Pancreatology最新文献

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Transcriptomic profiling of insulinomas reveals a new “low-endocrine” subtype with low YY1 expressions 胰岛素瘤的转录组学分析揭示了一种具有低YY1表达的新“低内分泌”亚型。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-02-13 DOI: 10.1016/j.pan.2026.02.006
Yongzheng Li , Xingwu Zhang , Qiang Xu , Xianlin Han , Dan Guo , Yixi Jiao , Hao Zhang , Bohui Yin , Xiafei Hong , Wenming Wu
{"title":"Transcriptomic profiling of insulinomas reveals a new “low-endocrine” subtype with low YY1 expressions","authors":"Yongzheng Li ,&nbsp;Xingwu Zhang ,&nbsp;Qiang Xu ,&nbsp;Xianlin Han ,&nbsp;Dan Guo ,&nbsp;Yixi Jiao ,&nbsp;Hao Zhang ,&nbsp;Bohui Yin ,&nbsp;Xiafei Hong ,&nbsp;Wenming Wu","doi":"10.1016/j.pan.2026.02.006","DOIUrl":"10.1016/j.pan.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Insulinoma is the most common functional pancreatic neuroendocrine tumors, typically originating from pancreatic β cells. However, the transcriptional heterogeneity and the regulatory role of transcription factor <em>YY1</em> remain incompletely understood.</div></div><div><h3>Methods</h3><div>High-throughput bulk-RNA sequencing was conducted on insulinoma tumor samples. Unsupervised clustering algorithms were employed to identify molecular subtypes of insulinomas. <em>YY1</em> mutation status was analyzed by whole-exome sequencing. Functional roles of <em>YY1</em> were analyzed by <em>Yy1</em>-overexpression and knockdown in INS-1 cell line. Spatial transcriptomic characteristics of insulinoma were analyzed using Visium HD platform.</div></div><div><h3>Results</h3><div>Transcriptomic analysis identified two distinct expression patterns: a low-endocrine subtype and an endocrine subtype. The low-endocrine subtype was characterized by reduced <em>PDX1</em> and insulin synthesis pathways, with an enrichment in exocrine-related functions. However, these two subtypes exhibited similar clinicopathological features. Notably, while <em>YY1</em> mutation rates were comparable between the two subtypes, <em>YY1</em> expression levels were significantly reduced in the low-endocrine subtype. Functional experiments demonstrated that <em>Yy1</em> levels directly correlated with insulin production, as <em>Yy1</em> overexpression in INS-1 cells markedly upregulated insulin processing genes and secretory pathways. <em>Yy1</em> knockdown led to suppression of insulin. Furthermore, spatial transcriptomics confirmed that low-endocrine subtype possessed reduced insulin scores compared to the endocrine subtype.</div></div><div><h3>Conclusion</h3><div>We found a low-endocrine subtype insulinoma with reduced <em>YY1</em> expression and insulin synthesis transcriptomic signature. This highlights the transcriptomic heterogeneity of insulinomas.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 451-458"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309115","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
Activation of pancreatic acinar cells by very low concentrations of cholecystokinin: mechanism and implications for physiology and pathology 极低浓度胆囊收缩素对胰腺腺泡细胞的激活:机制和生理病理意义。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-03-07 DOI: 10.1016/j.pan.2026.03.006
Muhanad Salih, Ole H. Petersen
{"title":"Activation of pancreatic acinar cells by very low concentrations of cholecystokinin: mechanism and implications for physiology and pathology","authors":"Muhanad Salih,&nbsp;Ole H. Petersen","doi":"10.1016/j.pan.2026.03.006","DOIUrl":"10.1016/j.pan.2026.03.006","url":null,"abstract":"<div><div>Cholecystokinin (CCK) is one of the three classical gut hormones. CCK is also, in contrast to the other two principal gut hormones (gastrin and secretin), an important neurotransmitter with widespread actions in the brain and in the periphery. Although not signposted by its name, one of the key physiological actions of CCK is to activate the secretion of an enzyme-rich neutral fluid produced by the pancreatic acinar cells. In general, hormones activate their target cells at concentrations that are much lower than those of neurotransmitters but, even in this context, the pancreatic acinar cells are extraordinarily sensitive to extremely low CCK concentrations (low pM). We explore the mechanism underlying this exceptional sensitivity as well as its consequences. The focus is on the intracellular transduction pathways that are activated when acinar cell CCK receptors are excited by the hormone. Uniquely, three different intracellular receptors – all linked to release of Ca<sup>2+</sup> from intracellular stores – are required for CCK to elicit secretion. The implications of this unusual arrangement for both pancreatic physiology and pathophysiology are discussed.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 343-354"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444520","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
