postintervention Izbicki score (n=5) showed similar findings. There was no difference in the change in pain scores between endotherapy and surgical cohorts in studies using NRS/VAS or Izbicki scores.</p><p><strong>Conclusions: </strong>Pain outcomes were similar between endotherapy and surgery for painful CP based on the use of simple and highly variable pain assessment tools. Referral bias and sham effects need to be considered in future trials.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e684-e693"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064325","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":"Development and Validation of the Comprehensive Acute Pancreatitis Pain Core Outcome Set (CAPPOS): Study Protocol.","authors":"Louise Kuhlmann, Esther M Pogatzki-Zahn, Nejo Joseph, James Lucocq, Jana Aulenkamp, Cecilie Siggaard Knoph, Søren S Olesen, John A Windsor, Asbjørn M Drewes, Sanjay Pandanaboyana","doi":"10.1097/MPA.0000000000002488","DOIUrl":"10.1097/MPA.0000000000002488","url":null,"abstract":"<p><strong>Introduction: </strong>Acute pancreatitis (AP) is a leading cause of gastrointestinal hospitalizations worldwide, with rising incidence, significant morbidity, and high healthcare costs. Pain, a hallmark symptom of AP, remains inadequately assessed, often relying on unidimensional scales such as visual analogue score, which fail to capture its multidimensional nature. Poorly managed acute pain negatively impacts clinical outcomes, prolongs recovery, and increases the risk of chronic pain syndromes. Comprehensive pain assessment tools specific to AP are lacking, highlighting the need for improved evaluation methods. The proposed study aims to develop and validate the Comprehensive Acute Pancreatitis Pain Outcome Set (CAPPOS) to address this evidence gap.</p><p><strong>Methods: </strong>The CAPPOS initiative follows COMET and COSMIN guidelines. Three systematic reviews will identify pain domains and assessment methods in AP, acute abdominal pain, and postpancreatectomy pain. A consensus process, using a modified Delphi approach, will involve multidisciplinary experts and patients to confirm and define key domains. Measurement tools will be selected for each domain and refined through iterative feedback. Pilot testing with 50 patients will evaluate the feasibility, clarity, and responsiveness to change of the preliminary tool. Validation studies with 200 AP patients will assess structural, content, and criterion validity, reliability, and sensitivity to change, ensuring content validity and clinical utility.</p><p><strong>Conclusion: </strong>CAPPOS will provide a validated, multidimensional core outcome set to optimize pain assessment in AP. It will also facilitate standardized reporting in clinical trials, advancing research and care for AP-related pain.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e661-e666"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657893","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":"Abdominal Pain Following Total Pancreatectomy With Islet Autotransplantation.","authors":"Julia Harrison, Mohamed A Shaaban, Emily Scheidecker, Karthik Ramanathan, Martin Freeman, Guru Trikudanathan, David Martin, Srinath Chinnakotla, Elissa M Downs, Sarah Jane Schwarzenberg, Melena D Bellin, Greg Beilman","doi":"10.1097/MPA.0000000000002510","DOIUrl":"10.1097/MPA.0000000000002510","url":null,"abstract":"<p><strong>Objective: </strong>Total pancreatectomy with islet autotransplantation (TPIAT) is increasingly used as an option for the treatment of chronic and recurrent acute pancreatitis in selected patients. Studies have shown significant improvements in pain, quality of life, and opioid use postoperatively. However, in long-term follow-up, over half of the patients have episodes of abdominal pain following TPIAT. The aim of this work is to describe the array of causes of abdominal pain in this complex and growing patient population.</p><p><strong>Methods: </strong>We conducted multidisciplinary discussions with experts at our institution and reviewed literature, where available, to identify and describe the diverse causes of abdominal pain following TPIAT.</p><p><strong>Results: </strong>We identify 15 distinct causes of abdominal pain following TPIAT, describing their presentation, workup, and management.</p><p><strong>Conclusion: </strong>As more patients undergo TPIAT, we must plan for and address the associated causes of abdominal pain that result from alterations in anatomy and physiology, both in the short and long term.