Pancreatology最新文献

{"title":"Perilesional branch duct dilation as a hallmark MRCP feature for differentiating high-grade PanIN from low-grade PanIN","authors":"Kentaro Yamao ,&nbsp;Yasuo Takehara ,&nbsp;Hiroshi Ogawa ,&nbsp;Jun Nakahodo ,&nbsp;Ryuki Minami ,&nbsp;Ryota Sagami ,&nbsp;Hidefumi Nishikiori ,&nbsp;Muneyori Okita ,&nbsp;Hidekazu Takahashi ,&nbsp;Yoshihisa Takada ,&nbsp;Kota Uetsuki ,&nbsp;Tadashi Iida ,&nbsp;Yasuyuki Mizutani ,&nbsp;Takuya Ishikawa ,&nbsp;Hiroki Kawashima","doi":"10.1016/j.pan.2025.06.003","DOIUrl":"10.1016/j.pan.2025.06.003","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Pancreatic cancer (PC) is frequently diagnosed at an advanced stage with a poor prognosis. Early detection of high-grade pancreatic intraepithelial neoplasia (HG-PanIN), a stage 0 lesion, has the potential to significantly improve patient outcomes. This study aimed to identify specific imaging findings on magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance imaging (MRI) that distinguish HG-PanIN from low-grade PanIN (LG-PanIN).</div></div><div><h3>Methods</h3><div>This multicenter retrospective study included 57 patients with pathologically confirmed PanIN (41 HG-PanIN, 16 LG-PanIN). MRCP and MRI images were independently reviewed by two experienced abdominal radiologists. Sensitivity, specificity, diagnostic accuracy, and interobserver agreement (kappa (κ) coefficient) were calculated. Multivariate logistic regression analysis identified independent predictors of HG-PanIN.</div></div><div><h3>Results</h3><div>On MRCP, perilesional branch pancreatic duct (BPD) dilation emerged as a promising imaging marker for distinguishing HG-PanIN, alongside substantial interobserver agreement (κ = 0.64). Pancreatic parenchymal atrophy (PPA) also exhibited diagnostic potential but were limited by lower reproducibility (κ = 0.23). Multivariate analysis identified both perilesional BPD dilation (OR 24.62; 95 % CI 2.66–227.86; p &lt; 0.01) and PPA (OR 37.21; 95 % CI 3.97–348.92; p &lt; 0.01) as independent predictors of HG-PanIN. In subgroup analyses, combining BPD dilation with PPA significantly enhanced specificity for early lesion detection.</div></div><div><h3>Conclusions</h3><div>Perilesional BPD dilation on MRCP is a primary imaging feature for differentiating HG-PanIN, characterized by substantial interobserver agreement. While PPA on MRI is another important independent predictor, its lower interobserver agreement warrants caution. These findings highlight the diagnostic value of utilizing both MRCP and MRI in the noninvasive evaluation of suspected PanIN.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 676-684"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic parenchymal volume measurement for predicting invasive intraductal papillary mucinous neoplasm","authors":"Tetsuhisa Ko ,&nbsp;Takeshi Tanaka ,&nbsp;Atsuhiro Masuda ,&nbsp;Keitaro Sofue ,&nbsp;Hirochika Toyama ,&nbsp;Arata Sakai ,&nbsp;Takashi Kobayashi ,&nbsp;Masahiro Tsujimae ,&nbsp;Masanori Gonda ,&nbsp;Noriko Inomata ,&nbsp;Hisahiro Uemura ,&nbsp;Shinya Kohashi ,&nbsp;Kae Nagao ,&nbsp;Yoshiyuki Harada ,&nbsp;Mika Miki ,&nbsp;Yosuke Irie ,&nbsp;Noriko Juri ,&nbsp;Yuki Oka ,&nbsp;Yusuke Yokotani ,&nbsp;Akira Shirohata ,&nbsp;Yuzo Kodama","doi":"10.1016/j.pan.2025.05.010","DOIUrl":"10.1016/j.pan.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Surgical resection is strongly recommended for intraductal papillary mucinous neoplasm<span> (IPMN) cases with high-risk stigmata (HRS). However, it is challenging to make this decision for elderly patients or those with multiple comorbidities. In such cases, it may be more appropriate to consider surgery for IPMN with higher malignancy potential, such as invasive IPMN. In this study, we investigated the significance of pancreatic parenchymal volume (PV) measurement in predicting invasive IPMN.</span></div></div><div><h3>Methods</h3><div>We retrospectively utilized a database comprising 162 consecutive resected IPMN cases between January 2000 and December 2018. PV, delineated through contrast-enhanced computed tomography scans, was quantified using Ziostation2 software and stratified into high and low categories based on the median value.