Aggressive fluid resuscitation in predicted severe acute pancreatitis: a secondary analysis of a multicenter randomized controlled trial 预测重症急性胰腺炎的积极液体复苏:多中心随机对照试验的二次分析
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-03-18 DOI: 10.1016/j.pan.2026.03.009
Yingjie Chen , Weibang Pan , Mingfeng Huang , Hongwei Zhang , Mingzhi Chen , Zeqiu Lao , Lin Gao , Bo Ye , Lu Ke , Xiujuan Zhou , Wenjian Mao , Peiyang Gao
{"title":"Aggressive fluid resuscitation in predicted severe acute pancreatitis: a secondary analysis of a multicenter randomized controlled trial","authors":"Yingjie Chen ,&nbsp;Weibang Pan ,&nbsp;Mingfeng Huang ,&nbsp;Hongwei Zhang ,&nbsp;Mingzhi Chen ,&nbsp;Zeqiu Lao ,&nbsp;Lin Gao ,&nbsp;Bo Ye ,&nbsp;Lu Ke ,&nbsp;Xiujuan Zhou ,&nbsp;Wenjian Mao ,&nbsp;Peiyang Gao","doi":"10.1016/j.pan.2026.03.009","DOIUrl":"10.1016/j.pan.2026.03.009","url":null,"abstract":"<div><h3>Background</h3><div>A recent trial showed that early aggressive fluid resuscitation in acute pancreatitis(AP) was associated with increased fluid overload characterized by respiratory symptoms/signs. However, the generalizability of these results in more severe AP is unknown. We aimed to evaluate the association between early fluid strategies and the incidence and duration of respiratory failure in patients with predicted severe acute pancreatitis(pSAP).</div></div><div><h3>Methods</h3><div>This is a secondary analysis using data from a multicenter, cluster-randomized trial of pSAP. The entire cohort was divided into three groups according to the amount of fluid volume. According to the interquartile range(IQR) value of fluid volume over the first two trial days, patients were assigned to conservative(quartile-1), moderate(quartile-2&amp;3), and aggressive(quartile-4) fluid strategies, respectively. A multivariable quantile regression model was used to demonstrate their effect on respiratory-failure-free-days(RFFD) to trial-day7.</div></div><div><h3>Results</h3><div>Overall, 259 pSAP patients were included, and the median(IQR) volume of fluid intake was 7.09(5.59–9.34) L. From lowest to highest, the three groups received median(range) fluid intake of 4.60(1.96–5.59), 7.09(5.59–9.34), and 11.22(9.34–18.78) L, respectively. The median(IQR) of RFFDs to trial-day7 were 5(2.3-7), 5(2-7), and 6(4-7) for each group. After adjustment for potential confounders, neither the conservative nor aggressive-group showed significant difference in RFFD compared with the moderate-group(p = 0.305 and 0.554, respectively). Moreover, the aggressive group had a higher SIRS free-days to trial-day7 compared with the moderate-group(adjusted p = 0.029). Subgroup analysis revealed that early aggressive fluid intake was not associated with decreased RFFDs to trial-day7 in all subgroups.</div></div><div><h3>Conclusion</h3><div>A higher amount of balanced fluids given according to the hematocrit and other clinical parameters does not appear to contribute to respiratory dysfunction in patients with pSAP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 380-386"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514105","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
Early direct admission to tertiary hospital specialized care reduces risk of severe acute pancreatitis: A propensity score-matched retrospective cohort study 早期直接接受三级医院专科治疗可降低严重急性胰腺炎的风险:一项倾向评分匹配的回顾性队列研究
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-02-05 DOI: 10.1016/j.pan.2026.02.002
Yuping Ren , Liang Xia , Lingyu Luo , Huifang Xiong , Zhijian Liu , Xin Huang , Yupeng Lei , Yin Zhu , Nonghua Lu , Jianhua Wan , Wenhua He
