Pancreatology最新文献

{"title":"Intratumoral microbiota in pancreatic neuroendocrine tumors: Enriched bacterial biomass and diversity with association to dyslipidemia.","authors":"Yu-Fan Meng, Long-Yu Liu, Zhi-Yao Fan, Han-Xiang Zhan","doi":"10.1016/j.pan.2026.08.004","DOIUrl":"10.1016/j.pan.2026.08.004","url":null,"abstract":"<p><strong>Background: </strong>Intratumoral microbiota have been implicated in several cancers, including pancreatic cancer, but data on pancreatic neuroendocrine tumors (PNETs) remain limited.</p><p><strong>Methods: </strong>We analyzed two complementary cohorts: a retrospective formalin-fixed paraffin-embedded cohort comprising 53 primary PNETs, 26 paired adjacent non-tumor tissues (ANTs), and 5 liver metastases assessed by fluorescence in situ hybridization (FISH); and a prospective subset of 25 paired fresh tumor-center and ANT samples analyzed by 16S rRNA gene sequencing. Taxonomic composition, alpha and beta diversity, differential abundance, predicted microbial functions, and associations with clinicopathological features and fasting serum lipids were evaluated.</p><p><strong>Results: </strong>PNETs showed a higher frequency of detectable bacterial signals and greater microbial richness and diversity than ANTs. LEfSe identified 38 nominally differentially abundant taxa (P < 0.05; LDA > 2.5), including enrichment of Blautia, Rothia, and Ferrovibrio in tumors. Their combined abundance differentiated PNETs from ANTs with an area under the curve of 0.843. Exploratory functional inference suggested enrichment of 15 pathways in PNETs, including fatty acid and short-chain fatty acid biosynthesis pathways. Serum high-density lipoprotein levels were inversely associated with intratumoral microbial richness (Ace index: r = -0.497, P = 0.049).</p><p><strong>Conclusions: </strong>PNETs exhibited greater bacterial burden, microbial richness, and diversity than ANTs, with distinct taxonomic patterns and lipid-related associations. These exploratory findings warrant external validation in larger cohorts with rigorous low-biomass contamination control.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726983","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":"Non-aggressive Lactated Ringer's resuscitation improves outcomes and has a favorable safety profile in acute pancreatitis: a comprehensive systematic review and component network meta-analysis of Randomized Controlled Trials using GRADE and CINeMA approaches.","authors":"Vincenzo D'Ambra, Claudio Ricci, Carlo Ingaldi, Laura Alberici, Leonardo Henry Eusebi, Enrique De Madaria, Riccardo Casadei","doi":"10.1016/j.pan.2026.08.007","DOIUrl":"https://doi.org/10.1016/j.pan.2026.08.007","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) frequently requires early fluid resuscitation to restore intravascular volume, preserve pancreatic perfusion, and prevent organ failure. However, the optimal fluid type and resuscitation strategy remain controversial.</p><p><strong>Methods: </strong>We performed a component network meta-analysis (CNMA) of randomized controlled trials comparing fluids (normal saline [NS], lactated Ringer [LR], other balanced multi-electrolyte solutions [BMES], and naso-jejunal hydration solution [NJ]) and resuscitation strategies (aggressive vs. non-aggressive) in patients with new-onset AP. Primary endpoints were progression to moderately severe or severe AP, systemic inflammatory response syndrome (SIRS), and adverse events. Secondary endpoints included mortality, local complications, organ failure, and length of stay (LOS). Incremental component effects were expressed as incremental odds ratios (iOR) or mean differences (iMD). Certainty of evidence was evaluated using CINeMA and GRADE.</p><p><strong>Results: </strong>Twelve trials (1216 patients) were included. LR significantly reduced progression to moderately severe/severe AP (iOR 0.51; 95% CI 0.33; 0.79) and pancreatitis-related local complications (iOR 0.53; 95% CI 0.33; 0.85). BMES and LR reduced LOS by approximately 4 and 1 day, respectively, compared with NS. Aggressive resuscitation increased adverse events (iOR 3.35; 95% CI 1.52; 7.37). Heterogeneity and inconsistency were generally low for primary endpoints.</p><p><strong>Conclusions: </strong>Balanced crystalloids, particularly LR, are associated with improved clinical outcomes compared with NS in early AP management, reducing disease progression, local complications, and hospital stay. Aggressive fluid regimens increase adverse events without a clear benefit. These findings support the preferential use of LR within a moderate, goal-directed resuscitation strategy, although the certainty of evidence was generally low to moderate due to risk of bias and imprecision.