</div></div><div><h3>Results</h3><div>The median PV was 36.40 cm³, ranging from 5.07 cm³ to 87.69 cm³. Low PV significantly correlated with invasive IPMN (multivariable odds ratio, 2.63; 95 % confidence interval, 1.22–5.68; <em>P</em><span> = 0.01). The specificity and accuracy of HRS for classifying invasive IPMN increased with the addition of PV measurement (specificity; HRS to HRS and low PV: 32.2 % [38/118] to 71.2 % [84/118], accuracy; HRS to HRS and low PV: 43.9 % [74/162] to 67.9 % [110/162]). Additionally, a significant decline in PV over time was observed in cases of invasive IPMN compared to those with low-grade and high-grade dysplasia (9.09 cm</span>³/year vs. 2.79 cm³/year, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Quantifying PV, particularly when combined with HRS, may improve diagnostic accuracy for invasive IPMN. Furthermore, changes in PV observed during surveillance may provide additional insight into the risk of progression to invasive IPMN.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 667-675"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uric acid and related disorders in the risk of pancreatic diseases: A UK Biobank prospective study","authors":"Yingluo Wang ,&nbsp;Junzhe Su ,&nbsp;Xin Liu ,&nbsp;Hui Song ,&nbsp;Zimin Liu ,&nbsp;He Ren ,&nbsp;Xiao Hu ,&nbsp;Guotao Lu ,&nbsp;Ying Chen ,&nbsp;Qian Yu","doi":"10.1016/j.pan.2025.06.012","DOIUrl":"10.1016/j.pan.2025.06.012","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Pancreatic diseases<span>, such as acute pancreatitis<span> (AP), chronic pancreatitis (CP), and </span></span></span>pancreatic cancer<span> (PC) present major clinical challenges with significant health impacts. Serum uric acid<span> (SUA), resulting from purine metabolism, is a significant biomarker reflecting metabolic health. Defined as SUA &gt;7.0 mg/dL, </span></span></span>hyperuricemia<span><span> (HUA) is associated with gout, renal dysfunction, and increased cardiometabolic risk. SUA triggers inflammation and </span>oxidative stress<span>, contributing to pancreatic damage and cancer pathogenesis. This study represents the first European cohort linking uric acid (UA) disorders to pancreatic disease risk.</span></span></div></div><div><h3>Method</h3><div>This prospective cohort study<span> analyzed 363,778 UK Biobank<span> participants over a median follow-up of 14.2 years, identifying 1951 AP, 474 CP, and 2107 PC cases. We analyzed the association between UA disorders and pancreatitis risk using Cox regression, reporting hazard ratios (HR) with 95 % confidence intervals (CI). Cox models evaluated SUA disorders' links to pancreatic diseases (AP, CP, PC), with full adjustment. Both categorical and continuous variables were employed in the Cox analysis, while categorical variables were utilized for the Kaplan-Meier (KM) curves.</span></span></div></div><div><h3>Result</h3><div>For each 1 mg/dL increase in SUA, the risk of AP was significantly increased: HR = 1.062 (95 % CI: 1.020–1.105; P = 0.0036) in the overall population; HR = 1.164 (95 % CI: 1.019–1.330; P = 0.0254) in individuals with HUA; and HR = 1.478 (95 % CI: 1.361–2.913; P = 0.0005) in individuals with gout. Findings were robust in subgroup analyses and after excluding pancreatic disease cases within 2 years of HUA and gout diagnosis.</div></div><div><h3>Conclusion</h3><div>Our study clarifies the role of SUA in pancreatic health and identifies that individuals with HUA or gout may benefit from pancreatic disease screening.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 631-640"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-wide discovery of enhancer – promoter interactions in the human pancreas using an improved Activity-By-Contact-based model","authors":"Andreas W. Schmidt ,&nbsp;German Demidov ,&nbsp;Ferdinand Krannich ,&nbsp;Matthias Heinig ,&nbsp;Stephan Ossowski ,&nbsp;Heiko Witt ,&nbsp;Jonas Rosendahl ,&nbsp;Helmut Laumen","doi":"10.1016/j.pan.2025.06.001","DOIUrl":"10.1016/j.pan.2025.06.001","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Enhancers are key drivers of tissue-specific gene expression and can contain variants associated with pancreatic diseases. Enhancer-target gene assignment remains challenging, with the Activity-By-Contact (ABC) model, integrating open-chromatin, histone modification and chromatin interaction data, consistently outperforming other approaches. Recently an advanced version, the generalized ABC (gABC) model was published, yet lacking a clear and unique promoter definition impairing interpretability. In pancreas the model has not yet been evaluated.