Pancreatology最新文献_第2页

Severity and outcome of a first episode of idiopathic acute pancreatitis is not more severe than pancreatitis of other etiologies 特发性急性胰腺炎首次发病的严重程度和结果并不比其他病因引起的胰腺炎严重。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.08.004

{"title":"Severity and outcome of a first episode of idiopathic acute pancreatitis is not more severe than pancreatitis of other etiologies","authors":"","doi":"10.1016/j.pan.2024.08.004","DOIUrl":"10.1016/j.pan.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><p>With respect to severity and outcome of an index episode of idiopathic acute pancreatitis the current literature reports conflicting retrospective results. One reason might be the retrospective study design precluding in depth analysis resulting in mixed etiologies and combination of index episode versus recurrent idiopathic acute pancreatitis.</p></div><div><h3>Methods</h3><p>In this retrospective monocentric cohort study, we retrieved all patients with a first acute pancreatitis episode treated between 2005 and 2021 at the LMU University Hospital from our clinical information system based on the respective ICD-10 codes. In an initial sample of 1390 presumed idiopathic pancreatitis patients we identified 68 confirmed idiopathic acute pancreatitis patients and compared those to 75 first-time alcohol-induced acute pancreatitis patients and 390 first-time biliary-induced acute pancreatitis patients. Clinical outcome (severity, SIRS, mortality, and re-admission rate) was set as outcome measures. Multinomial logistic regression analysis was performed.</p></div><div><h3>Results</h3><p>In alcohol-induced acute pancreatitis moderate and severe courses occur significantly more often when compared to idiopathic acute pancreatitis (17.33 % vs. 10.29 %; multinomial logistic regression p = 0.0021). There were no significant differences in mortality between first-time alcoholic, idiopathic and biliary pancreatitis (p = 0.6328). Patients with idiopathic acute pancreatitis had significantly more hospital readmissions (within 30 days) compared to alcohol-induced pancreatitis patients (p = 0.0284).</p></div><div><h3>Conclusion</h3><p>In the context of a first episode of acute pancreatitis, idiopathic acute pancreatitis remains a challenging diagnosis posing an increased risk of recurrence, but not an increased risk for a more severe disease course.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1424390324007014/pdfft?md5=c7a7cf527e2b28ab98442d6c06c3cbf5&pid=1-s2.0-S1424390324007014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrence pattern and its risk factors in patients with resected pancreatic ductal adenocarcinoma – A retrospective analysis of 272 patients 切除胰腺导管腺癌患者的复发模式及其风险因素--对272名患者的回顾性分析。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.07.017

{"title":"Recurrence pattern and its risk factors in patients with resected pancreatic ductal adenocarcinoma – A retrospective analysis of 272 patients","authors":"","doi":"10.1016/j.pan.2024.07.017","DOIUrl":"10.1016/j.pan.2024.07.017","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to investigate the patterns of recurrence and their associated risk factors in patients who underwent resection for pancreatic carcinoma.</p></div><div><h3>Methods</h3><p>This retrospective study included 272 patients, who underwent Ro/R1-resection of PDAC from 2005 to 2020 at the University Hospital Erlangen. Risk factors for different recurrence patterns and the prognostic value of recurrence pattern on the overall survival after recurrence were evaluated.</p></div><div><h3>Results</h3><p>61 % of the patients experienced recurrence, mostly within the first 12 postoperative months (62 %) and in the form of metastases (87 %). The median overall survival from recurrence was 9.2 months. The preoperative absence of diabetes and the presence of lymph node metastasis were independent risk factors for recurrence and a preoperative CA19-9 exceeding 97 U/ml for early recurrence. Additionally, lymph node metastases were associated with a higher risk of metastatic recurrence. Early recurrence, but not the site of recurrence, was identified as an independent prognostic factor for worse overall survival from recurrence.</p></div><div><h3>Conclusion</h3><p>The occurrence of recurrence and especially of early and metastatic recurrence are associated with a worse overall survival. Patients lacking preoperative diabetes, having high preoperative CA19-9 values and lymph node metastases are particularly at risk for (early) recurrence.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1424390324006975/pdfft?md5=d526026721e1fbbd4e39b42d3bb11b32&pid=1-s2.0-S1424390324006975-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Quality of life is impaired in children with chronic pancreatitis: A multicenter study” "慢性胰腺炎患儿的生活质量受损：一项多中心研究"。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.06.009

