Pancreas最新文献

{"title":"Pancrelipase Delayed-Release Capsules Improve Stool Frequency and Consistency in Patients With Exocrine Pancreatic Insufficiency Due to Chronic Pancreatitis or Pancreatic Surgery: Posthoc Analysis of Patient-Reported Daily Symptoms in a Double-Blind Randomized Trial.","authors":"Jodie A Barkin, Jens J Kort, Jamie S Barkin","doi":"10.1097/MPA.0000000000002423","DOIUrl":"10.1097/MPA.0000000000002423","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e278-e280"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Cancer Risk and Screening Outcomes in Li-Fraumeni Syndrome.","authors":"Conrad J Fernandes, Yun K Du, Ann Naumer, Laura A Kagami, Anh Le, Madeline Good, Melani Duvall, Jacquelyn Powers, Kristin Zelley, Luke Maese, Suzanne MacFarland, Wendy Kohlmann, Kara N Maxwell, Bryson W Katona","doi":"10.1097/MPA.0000000000002483","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002483","url":null,"abstract":"<p><strong>Objectives: </strong>Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome that may confer increased pancreatic cancer (PC) risk. This study assesses PC risk and the rate of pancreatic imaging abnormalities in LFS.</p><p><strong>Methods: </strong>PC prevalence in LFS was calculated for individuals with a known TP53 variant from the IARC/NCI database. Pancreatic imaging studies across three institutional LFS cohorts were reviewed and compared using Fisher's Exact test.</p><p><strong>Results: </strong>Of 3043 individuals with LFS in the IARC/NCI database 46 (1.5%) had PC and 42/1243 (3.4%) LFS families had a member with PC. Amongst PCs with a known age of diagnosis, 2.6% and 43.2% were diagnosed prior to age 30 and 50 respectively. Across three institutional LFS cohorts, 32/329 (9.7%) individuals had a pancreatic imaging abnormality, including cysts in 20 (6.1%) and a mass in 4 (1.2%). Whole-body MRI (WBMRI) had the lowest detection rate of pancreatic abnormalities (6%) whereas endoscopic ultrasound (EUS)/MRI Abdomen (MRI Abd) had the highest (50%/20.8%, respectively). Cysts were detected more frequently with EUS/MRI Abd (33.1%/18.1%, respectively) compared to WBMRI (4.3%). Individuals older than age 50 were more likely to have a pancreatic abnormality (35.8% versus 4.7%, P<0.01) or pancreatic cyst (26.4% compared to 2.2%, P<0.001) compared to those younger than age 50.</p><p><strong>Conclusions: </strong>PC may occur earlier in LFS compared to the general population. WBMRI identifies pancreatic abnormalities less frequently than other pancreatic cancer screening modalities in LFS. If dedicated PC screening is performed in LFS, screening should likely start prior to age 50 and use either EUS or MRI Abd.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503070","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":"Differences in the Clinicopathologic and Radiological Characteristics of Patients with Microcystic and Macrocystic Serous Cystadenoma of the Pancreas.","authors":"Xiaozhi Lu, Yuran Dai, Xinchun Liu, Lei Jiang, Kai Zhang, Junli Wu, Wentao Gao, Kuirong Jiang, Cuncai Dai, Yi Miao, Mingna Li, Jishu Wei","doi":"10.1097/MPA.0000000000002436","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002436","url":null,"abstract":"<p><strong>Objectives: </strong>To elucidate the clinicopathological characteristics, imaging features, and surgical outcomes of patients with serous cystic neoplasms (SCNs), and to compare the features between microcystic (MiC) and macrocystic (MaC) SCNs.</p><p><strong>Methods: </strong>In this single-center retrospective study, information of patients with SCN between 2016 and 2022 at our institution was collected and analyzed.</p><p><strong>Results: </strong>A total of 105 patients with SCNs were identified, including 58 (55.2%) with MiC type and 47 (44.8%) with MaC type. Patient age and American Society of Anesthesiologists (ASA) grade in the MiC group were significantly higher than those in the MaC group. The overall preoperative diagnostic accuracy was 7.6%, with no patients in the MaC group correctly diagnosed before surgery. In imaging examinations, almost all (97.1%) exhibited a lobulated pattern. Internal septation, honeycomb pattern, central scar, and calcification were common, with a significantly higher incidence in the MiC group. No in-hospital deaths occurred, and the incidence of major complications were comparable in both groups.</p><p><strong>Conclusions: </strong>Although many patients presented with typical imaging features, accurate diagnosis of SCN remained difficult. Except for older age and higher ASA grade in the MiC group, there were no significant differences in the clinicopathological characteristics between MiC and MaC SCN patients.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503066","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":"Hypophosphatemia as a Predictor of Pancreatic Necrosis in Acute Alcohol Induced Pancreatitis.","authors":"Syed Alishan Nasir, Deep Pandya, Ethan Chambers, Sarah Zubair, Sri Prathima Kanneganti, Reid Hopkins, Rakhee Mangla, Naveen Anand","doi":"10.1097/MPA.0000000000002459","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002459","url":null,"abstract":"<p><strong>Objective: </strong>Pancreatic necrosis is a catastrophic complication of acute pancreatitis and is associated with increased morbidity and mortality. While there is no objective means to predict pancreatic necrosis, recent studies have identified serum phosphate levels as a contributor in the disease process with worse outcomes noted in patients with low serum phosphates. We aimed to determine if there was a relationship between low serum phosphate levels and the risk of developing pancreatic necrosis in patients with acute alcoholic pancreatitis (AAP).