</div></div><div><h3>Methods</h3><div><span>We applied both basal ABC and gABC to map gene-regulatory regions to their respective candidate target genes in pancreas datasets. Next, to balance high gABC performance and ABC interpretability, we implemented the novel canonical-transcript-based and adapted ABC (caABC) model using ENSEMBL canonical transcripts. We compared the performance of all three approaches to predict gene-regulatory regions overlapping with fine-mapped pancreatic expression quantitative trait loci (eQTLs) from GTEx (V8). At the eQTL-colocalized and fine-mapped chronic pancreatitis risk locus </span><em>CTRC</em> we exemplarily evaluated predicted enhancer-promoter interactions. Finally, we provide a genome-wide unified caABC dataset of pancreatic enhancers and regulated genes.</div></div><div><h3>Results</h3><div>We demonstrate significantly improved performance of both gABC and caABC compared to ABC in the pancreas, with slightly better performance of gABC at the cost of impaired interpretability compared to caABC. At the chronic pancreatitis risk locus <em>CTRC,</em> caABC enhancer predictions separate fine-mapped risk-variants from high-LD non-fine-mapped variants.</div></div><div><h3>Conclusions</h3><div>We provide a genome-wide set of pancreas-specific enhancer regions and respective target genes. Our dataset will be helpful for the prioritization of regulatory disease-causing mutations in pancreatic tissue.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 718-727"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of post-neoadjuvant CA19-9 values in pancreatic cancer: more pronounced following neoadjuvant chemotherapy compared to neoadjuvant chemoradiotherapy","authors":"Satoru Miyahara,&nbsp;Hidenori Takahashi,&nbsp;Yoshito Tomimaru,&nbsp;Shogo Kobayashi,&nbsp;Kazuki Sasaki,&nbsp;Daisaku Yamada,&nbsp;Hirofumi Akita,&nbsp;Takehiro Noda,&nbsp;Yuichiro Doki,&nbsp;Hidetoshi Eguchi","doi":"10.1016/j.pan.2025.06.016","DOIUrl":"10.1016/j.pan.2025.06.016","url":null,"abstract":"<div><h3>Background/objectives</h3><div><span><span><span>Neoadjuvant treatment (NAT), including chemotherapy (NAC) and </span>chemoradiation therapy (NACRT), is a promising approach to treat </span>pancreatic cancer<span> (PC). Alterations in serum carbohydrate antigen 19-9 (CA19-9) following NAT have been studied as outcome indicators. The impact of adding radiation therapy (RT) to NAT on the prognostic significance of changes in CA19-9 is unclear. This study compares changes in CA19-9 levels following NAC vs. </span></span>NACRT with regard to prognosis.</div></div><div><h3>Methods</h3><div>Patients with resectable or borderline resectable PC who underwent curative resection after either NAC or NACRT were enrolled. A cutoff value of 100 U/mL for post-NAT CA19-9 was established, and its association with prognosis was investigated in both the NAC and NACRT groups.</div></div><div><h3>Results</h3><div>No significant difference was observed in survival between the NAC and NACRT groups. While both groups showed clear stratification according to the CA19-9 cutoff for overall survival<span> and disease-free survival, a significant difference in survival after recurrence (SAR) was observed only in the NAC group. Among patients with post-NAT CA19-9 levels &lt;100 U/mL, the NAC group had a significantly higher 2-year survival rate and more favorable SAR than did the NACRT group. Conversely, among patients with values above the cutoff, no significant prognostic differences were observed between the two groups.</span></div></div><div><h3>Conclusions</h3><div>The prognostic significance of post-NACRT CA19-9 values is suboptimal compared to post-NAC CA19-9 values.