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e719-e727"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031304","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":"Proteomic Characterization Reveals CYP2S1 as a Mediator of Drug Resistance in PDAC.","authors":"Vera Thiel, Wiebke M Nadler, Alexander Kerner, Laura Kuhlmann, Manuel Reitberger, Tim Vorberg, Paul Schwerd-Kleine, Elisa Noll, Nathalia A Giese, Hsi-Yu Yen, Katja Steiger, Vanessa Vogel, Corinna Klein, Thilo Hackert, Ronald Koschny, Christiane A Opitz, Andreas Trumpp, Martin R Sprick, Christoph Rösli","doi":"10.1097/MPA.0000000000002553","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002553","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the proteomic profile of different molecular subtypes of pancreatic ductal adenocarcinoma (PDAC) and understand their impact on patient outcomes, particularly focusing on pathways involved in xenobiotic metabolism and drug resistance.</p><p><strong>Methods: </strong>The study utilized the serum-free PACO cell culture model and a quantitative prefractionation-based MALDI/MS approach to establish the proteomic profiles of various PDAC subtypes. Differential protein regulation was analyzed to identify systematic alterations in metabolic and drug resistance pathways. Mechanistic studies involved the knockdown and overexpression of key proteins to assess their role in drug resistance.</p><p><strong>Results: </strong>Proteomic analysis revealed subtype-specific alterations, particularly in pathways associated with xenobiotic metabolism and drug resistance. Notably, CYP2S1, a member of the CYP450 family, was upregulated in the HNF1A+ PDAC subtype. CYP2S1 levels were further inducible by polyaromatic hydrocarbons (PAHs) and SN38, the active metabolite of irinotecan via AHR. Mechanistic studies demonstrated that knockdown of AHR or CYP2S1 sensitized PDAC cells to SN38, whereas overexpression of CYP2S1 increased resistance to SN38.</p><p><strong>Conclusions: </strong>The findings highlight the significant role of CYP2S1 in mediating drug resistance in certain PDAC subtypes. Targeting CYP2S1 and its regulatory pathways could enhance the efficacy of chemotherapeutic agents like irinotecan in treating PDAC. These results provide new insights into the molecular mechanisms underlying PDAC subtype-specific drug resistance and suggest potential therapeutic targets.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150372","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":"Alteration of Apolipoprotein A2 Isoforms is Associated with the Progression of Chronic Pancreatitis.","authors":"Toshiaki Abe, Ryotaro Matsumoto, Shin Hamada, Tetsuya Takikawa, Kazuhiro Kikuta, Hidehiro Hayashi, Takanori Sano, Yu Tanaka, Fumiya Kataoka, Misako Sakano, Tomoo Manaka, Yasumasa Sekino, Yuichi Tanaka, Takayuki Masuo, Hitomi Nakasuji, Yan Xu, Ren Jie, Shin Miura, Kiyoshi Kume, Michiaki Unno, Atsushi Masamune","doi":"10.1097/MPA.0000000000002559","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002559","url":null,"abstract":"<p><strong>Objectives: </strong>Alteration in plasma apolipoprotein A2 isoforms (apoA2-i) has been reported in patients with pancreatic cancer; however, data on apoA2-i in chronic pancreatitis (CP) remain limited. This study aimed to clarify the alteration in apoA2-i in patients with CP, focusing on its association with disease progression.</p><p><strong>Methods: </strong>A total of 165 patients with CP (27 early-stage, 40 compensated-stage, 61 transitional-stage, and 37 decompensated-stage) were enrolled. Plasma concentrations of apoA2-AT and apoA2-ATQ isoforms were measured. The apoA2-i index was calculated as √(ATQ×AT), and an index <59.5 µg/mL was considered positive. ApoA2 processing type was classified as hyper-processing (AT>ATQ) or hypo-processing (AT<ATQ). We assessed the association of the apoA2-i index and apoA2 processing type with clinical characteristics and imaging findings.</p><p><strong>Results: </strong>The apoA2-i index was positive in 86 patients (52.1%), including 33 (38.4%) with the hyper-processing type and 53 (61.6%) with the hypo-processing type. As CP progressed, the proportion of patients with a positive apoA2-i index increased, and the processing type shifted from hyper-processing to hypo-processing. Patients with a positive apoA2-i index had longer disease duration, more advanced disease stages, higher Controlling Nutritional Status scores, and lower serum lipase levels, suggesting worse nutritional status and impaired pancreatic exocrine function. On CT, these patients exhibited thinner pancreatic parenchyma and greater main pancreatic duct dilation.</p><p><strong>Conclusions: </strong>A positive apoA2-i index was associated with CP progression. Further studies are warranted to determine whether it could serve as a surrogate marker for pancreatic exocrine dysfunction.