</p><p><strong>Methods: </strong>Health care records from patients admitted between January 2017 to December 2022 for acute alcoholic pancreatitis were retrospectively reviewed. These patients were categorized based on their phosphate levels within 48 hours of admission: normal phosphate levels (2.8-4.5 mg/dL) and hypophosphatemia (<2.8 mg/dL). Imaging findings from hospital stays were examined to identify cases of pancreatic necrosis. These cases were then compared across patients with normal and low phosphate levels.</p><p><strong>Results: </strong>Among the 207 patients admitted for acute alcoholic pancreatitis, 67 met the inclusion and exclusion criteria. Of these, 37 patients exhibited serum phosphate levels below 2.8 mg/dL, while 30 maintained levels between 2.8 and 4.5 mg/dL within the first 48 hours of admission. Of the patients in the hypophosphatemia group 27.02% were noted to develop pancreatic necrosis during hospital stay compared to only 6.66% in the normal phosphate group (P-value: 0.029). Additionally, those that developed necrosis had an overall lower mean phosphate level of 2.13 mg/dL compared to the mean phosphate level of 2.60 mg/dL (P-value: 0.0521) in patients without necrosis. The median duration of hospital stay (P-value: 0.65) and rate of intensive care unit (ICU) admission (P-value: 0.41) were similar in both groups.</p><p><strong>Conclusion: </strong>Early hypophosphatemia during admission for AAP was associated with increased risk of developing pancreatic necrosis, however it may not affect overall length of hospital stay or rate of ICU admission.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493055","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":"Protocol and Study Population of a Prospective Study of Patients With Chronic Pancreatitis and Exocrine Pancreatic Insufficiency: Preliminary Findings From the PACT-CP Registry Show Reduced Health-Related Quality of Life.","authors":"Jodie A Barkin, Samer Al-Kaade, Rahul Pannala, Yasmin Hernandez-Barco, Janine Twal, Jennifer Pack, Dianne Nguyen, Valerie J Powell, Cindy Frommer, Carmine D'Urzo, David C Whitcomb","doi":"10.1097/MPA.0000000000002460","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002460","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458786","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":"Underuse of Pancreatic Enzyme Replacement Therapy Among Patients with Gastroenteropancreatic Neuroendocrine Neoplasms and Exocrine Pancreatic Insufficiency.","authors":"Udhayvir S Grewal, Apoorva K Chandar","doi":"10.1097/MPA.0000000000002477","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002477","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649830","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 Exosomal miR-216a Contributes to Acute Pancreatitis-Associated Acute Lung Injury by Enhancing Endothelial cell Vascular Permeability via Downregulating LAMC1.","authors":"Huiyun Zhu, Xianzhu Zhou, Xingcheng Sun, Chunting Fu, Ge Li, Xiaoyang Dong, Xiangyu Kong, Xiaoju Su, Yiqi Du","doi":"10.1097/MPA.0000000000002467","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002467","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is an internal medical emergency disease, with fatal complications including acute lung injury (ALI). Recent studies have highlighted the critical roles of exosomal microRNAs (miRNAs) in AP-ALI. In the present study, we aim to investigate the role of serum exosomal miR-216a in AP-ALI and its underlying mechanisms.</p><p><strong>Methods: </strong>The levels of miR-216a in patients and rat models with AP and AP-ALI were assessed via real-time quantitative PCR (qRT-PCR) analysis. Patient and rat blood exosomes were isolated and co-cultured with HUVECs. The permeability of HUVECs was evaluated via trans-endothelial electrical resistance (TEER) assay. Bioinformatics predicting and luciferase reporter assays were used to identified potential targets of miR-216a. In addition, miR-216a mimic and LAMC1 overexpressed plasmid were constructed to identify the effects of miR-216a/LAMC1 axis on endothelial cell permeability in vitro. Anti-miR-216a and exosomes were used to identify the critical role of exosomal miR-216a in AP-ALI in vivo.</p><p><strong>Results: </strong>The findings indicated that there was a significant upregulation of miR-216a in AP-ALI patients and rat models. The occurrence of ALI during AP progression promoted the expression of serum exosomal miR-216a. Exosomal could promote HUVECs permeability by releasing miR-216a. For target studies, miR-216a was found to bind to LAMC1 to regulate its transcription level. MiR-216a-mediated downregulation of LAMC1 lead to increased permeability of HUVECs. Exosome-derived miR-216a has also been proved to promote lung damage in AP-ALI rats.