{"title":"Early direct admission to tertiary hospital specialized care reduces risk of severe acute pancreatitis: A propensity score-matched retrospective cohort study","authors":"Yuping Ren ,&nbsp;Liang Xia ,&nbsp;Lingyu Luo ,&nbsp;Huifang Xiong ,&nbsp;Zhijian Liu ,&nbsp;Xin Huang ,&nbsp;Yupeng Lei ,&nbsp;Yin Zhu ,&nbsp;Nonghua Lu ,&nbsp;Jianhua Wan ,&nbsp;Wenhua He","doi":"10.1016/j.pan.2026.02.002","DOIUrl":"10.1016/j.pan.2026.02.002","url":null,"abstract":"<div><h3>Background</h3><div>The impact of delay in specialized treatment (DST) on disease progression in acute pancreatitis (AP) patients before transfer to tertiary hospitals remains unclear. This study investigates the association between DST and risk of severe acute pancreatitis (SAP) using propensity score matching (PSM).</div></div><div><h3>Methods</h3><div>Based on 5818 AP patients treated at The First Affiliated Hospital of Nanchang University (2014–2023), patients were divided into DST and non-DST groups. A 1:1 PSM with 0.2 SD caliper width balanced 16 baseline covariates. Multivariable logistic regression evaluated DST's effect on SAP, supported by inverse probability weighting and subgroup analyses.</div></div><div><h3>Results</h3><div>After PSM (2215 pairs), the DST group exhibited higher SAP incidence (19.5% vs. 14.9%; aOR = 1.38, 95%CI 1.18–1.62), pancreatic necrosis (18.1% vs. 15.4%), persistent respiratory failure (16.3% vs. 12.4%), and longer median hospitalization (8 vs. 7 days; all p &lt; 0.05). Subgroup analyses revealed amplified risks in BMI≥24 (OR = 1.44) and alcohol users (OR = 1.62). Sensitivity analyses confirmed robustness (weighted OR 1.14–1.52), while mortality showed no intergroup difference.</div></div><div><h3>Conclusions</h3><div>DST independently increases SAP risk. Early direct admission to tertiary specialized care reduces SAP risk by 38%, providing high-level evidence for optimizing AP management pathways, particularly prioritizing rapid referral for obese and alcohol-using populations.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 363-369"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202167","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
Risk factors for pancreatic exocrine insufficiency after acute pancreatitis: A systematic review and meta-analysis 急性胰腺炎后胰腺外分泌功能不全的危险因素:系统回顾和荟萃分析。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-03-03 DOI: 10.1016/j.pan.2026.03.001
Orsolya Eperjesi , Maria Bucur , Anett Rancz , Ádám Zolcsák , Marie Anne Engh , Mahmoud Obeidat , Andrea Szentesi , Péter Hegyi , Stefania Bunduc
{"title":"Risk factors for pancreatic exocrine insufficiency after acute pancreatitis: A systematic review and meta-analysis","authors":"Orsolya Eperjesi ,&nbsp;Maria Bucur ,&nbsp;Anett Rancz ,&nbsp;Ádám Zolcsák ,&nbsp;Marie Anne Engh ,&nbsp;Mahmoud Obeidat ,&nbsp;Andrea Szentesi ,&nbsp;Péter Hegyi ,&nbsp;Stefania Bunduc","doi":"10.1016/j.pan.2026.03.001","DOIUrl":"10.1016/j.pan.2026.03.001","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Pancreatic exocrine insufficiency (PEI) may develop after acute pancreatitis (AP). The incidence and predisposing factors are not well described, nor is optimal pancreatic enzyme replacement (PERT) in this setting. We aimed to investigate the proportion, risk factors, and effect of PERT in patients with PEI after AP.</div></div><div><h3>Methods</h3><div>The study protocol was registered on PROSPERO (CRD42024516403). We systematically searched three databases (PubMed, EMBASE, and CENTRAL) on November 08, 2025. We included studies reporting on risk factors and PERT efficacy in PEI associated with AP. Pooled proportion and odds ratios (OR) with the 95% confidence intervals (CI) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>We identified 64 eligible articles. PEI occurred in 22% (CI:17–27%) of the 24111 analyzed AP patients. The rate was high at discharge at 48% (CI: 19–79%) but decreased and stabilized at 26% (CI: 17–39%) after the 1st year of follow-up. The rates of PEI were 10% (CI: 5–20%), 24% (CI:13–40%), and 31% (CI: 18–47%) after mild, moderately severe, and severe AP, respectively. The proportion of severe PEI reached 21% (CI: 13–31%) overall, and even following mild AP, severe PEI was observed in 10% (CI:4–22%) of cases. The odds were significantly higher for alcoholic (vs. biliary) AP (OR = 1.89, CI: 1.06–3.37) cases. Necrosis did not significantly increase the risk of PEI (OR = 2.12, CI: 0.54–8.28), but necrosectomy did (OR = 3.09, CI:1.79–5.31).</div></div><div><h3>Conclusion</h3><div>PEI affects one in five AP patients in the long term. Alcoholic AP and necrosectomy are risk factors for AP-induced PEI. PEI can develop even after mild AP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 404-411"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434691","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