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 728-735"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of and factors influencing the progression from acute to recurrent acute to chronic pancreatitis","authors":"Ji Young Park ,&nbsp;Seungmin Bang ,&nbsp;Tae Joo Jeon ,&nbsp;Jae Hee Cho ,&nbsp;Kyong Joo Lee","doi":"10.1016/j.pan.2025.04.004","DOIUrl":"10.1016/j.pan.2025.04.004","url":null,"abstract":"<div><h3>Objectives &amp; Aims</h3><div><span><span>Acute pancreatitis (AP) recurrence rates range from 11 to 36 % yet accurately predicting recurrent acute pancreatitis (RAP) and its progression to </span>chronic pancreatitis (CP) after an initial episode remains challenging. Thus, this study explored the </span>risk factors contributing to RAP and its progression to CP.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with AP from three tertiary medical centers between January 2010 and December 2017. The patients were followed up for up to 60 months. The primary endpoint was the incidence of RAP and CP; risk factors influencing these outcomes were also identified.</div></div><div><h3>Results</h3><div><span><span>Overall, 501 patients were included, of which 164 (32.7 %) experienced RAP, and 71 (14.2 %) progressed to CP. The leading causes of AP were alcohol consumption (43.1 %), gallstones (41.5 %) and </span>hypertriglyceridemia<span> (4.4 %). Multivariate Cox regression analysis revealed that smoking (HR, 4.09; 95 % CI, 2.752–6.078, p &lt; 0.001), and organ failure after 48 h of hospitalization (HR, 3.52; 95 % CI, 1.22–10.19, p &lt; 0.02) were significant risk factors for RAP. Significant risk factors for progression to CP included age over 60 years (HR, 5.29; 95 % CI, 1.25–22.47, p = 0.024), smoking (HR, 2.50; 95 % CI, 1.04–6.01, p = 0.04), alcohol consumption (HR, 8.79; 95 % CI, 2.06–37.43, p = 0.003), </span></span>computed tomography severity index (CTSI) (HR, 1.22; 95 % CI, 1.04–1.44, p = 0.015), and recurrence of AP (HR, 70.69; 95 % CI, 2.61–1914.86, p = 0.011). In alcohol-induced RAP patients, ≥3 recurrences (HR, 4.18; 95 % CI, 1.75–9.98, p = 0.001) was significant risk factor for progression to CP.</div></div><div><h3>Conclusions</h3><div>Alcohol consumption was the predominant cause of AP and RAP. The severity of the initial AP episode was the key determinant for RAP, and RAP was the most significant risk factor for the progression to CP. Therefore, smoking and alcohol cessation are important to prevent the development of recurrent AP and CP during long-term follow-up.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 624-630"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between ABO blood groups and pancreatic cancer outcomes: A systematic review and meta-analysis","authors":"Tulio L. Correa ,&nbsp;Mario Keko ,&nbsp;Pedro Danielian ,&nbsp;Anna M. Modest ,&nbsp;Vanio Antunes ,&nbsp;Marcelo CP. Costa ,&nbsp;Matheus V. Fernandes ,&nbsp;Natalia J. Milioli ,&nbsp;Otavio C. Martins ,&nbsp;Stefano Baraldo ,&nbsp;Bruno Bockorny","doi":"10.1016/j.pan.2025.06.002","DOIUrl":"10.1016/j.pan.2025.06.002","url":null,"abstract":"<div><h3>Background/objectives</h3><div><span>Although some studies report an increased overall survival<span><span> for patients with pancreatic cancer and blood type O, others show no significant association. Therefore, we sought to perform a </span>systematic review and meta-analysis to evaluate the association between </span></span>ABO blood groups<span> and the outcomes of patients with pancreatic cancer.</span></div></div><div><h3>Methods</h3><div><span>A systematic review<span> of the literature was conducted using the PubMed/Medline, Cochrane Library<span>, and Embase<span> databases in April 2024. This review included observational studies<span> that assessed pancreatic cancer outcomes regarding different ABO blood groups<span>. The outcomes of interest included overall survival (OS), </span></span></span></span></span></span>median survival time<span>, tumor stage, lymph node metastasis<span>, and distant metastasis.