</p><p><strong>Conclusions: </strong>In summary, serum exosomal miR-216a can promote the onset and progression of AP-ALI by augmenting endothelial cell vascular permeability. This finding presents a theoretical basis for exploring new therapeutic approaches targeting AP-ALI.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409563","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 Malformation and Heterotaxy Syndrome Associated With 6q25.1 Haploinsufficiency.","authors":"Berta Sufrate-Vergara, Carla Martín Grau, Laia Pedrola Vidal, Purificación Marín-Reina, María Jesús Esteban Ríos, Raquel Rodríguez-López","doi":"10.1097/MPA.0000000000002473","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002473","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408471","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 Predictive Value of Red Cell Distribution Width for the Risk of Sepsis in Patients with Acute Pancreatitis: A Retrospective Cohort Study.","authors":"Chao Yang, Haijun Cao, Shanshan Chen, Cheng Ye, Zemin Feng, Haochen Zhang, Li Xu","doi":"10.1097/MPA.0000000000002475","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002475","url":null,"abstract":"<p><strong>Objectives: </strong>This study was to evaluate the association between red cell distribution width (RDW) and sepsis in acute pancreatitis (AP) patients, and assess its predictive value for sepsis in AP patients.</p><p><strong>Methods: </strong>This retrospective cohort study collected patients' data from the Medical Information Mart for Intensive Care databases. Univariate and multivariate Cox models were exploited to compare the mortality within 30 days in AP patients with or without sepsis, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. Univariate and multivariate logistic regression analyses were conducted to estimate the association, with odds ratios (ORs) and 95%CIs calculated. The predictive value of RDW, white blood cell (WBC) sequential organ failure assessment (SOFA), SOFA+RDW, simplified acute physiology score II (SAPSII), SAPSII+RDW, bedside index of severity in acute pancreatitis (BISAP), BISAP+RDW for sepsis risk in patients with AP were evaluated by receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>A total of 327 AP patients developed sepsis. The high RDW level was linked to a higher sepsis risk in patients with AP, carrying a (95% CI) of 1.10. Delong test showed that the area under the curve (AUC) of SOFA+RDW, SAPSII+RDW and BISAP+RDW scoring models were significantly greater than those of SOFA, SAPSII and BISAP scoring models, respectively (0.822 vs 0.776; 0.708 vs 0.688; 0.609 vs 0.550, respectively).</p><p><strong>Conclusion: </strong>RDW is not only linked to sepsis risk, but also has a certain additive effect on SOFA, SAPSII and BISAP models, among which SOFA+RDW has the highest discrimination capacity for sepsis in AP patients.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409525","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":"Usefulness of MRI T1 Mapping in Predicting Postoperative Pancreatic Fistula After Distal Pancreatectomy.","authors":"Noriyuki Kitagawa, Akira Shimizu, Akira Yamada, Koji Kubota, Tsuyoshi Notake, Hitoshi Masuo, Shiori Yamazaki, Shohei Hirano, Yoshiharu Yokokawa, Yuji Soejima","doi":"10.1097/MPA.0000000000002471","DOIUrl":"https://doi.org/10.1097/MPA.0000000000002471","url":null,"abstract":"<p><strong>Objectives: </strong>Postoperative pancreatic fistula (POPF) is the most significant and potentially lethal complication of pancreatectomy. This study evaluated the association between MRI pancreatic T1 mapping and POPF and developed a new, useful, and noninvasive predictor of distal pancreatectomy (DP).</p><p><strong>Methods: </strong>The study included 39 patients who underwent preoperative MRI T1 mapping using the Modified Look-Locker Inversion Recovery Sequence (MOLLI) followed by DP between January 2018 and July 2024. Patients with (POPF (+), n=15) and those without POPF (POPF (-), n=24) were compared for their characteristics, perioperative outcomes, and parameters derived from MRI. The circular region of interest was positioned on the pancreatic head, ventral side of the portal vein, and transection site to measure the T1 mapping value. The data were analyzed using R1 values (R1=1/T1), and the cut-off values were calculated using the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The R1 value of the pancreatic transection site in the POPF (+) group was significantly higher than that in the POPF (-) group (1.180 vs. 1.066 sec-1; P<0.001). The R1 value of the pancreatic transection site was an independent risk factor for grade B/C POPF (odds ratio, 5.01; P=0.005). To predict POPF, a cutoff R1 value of 1.116 sec-1 at the transection site was obtained by maximizing the Youden index.</p><p><strong>Conclusions: </strong>High R1 values at the pancreatic transection site indicate a higher possibility of developing grade B/C POPF. Preoperative MRI T1 mapping may be valuable for predicting POPF after DP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409668","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}