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830682","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":"Baseline current smoking and time-varying recurrence risk after first-episode of hypertriglyceridemia-induced acute pancreatitis: A multicenter retrospective cohort study.","authors":"Jianying Liu, Yahong Yu, Xiaonan Qiu, Haimei Xu, Xuefeng Lu, Chengzhao Weng, Yijiao Xu, Chao Wang","doi":"10.1016/j.pan.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.pan.2026.08.005","url":null,"abstract":"<p><strong>Background: </strong>Evidence on behavioral predictors of recurrence after first-episode of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) is limited. We investigated the association between baseline current smoking status and post-discharge recurrence and whether this association varied over follow-up.</p><p><strong>Methods: </strong>This multicenter retrospective cohort included patients with first-episode of HTG-AP hospitalized at three centers between January 2020 and March 2025. Smoking status was determined at the index hospitalization. Cox regression assessed time to first recurrence, and negative binomial regression assessed recurrence burden. Landmark and time-varying coefficient Cox models evaluated temporal variation in the association, with center-stratified and overlap-weighted analyses used for robustness.</p><p><strong>Results: </strong>Among 311 patients, 111 were baseline current smokers and 84 experienced recurrence. Baseline current smoking status was associated with a higher cumulative recurrence probability (log-rank P = 0.009), an increased hazard of first recurrence (HR 3.00, 95% CI 1.69-5.33; P < 0.001), and greater recurrence burden (IRR 3.69, 95% CI 1.79-7.63; P < 0.001). No significant multiplicative interaction was observed between current smoking and current alcohol consumption, with an adjusted interaction term HR of 1.60 (95% CI: 0.49-5.29, P = 0.439). Current alcohol consumption was not independently associated with recurrence (center-stratified HR 0.75, 95% CI 0.44-1.29; P = 0.303). Landmark analysis showed no significant association within 6 months, whereas the association was evident thereafter. The time-varying coefficient Cox model indicated that the association was not constant over follow-up, and overlap weighting showed greater between-group differences during mid-to long-term follow-up.</p><p><strong>Conclusions: </strong>Baseline current smoking status was associated with higher recurrence risk and burden after first-episode of HTG-AP. The association appeared stronger during later follow-up, supporting its potential use as a simple behavioral marker for risk assessment and follow-up planning.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697836","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 outcomes and cost-effectiveness of surveillance for asymptomatic pancreatic head cystic neoplasms in adults aged 40-75: a microsimulation study.","authors":"Ailing Gong, Jintao Guo, Siyu Sun","doi":"10.1016/j.pan.2026.08.001","DOIUrl":"10.1016/j.pan.2026.08.001","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725868","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":"Amylase and lipase in alcohol-induced acute pancreatitis: Time to rethink diagnostic thresholds?","authors":"J-Matthias Löhr, Miroslav Vujasinovic","doi":"10.1016/j.pan.2026.07.631","DOIUrl":"https://doi.org/10.1016/j.pan.2026.07.631","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679543","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":"Pancreas divisum is no longer an indication for ERCP.","authors":"Gregory A Coté","doi":"10.1016/j.pan.2026.07.630","DOIUrl":"https://doi.org/10.1016/j.pan.2026.07.630","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654163","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":"Accumulation of p62/sequestosome-1 in pancreatic cancer progression: association with inflammation and immune cell infiltration.","authors":"Eva Philipson, Thayna Cruz, Cecilia Engström, Peter Naredi, Johan Bourghardt Fagman","doi":"10.1016/j.pan.2026.07.005","DOIUrl":"https://doi.org/10.1016/j.pan.2026.07.005","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer that develops from precursor lesions such as pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). The adaptor protein p62 links autophagy defects with oxidative stress and inflammatory signaling, but its role across disease stages is not well defined. We examined p62 expression together with markers of autophagy, metabolic stress responses, and inflammation in human pancreatic lesions and a Kras-driven mouse model.