{"title":"“Quality of life is impaired in children with chronic pancreatitis: A multicenter study”","authors":"","doi":"10.1016/j.pan.2024.06.009","DOIUrl":"10.1016/j.pan.2024.06.009","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The impact of chronic pancreatitis<span> (CP) on quality of life (QOL) of children is not well established. Our objective was to evaluate the QOL, identify contributing factors, and determine the prevalence of anxiety and depression in children with CP in India.</span></p></div><div><h3>Methods</h3><p><span>Children (8-18y old) with CP were prospectively enrolled across three pediatric gastroenterology centres in India. QOL was assessed using the </span>pediatric QOL inventory<span> (PedsQL 4.0) scale, administered to both children and their parents. Anxiety and depression was studied using the Revised Children's Anxiety and Depression Scale (RCADS 25). Contributing factors were identified using binary logistic regression analysis. The data was compared against published QOL data in healthy Indian children.</span></p></div><div><h3>Results</h3><p>121 children with CP (boys-57.9 %, age at QOL-14 ± 3.2years) were enrolled. A majority (82.7 %) had pain and advanced disease (Cambridge grade IV- 63.6 %). Children with CP had poorer QOL compared to controls (total score 74.6 ± 16 vs. 87.5 ± 11.1, p < 0.0001). QOL scores were similar across centres. Older children were similar to younger ones, except for a poorer emotional QOL. Taking QOL < -2 standard deviation (SD) of controls, ∼35 % had poor physical (50.9 ± 11.9) and 20 % had poor psychosocial (PS) QOL score (52.1 ± 7.2). On analysis, presence of pain and lower socio-economic status (SES) adversely affected both physical and PS-QOL. Additionally, girls had poorer PS-QOL than boys (Odds ratio 3.1, 95%CI:1.23–7.31). Anxiety and depression were uncommon (2,1.6 %).</p></div><div><h3>Conclusions</h3><p>Patients with CP had impaired physical and psycho-social QOL. Presence of pain and lower SES adversely affected QOL. Psychiatric comorbidities were uncommon.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470056","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}

引用次数: 0

Altered centriolar cohesion by CEP250 and appendages impact outcome of patients with pancreatic cancer CEP250 和附属物改变的中心粒内聚力会影响胰腺癌患者的预后。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.06.010

{"title":"Altered centriolar cohesion by CEP250 and appendages impact outcome of patients with pancreatic cancer","authors":"","doi":"10.1016/j.pan.2024.06.010","DOIUrl":"10.1016/j.pan.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><p>Pancreatic ductal adenocarcinoma<span><span> (PDAC) is one of the leading cause of cancer death worldwide. PDACs are characterized by </span>centrosome aberrations, but whether centrosome-related genes influence patient outcomes has not been tested.</span></p></div><div><h3>Methods</h3><p><span>Publicly available RNA-sequencing data of patients diagnosed with PDAC were interrogated with unsupervised approaches to identify centrosome protein-encoding genes with prognostic relevance. Candidate genes were validated by </span>immunohistochemistry<span> and multiplex immunofluorescence in a set of clinical PDAC and normal pancreatic tissues.</span></p></div><div><h3>Results</h3><p>Results showed that two genes <em>CEP250</em> and <em>CEP170,</em> involved in centrosome linker and centriolar subdistal appendages, were expressed at high levels in PDAC tissues and were correlated with prognosis of PDAC patients in independent databases.</p><p>Large clustered γ-tubulin-labelled centrosomes were linked together by aberrant circular and planar-shaped CEP250 arrangements in CEP250-high expressing PDACs. Furthermore, PDACs displayed prominent centrosome separation and reduced CEP164-centrosomal labelling associated with acetylated-tubulin staining compared to normal pancreatic tissues. Interestingly, in a small validation cohort, CEP250-high expressing patients had shorter disease free- and overall-survival and almost none of those who received gemcitabine plus nab-paclitaxel first-line therapy achieved a clinical response. In contrast, weak CEP250 expression was associated with long-term survivors or responses to medical treatments.</p></div><div><h3>Conclusions</h3><p>Alteration of the centriolar cohesion and appendages has effect on the survival of patients with PDAC.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470057","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}