</span></span></div></div><div><h3>Results</h3><div>A total of 18 studies were included in this systematic review, encompassing 9084 patients. The mean age of patients was 62.6 ± 36.5 years old and the proportion of males was 58.8 % (n = 4177). Blood type O showed better OS than non-O in both unadjusted (HR 0.82; 95 % CI 0.75–0.91) and adjusted analyses (HR 0.76; 95 % CI 0.68–0.85). Blood type O patients were also less frequently diagnosed with advanced disease stages upon presentation (OR 0.82; 95 % CI 0.69–0.97). There were no statistically significant differences in either lymph node<span> metastasis or distant metastasis.</span></div></div><div><h3>Conclusions</h3><div>Patients with blood type O exhibited better OS and were less frequently diagnosed with advanced cancer stages (III-IV) upon presentation compared to those with non-O blood types. Further research is needed to investigate the mechanisms underlying these associations.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 709-717"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical predictors of KRAS mutation detection in liquid biopsies for pancreatic ductal adenocarcinoma","authors":"Takaaki Furukawa ,&nbsp;Ippei Fukada ,&nbsp;Naomi Hayashi ,&nbsp;Takeshi Okamoto ,&nbsp;Yoichiro Sato ,&nbsp;Yuri Maegawa ,&nbsp;Tatsuki Hirai ,&nbsp;Takafumi Mie ,&nbsp;Tsuyoshi Takeda ,&nbsp;Takashi Sasaki ,&nbsp;Masato Ozaka ,&nbsp;Shunji Takahashi ,&nbsp;Naoki Sasahira","doi":"10.1016/j.pan.2025.06.013","DOIUrl":"10.1016/j.pan.2025.06.013","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Liquid biopsy<span> offers an alternative to tissue specimens for comprehensive genomic profiling. However, detection of circulating tumor DNA (ctDNA) remains challenging in </span></span>pancreatic ductal adenocarcinoma (PDAC). This study assessed predictive ability of CA19-9 and other factors for detecting </span><em>KRAS</em> mutations on liquid biopsy. <em>Methods</em>: We retrospectively reviewed clinical and genomic databases for PDAC patients who underwent liquid biopsy between September 2021 and August 2024. <em>Results</em>: A total of 106 patients were enrolled. The overall detection rate of <em>KRAS</em><span> mutations was 48 %. Univariate analysis<span> identified hepatic metastases (Odds ratio (OR) 4.50, </span></span><em>p</em> &lt; 0.01) and CA19-9 levels ≥2000 U/mL (OR 3.82, <em>p</em> &lt; 0.01) as significantly associated with higher detection of <em>KRAS</em><span> mutations. These factors remained independent predictors in multivariate analysis<span>: hepatic metastases (OR 4.51, </span></span><em>p</em> &lt; 0.01) and CA19-9 ≥ 2000 U/mL (OR 3.91, <em>p</em> &lt; 0.01). <em>KRAS</em><span> mutations were detected in 79 % of patients with both factors. In an overall survival (OS) analysis of 102 patients, detection of </span><em>KRAS</em> mutations was associated with worse prognosis (detected vs not-detected: 16.5 vs. 26.9 months, <em>p</em> = 0.02). Further stratification by maximum variant allele frequency (Max VAF) among patients with <em>KRAS</em> mutations revealed significantly shorter OS in patients with Max VAF &gt;10 % compared to those with Max VAF &lt;1 % (10.6 vs. 19.8 months, <em>p</em> &lt; 0.01) or 1–10 % (10.6 vs. 18.0 months, <em>p</em> = 0.02). <em>Conclusions</em>: CA19-9 levels and hepatic metastases are predictive of <em>KRAS</em> mutation detection in ctDNA. Higher Max VAF may reflect more aggressive disease biology in PDAC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 736-742"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragments of Truth: AI-nCLE and the Mirage of Universal Benefit","authors":"Matteo Tacelli,&nbsp;Paolo Giorgio Arcidiacono","doi":"10.1016/j.pan.2025.07.006","DOIUrl":"10.1016/j.pan.2025.07.006","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 5","pages":"Pages 607-608"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Concealed pancreatic cancer in acute pancreatitis: Early MRCP and EUS surveillance improves prognosis and identifies high-risk patients\".","authors":"Merve Eren Durmus, Gokhan Koker","doi":"10.1016/j.pan.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.pan.2025.07.010","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}