</p><p><strong>Methods: </strong>Formalin-fixed sections from 29 patients (PanIN2/3, n = 10; IPMN, n = 9; PDAC, n = 10) were analyzed by immunohistochemistry for p62, LC3B, NRF2, TFEB, phosphorylated NFκB p65, CD45, and CD3. Staining was quantified using digital pathology (QuPath). Parallel studies were conducted in Pdx1-Cre;LSL-Kras^G12D mice aged 4-12 months, with blinded histological scoring.</p><p><strong>Results: </strong>p62 expression was higher in PDAC than in PanIN2/3 and IPMN (p < 0.01), while LC3B, NRF2, and TFEB showed no differences. Immune infiltration (CD45) was increased in PDAC versus PanIN2/3 (p < 0.01), whereas phosphorylated NFκB p65 did not differ between groups. Correlation analysis showed stage-specific associations: p62-LC3B in PanIN2/3, p62-CD45 in IPMN, and p62-TFEB in PDAC. In mice, p62 and phosphorylated NFκB p65 followed a biphasic pattern, peaking in early lesions, decreasing in PanIN, and rising again in PDAC.</p><p><strong>Conclusion: </strong>These findings show that p62 accumulation is stage-dependent and is associated with inflammatory and immune changes during pancreatic cancer progression, suggesting a potential role in the transition to invasive PDAC.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423164","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":"A call for caution in interpreting gender and racial disparities in acute necrotizing pancreatitis outcomes","authors":"Di Wu ,&nbsp;Yan Jia ,&nbsp;Yilin Huang ,&nbsp;Jie Peng","doi":"10.1016/j.pan.2025.09.014","DOIUrl":"10.1016/j.pan.2025.09.014","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Page 655"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086719","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":"Methodological Considerations Regarding \"Prognostic impact of serum triglycerides in acute pancreatitis\"","authors":"Wenhua Zhou ,&nbsp;Liuying Li ,&nbsp;Xia Zhou","doi":"10.1016/j.pan.2025.11.008","DOIUrl":"10.1016/j.pan.2025.11.008","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 651-652"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550138","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":"Serum GAS6 is useful biomarker for identifying patients with severe acute pancreatitis within 24 h of admission: a multi-cohort analysis of 869 patients","authors":"Xiuli Zhang ,&nbsp;Kaixin Peng ,&nbsp;Yunpeng Peng ,&nbsp;Jiongdi Lu ,&nbsp;Hanzhang Deng ,&nbsp;Bin Li ,&nbsp;Zipeng Lu ,&nbsp;Feng Cao ,&nbsp;Qiang Li ,&nbsp;Li Wen","doi":"10.1016/j.pan.2026.04.009","DOIUrl":"10.1016/j.pan.2026.04.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Early identification of severe acute pancreatitis (SAP) within 24 h of admission remains challenging and specific biomarkers reflecting the underlying mechanisms, particularly pancreatic necrosis, are lacking. We have previously identified a crucial role of AXL and MERTK in regulating pancreatic necrosis. Their ligands, Growth Arrest-Specific 6 (GAS6) and Protein S (PROS1) can be detected in serum. Therefore, this study aims to evaluate the value of serum GAS6 and PROS1 levels within 24 h of admission for identifying SAP.</div></div><div><h3>Methods</h3><div>Serum GAS6 and PROS1 were initially assessed in a retrospective discovery cohort and subsequently validated in a prospective cohort using ELISA. A subset of patients provided serial serum samples over 4 weeks to analyze temporal dynamics and correlations with disease severity.</div></div><div><h3>Results</h3><div>A total of 869 AP patients were enrolled. Serum GAS6 levels were significantly elevated and PROS1 levels reduced compared with healthy controls, with greater changes in moderately severe and severe cases. As a single marker, GAS6 showed robust performance for predicting SAP (AUC = 0.722, 95%CI: 0.620-0.832), outperforming CRP (AUC = 0.595) and BUN (AUC = 0.681), and comparable to SIRS (AUC = 0.659), BISAP (AUC = 0.755), and APACHE-II (AUC = 0.797). The GAS6+BISAP combination yielded an AUC of 0.818, significantly superior to GAS6 alone (p = 0.001), SIRS (p = 0.013), CRP (p = 0.002), and BUN (p = 0.015), and numerically higher than APACHE-II (0.818 vs. 0.797). The temporal dynamic changes of both further correlated with disease severity.</div></div><div><h3>Conclusions</h3><div>Serum levels of GAS6 measured within 24 h provide a valuable, rapid approach for identifying SAP, and when combined with established scoring systems, can further improve performance.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 573-580"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646141","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}