Spink1 promotes the survival of Kras-mutant pancreatic acinar cells Spink1促进kras突变型胰腺腺泡细胞的存活。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-03-19 DOI: 10.1016/j.pan.2026.03.014
Hidehiro Hayashi , Shin Hamada , Ryotaro Matsumoto , Tetsuya Takikawa , Yan Xu , Ren Jie , Hitomi Nakasuji , Toshiaki Abe , Kazuhiro Kikuta , Hozumi Motohashi , Masaki Ohmuraya , Atsushi Masamune
{"title":"Spink1 promotes the survival of Kras-mutant pancreatic acinar cells","authors":"Hidehiro Hayashi ,&nbsp;Shin Hamada ,&nbsp;Ryotaro Matsumoto ,&nbsp;Tetsuya Takikawa ,&nbsp;Yan Xu ,&nbsp;Ren Jie ,&nbsp;Hitomi Nakasuji ,&nbsp;Toshiaki Abe ,&nbsp;Kazuhiro Kikuta ,&nbsp;Hozumi Motohashi ,&nbsp;Masaki Ohmuraya ,&nbsp;Atsushi Masamune","doi":"10.1016/j.pan.2026.03.014","DOIUrl":"10.1016/j.pan.2026.03.014","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer remains one of the most intractable malignancies due to its strong therapeutic resistance and the difficulty of early detection. Previous studies have suggested that pancreatic inflammation can promote carcinogenesis. In contrast, the regulatory mechanisms controlling trypsin activity are closely associated with susceptibility to pancreatitis. Genetic variants that lead to sustained trypsin activity—thereby promoting protease activation—have been identified in hereditary pancreatitis. Serine protease inhibitor Kazal type 1 (SPINK1) functions as an endogenous inhibitor of trypsin activity. Deletion of <em>Spink1</em> in mice causes severe pancreatic atrophy and early postnatal death. In addition to its role in pancreatitis, SPINK1 has been reported to exert cancer-promoting effects in several tumor types by supporting cell survival.</div></div><div><h3>Methods</h3><div>In the present study, we investigated whether pancreas-specific deletion of <em>Spink1</em> affects inflammation and fibrosis after caerulein-induced pancreatitis. We also investigated whether pancreas-specific deletion of <em>Spink1</em> affects <em>Kras</em>-mutant driven carcinogenesis in mice.</div></div><div><h3>Results</h3><div>Loss of <em>Spink1</em> in the pancreas induced histological changes consistent with chronic pancreatitis and was accompanied by muscle atrophy. Moreover, the combination of <em>Spink1</em> deletion and mutant <em>Kras</em> expression resulted in early lethality due to severe pancreatic atrophy. Heterozygous loss of <em>Spink1</em> also attenuated the development of pancreatic intraepithelial neoplasia (PanIN), a precancerous lesion induced by mutant <em>Kras</em>.</div></div><div><h3>Conclusions</h3><div>These findings demonstrate that SPINK1 supports the early stages of pancreatic carcinogenesis. Targeting SPINK1 may represent a novel preventive strategy to eliminate <em>Kras</em> mutant acinar cells and suppress the initiation of pancreatic cancer.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 469-478"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512900","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
Acute pancreatitis management and outcome at tertiary hospitals in Rwanda: A prospective multicenter study 卢旺达三级医院的急性胰腺炎管理和结果:一项前瞻性多中心研究。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-01-31 DOI: 10.1016/j.pan.2026.01.074
Marie Solange Mukanumviye , Emile Sebera , Vincent Dusabejambo , Innocenti Dadamessi , Dirk J. van Leeuwen , Timothy B. Gardner , Berhane Redae , Dyna Nyampinga , Eric Rutaganda , Zainab Ingabire , Isaie Nzayisenga , Marcellin Musabende , Felicien Shikama , Michel Niyonsenga , Gamal Salaheldin , Hanna Aberra
{"title":"Acute pancreatitis management and outcome at tertiary hospitals in Rwanda: A prospective multicenter study","authors":"Marie Solange Mukanumviye ,&nbsp;Emile Sebera ,&nbsp;Vincent Dusabejambo ,&nbsp;Innocenti Dadamessi ,&nbsp;Dirk J. van Leeuwen ,&nbsp;Timothy B. Gardner ,&nbsp;Berhane Redae ,&nbsp;Dyna Nyampinga ,&nbsp;Eric Rutaganda ,&nbsp;Zainab Ingabire ,&nbsp;Isaie Nzayisenga ,&nbsp;Marcellin Musabende ,&nbsp;Felicien Shikama ,&nbsp;Michel Niyonsenga ,&nbsp;Gamal Salaheldin ,&nbsp;Hanna Aberra","doi":"10.1016/j.pan.2026.01.074","DOIUrl":"10.1016/j.pan.2026.01.074","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 479-481"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202130","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