引用次数: 0

Preoperative level of serum transthyretin as a novel biomarker predicting survival in resected pancreatic ductal adenocarcinoma with neoadjuvant therapy 血清转甲状腺素的术前水平是预测接受新辅助治疗的切除胰腺导管腺癌生存率的新型生物标记物。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.07.012

{"title":"Preoperative level of serum transthyretin as a novel biomarker predicting survival in resected pancreatic ductal adenocarcinoma with neoadjuvant therapy","authors":"","doi":"10.1016/j.pan.2024.07.012","DOIUrl":"10.1016/j.pan.2024.07.012","url":null,"abstract":"<div><h3>Background</h3><p>Systemic inflammation and altered metabolism are essential hallmarks of cancer. We hypothesized that the rapid turnover protein transthyretin (TTR) (half-life: 2–3 days), compared with the conventional marker albumin (21 days), better reflects the inflammatory/metabolic dynamics of pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy (NAT) and is a useful prognostic marker.</p></div><div><h3>Methods</h3><p>Serum TTR and albumin levels were measured in 104 consecutive post-NAT PDAC patients before curative resection. The associations of preoperative TTR and albumin levels with overall survival (OS) after pancreatectomy were retrospectively analyzed.</p></div><div><h3>Results</h3><p>The mean (SD) TTR and albumin levels were 21.6 (6.4) mg/dL (normal range: ≥22.0 mg/dL) and 3.9 (0.55) g/dL. A low (<22.0 mg/dL) post-NAT TTR level was associated with an advanced tumor stage and higher CEA and CRP levels. Patients with low TTR levels showed significantly worse OS compared with normal levels (3-year OS 39 % vs. 54 %, <em>P</em> = 0.037), although albumin levels did not. We modified prognostic biomarkers of systemic inflammation/metabolism, such as GPS, PNI, and CONUT scores, using the serum TTR instead of albumin level and successfully showed that modified scores were better associated with OS compared with original scores using serum albumin level.</p></div><div><h3>Conclusions</h3><p>Our data suggest that the TTR level is a promising prognostic biomarker for PDAC patients after NAT.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056359","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}

引用次数: 0

Symptomatic pancreatico-pleural fistula: Diverting a diversion 有症状的胰胸膜瘘：转流。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.08.002

引用次数: 0

Two cases of hemoptysis in pancreatitis and their rescue endovascular embolization 两例胰腺炎咯血病例及其抢救性血管内栓塞术

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.07.011

引用次数: 0

Venous thromboembolism in patients with pancreatic adenocarcinoma: Disease burden and initiation of ambulatory thromboprophylaxis 胰腺腺癌患者的静脉血栓栓塞：疾病负担和流动血栓预防措施的启动。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.06.008