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964124","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 and Peripancreatic Neural-Crest Derived Tumors: An Updated Contemporary Single Center Experience.","authors":"Feras Shamoun, Elie M Ghabi, Elizabeth D Thompson, John L Cameron, Christopher R Shubert, Kelly J Lafaro, Richard A Burkhart, William R Burns, Jin He","doi":"10.1097/MPA.0000000000002556","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002556","url":null,"abstract":"<p><strong>Introduction: </strong>Schwannomas, paragangliomas, and gangliocytic paragangliomas are rare tumors of the pancreas and peripancreas. Diagnosis and management of these tumors remain challenging.</p><p><strong>Methods: </strong>A retrospective review was conducted at a single institution. Nineteen cases were identified from 1990 to 2022. Descriptive statistics summarized the demographic, clinicopathologic, and long-term outcome data.</p><p><strong>Results: </strong>Schwannomas were encountered within the pancreatic parenchyma, whereas half of the paragangliomas were intraparenchymal and the other half were in the peripancreatic connective tissue. Symptoms varied and occurred in half of the patients encountered. Imaging characteristics were nonspecific. When obtained, EUS-FNA (n=16) and nuclear imaging (n=3) assisted with making a preoperative diagnosis. Intraparenchymal tumors were predominantly managed with a pancreatectomy (n=12) while tumors in the peripancreatic connective tissue were managed with tumor resection without a pancreatectomy (n=4). The median follow-up for Schwannomas and gangliocytic paragangliomas was 66.8 and 13.6 months, respectively, during which time zero recurrences occurred. Paraganglioma patients had a median follow-up of 21.4 months, and tumor recurrence was encountered in 50% of patients.</p><p><strong>Conclusion: </strong>Schwannomas and gangliocytic paragangliomas are benign tumors. Paragangliomas have malignant potential and should be managed with an oncologic resection. Accurate preoperative diagnosis using EUS-FNA and nuclear imaging is crucial for recommending the appropriate surgical intervention and minimizing surgical morbidity.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964070","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":"Comment on: \"The Significant Impact of Fibrinogen-C-Reactive Protein--Albumin Ratio on the Long-Term Outcomes After Pancreatic Resection for Pancreatic Cancer\".","authors":"Limei Yuan, Chong Zhang","doi":"10.1097/MPA.0000000000002557","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002557","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859521","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":"Stroke in Patients with Unresectable Pancreatic Cancer Undergoing Chemotherapy: Clinical Characteristics and Risk Assessment.","authors":"Ayako Hata, Masayuki Ueno, Hidenobu Hata, Yuki Ikeda, Yosuke Uenishi, Ayako Togawa, Toshifumi Mano, Takafumi Kanadani, Yuki Ishihara, Toshikazu Moriwaki, Etsuji Ishida, Yutaka Akimoto, Hirokazu Mouri, Motowo Mizuno","doi":"10.1097/MPA.0000000000002555","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002555","url":null,"abstract":"<p><strong>Objectives: </strong>Ischemic stroke is one of the most serious complications in pancreatic cancer patients. In this study, we examined the clinical characteristics and risk factors for stroke in patients with unresectable pancreatic cancer receiving chemotherapy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 343 consecutive patients with recurrent or unresectable pancreatic cancer with chemotherapy started between April 2017 and December 2022. We investigated the clinical characteristics of stroke and risk factors for stroke within 180 days after starting chemotherapy and during the entire follow-up period.</p><p><strong>Results: </strong>Stroke occurred in 11 patients (3.2%) within the first 180 days. Although five patients were treated with anticoagulants and/or mechanical thrombectomy, only two patients were able to continue chemotherapy after the stroke. The median survival time after stroke was 28 days. Elevated D-dimer (≥2.9 μg/mL) and CA19-9 (≥1621 U/mL) values at the start of chemotherapy were significant independent risk factors for stroke within 180 days. The combined score calculated with these two factors stratified the stroke risk within 180 days and during the entire follow-up period of a median of 11.3 months and as long as 58.7 months.</p><p><strong>Conclusions: </strong>Stroke within 180 days occurred in 3.2% of patients and was commonly associated with discontinuation of chemotherapy and short survival. The combined score calculated with D-dimer and CA 19-9 levels predicted the stroke risk in pancreatic cancer patients receiving chemotherapy.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859522","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}