Re-evaluating routinely collected clinical and laboratory parameters in the preoperative risk assessment of intraductal papillary mucinous neoplasms: model development and internal validation 重新评估导管内乳头状粘液瘤术前风险评估中常规收集的临床和实验室参数:模型开发和内部验证。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-03-06 DOI: 10.1016/j.pan.2026.03.003
Camila Hidalgo Salinas , Mahip Grewal , Vishnu Jayaprakash , Joseph R. Habib , D Brock Hewitt , Brian J. Kaplan , Katherine A. Morgan , Tamas A. Gonda , Christopher L. Wolfgang , Rafael Perera , Greg D. Sacks , Ammar A. Javed
{"title":"Re-evaluating routinely collected clinical and laboratory parameters in the preoperative risk assessment of intraductal papillary mucinous neoplasms: model development and internal validation","authors":"Camila Hidalgo Salinas ,&nbsp;Mahip Grewal ,&nbsp;Vishnu Jayaprakash ,&nbsp;Joseph R. Habib ,&nbsp;D Brock Hewitt ,&nbsp;Brian J. Kaplan ,&nbsp;Katherine A. Morgan ,&nbsp;Tamas A. Gonda ,&nbsp;Christopher L. Wolfgang ,&nbsp;Rafael Perera ,&nbsp;Greg D. Sacks ,&nbsp;Ammar A. Javed","doi":"10.1016/j.pan.2026.03.003","DOIUrl":"10.1016/j.pan.2026.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative malignancy risk assessment in intraductal papillary mucinous neoplasm (IPMN) is essential to balance timely intervention for high-grade dysplasia or invasive cancer (HGD/IC) against avoiding unnecessary or premature surgery in low-grade IPMN. This study aimed to externally validate the 2023 International Association of Pancreatology (IAP)/Kyoto guidelines and develop a combined prediction model incorporating routinely collected clinical data and laboratory parameters.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 194 patients who underwent resection for IPMN between 2012 and 2024. We evaluated the predictive performance of the current IAP/Kyoto criteria (“Kyoto model”), developed a clinical model using routinely available laboratory and clinical variables, and integrated both into a combined model. Model performance was assessed using discrimination and calibration metrics, with internal validation via bootstrapping and five-fold cross-validation.</div></div><div><h3>Results</h3><div>The Kyoto model demonstrated modest discrimination (AUC 0.62). The clinical model, incorporating neutrophil-to-lymphocyte ratio (NLR), smoking history, blood glucose, CA19-9, and alkaline phosphatase, achieved an optimism-corrected AUC of 0.76. Compared to the Kyoto model, the combined model (AUC 0.77) significantly improved discrimination and calibration (p &lt; 0.001). At a predicted probability threshold of &gt;0.75, the combined model achieved a 90% specificity and 91% positive predictive value for HGD/IC, identifying a high-risk subgroup suitable for surgical intervention.</div></div><div><h3>Conclusions</h3><div>Integrating routinely collected clinical and laboratory parameters with guideline-based imaging features shows promise to enhance preoperative identification of high-risk IPMN in patients already being considered for surgical resection. The combined model offers a practical, high-specificity tool to support surgical decision-making in this selected population, though its performance metrics should not be extrapolated to unselected surveillance cohorts. External validation is required before broader clinical implementation.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 436-443"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444610","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
Development of an experimental model of severe acute pancreatitis with organ failure 重症急性胰腺炎伴器官衰竭实验模型的建立。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2026-03-21 DOI: 10.1016/j.pan.2026.03.008
Manpreet Uppal , Sudheer Kumar Neredimelli , Harlokesh Narayan Yadav , Rajni Yadav , Sudip Kumar Datta , Soumya Jagannath Mahapatra , Anand Narayan Singh , Tony George Jacob , Pramod Kumar Garg , Peush Sahni
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引用次数: 0
Event timing inaccuracies in a retrospective study of low-dose aspirin and acute pancreatitis 低剂量阿司匹林与急性胰腺炎回顾性研究中的事件时间不准确。
IF 2.7 2区 医学
Pancreatology Pub Date : 2026-05-01 Epub Date: 2025-11-12 DOI: 10.1016/j.pan.2025.11.006
Hung-Da Chen , Joshua Wang
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引用次数: 0
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