{"title":"Venous thromboembolism in patients with pancreatic adenocarcinoma: Disease burden and initiation of ambulatory thromboprophylaxis","authors":"","doi":"10.1016/j.pan.2024.06.008","DOIUrl":"10.1016/j.pan.2024.06.008","url":null,"abstract":"<div><h3>Background/Objectives</h3><p>Ambulatory thromboprophylaxis (AT) in patients with pancreatic adenocarcinoma (PAC) reduces venous thromboembolism (VTE) risk and is recommended for patients receiving systemic chemotherapy. We evaluated VTE rates, severity, timing, and risk factors in PAC patients as well as AT rates and initiation times.</p></div><div><h3>Methods</h3><p>Patients diagnosed with PAC were included. Data collected included patient demographics, medical history, PAC diagnosis, development of VTE, AT, and bleeding episodes. VTE was defined as a DVT or a PE. Patients were classified as receiving AT for VTE prevention if they received a prescription for outpatient anticoagulation.</p></div><div><h3>Results</h3><p>The cohort included 243 PAC patients. VTE occurred in 24 %. Overall, 52 % developing VTE were hospitalized and 5 % died as a result of the VTE. Of those who developed VTE 50 % were diagnosed within the first 2 months of PAC diagnosis. Univariate predictors of elevated VTE risk included an elevated Onkotev score, metastasis at diagnosis, male gender and not receiving AT. Multivariate predictors of elevated VTE risk included male gender (P = 0.014) and not receiving AT (P = 0.001). Overall, 30 % of patients received AT. The median time from diagnosis to initiation of AT was 43 days. Major bleeding occurred in 5.8 %. Patients receiving AT were not at a significantly increased risk of major bleeding (p = 0.5). Patients with intestinal tumor invasion were at significantly increased risk of major bleeding (P = 0.021).</p></div><div><h3>Conclusion</h3><p>VTE risk is significant and morbid in PAC patients. AT rates are low, and initiation is often delayed. Therapeutic endoscopists diagnosing PAC may be helpful in AT initiation.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S142439032400663X/pdfft?md5=aef3b517da7a11a22f1e74088b5380ed&pid=1-s2.0-S142439032400663X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation between endoscopic ultrasound features and exocrine pancreatic function in chronic pancreatitis 慢性胰腺炎患者的内镜超声特征与胰腺外分泌功能之间的相关性。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.08.001

{"title":"Correlation between endoscopic ultrasound features and exocrine pancreatic function in chronic pancreatitis","authors":"","doi":"10.1016/j.pan.2024.08.001","DOIUrl":"10.1016/j.pan.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Endoscopic ultrasound (EUS) is the most sensitive method for diagnosing chronic pancreatitis (CP) in its early stages, and Rosemont Classification (RC) is used for its evaluation. Data on the correlation between EUS features and pancreatic exocrine insufficiency (PEI) are limited. We investigated the correlation between the EUS findings and PEI.</p></div><div><h3>Methods</h3><p>This was a retrospective, monocentric cohort study involving patients prospectively enrolled from 2018 to 2022, with definite or probable CP according to the M-ANNHEIM criteria. All the patients underwent EUS and exocrine function investigations within 12 months of diagnosis. PEI was diagnosed using fecal elastase (FE) or when overt steatorrhea was reversed by pancreatic enzyme replacement therapy. Logistic regression analyses, rank correlation, ROC curve, and area under the curve (AUROC) were performed to evaluate the association between EUS features and PEI, and the accuracy of RC in predicting PEI.</p></div><div><h3>Results</h3><p>Among 128 patients examined (63.3 % male; mean age, 47 years), 69.5 % were diagnosed with PEI. In multivariate logistic regression among all the RC criteria, only lithiasis in the main pancreatic duct (MPD) was associated with increased risk of PEI (OR 2.92, 95 % CI 1.29–6.61; p = 0.01). Rank analysis showed a weak inverse correlation between RC and FE (Spearman's rho = −0.02; p = 0.03). The accuracy of RC was moderate (AUROC 0.62, p = 0.014).</p></div><div><h3>Conclusions</h3><p>Among RC EUS features, lithiasis in the MPD is helpful for predicting the risk of PEI, while other findings are of limited utility in evaluating exocrine function.</p></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976333","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}

引用次数: 0

Cystic fibrosis transmembrane conductance regulator (CFTR) variants and CFTR function in patients with pancreatitis 胰腺炎患者的囊性纤维化跨膜传导调节器（CFTR）变体和 CFTR 功能。

IF 2.8 2区医学

Pancreatology Pub Date : 2024-09-01 DOI: 10.1016/j.pan.2024.07.009

引用次数: 0