Pancreatology最新文献

{"title":"Response to Letter to the editor regarding \"Anticoagulation for splanchnic vein thrombosis in acute pancreatitis increases bleeding risk without improving outcomes\".","authors":"Arpita N Jajoo, Venkata S Akshintala","doi":"10.1016/j.pan.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.010","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113801","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":"Identification of A-to-I RNA editing profiles and their clinical relevance in pancreatic neuroendocrine neoplasms.","authors":"Yanling Xu, Na He, Guanqun Dai, Ting Zhou, Mujie Ye, Qiyun Tang","doi":"10.1016/j.pan.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.006","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic neuroendocrine neoplasms (pNENs) exhibit significant clinical and molecular heterogeneity, complicating prognosis and treatment. This study aimed to characterize A-to-I RNA editing profiles in pNENs and evaluate their clinical relevance.</p><p><strong>Methods: </strong>Four RNA-seq datasets (EGAS00001005024, EGAS00001001732, GSE149395, GSE118014) were included in this study. A-to-I editing sites were identified using the GATK pipeline, filtered via REDIportal, and quantified by the Alu editing index (AEI). LASSO Cox regression was used to derive prognostic risk score from site-specific editing levels. A nomogram integrating editing signatures with TNM stage and G grade was developed and validated for survival prediction.</p><p><strong>Results: </strong>We identified 19,811 A-to-I editing sites, predominantly in noncoding regions (78.1 % intronic, 7.9 % intergenic) and Alu repeats (79.3 %). AEI was elevated in lymph node metastasis (p < 0.05) but not correlated with ADAR expression. Three key editing sites stratified patients into high- and low-risk groups, with significantly worse survival for high-risk patients (p < 0.001). The survival nomogram integrating RNA-editing signatures showed an area under the ROC curve (AUC)of 0.87 (95 % CI: 0.71-0.98), 0.87 (95 % CI: 0.74-0.97), and 0.92 (95 % CI: 0.77-1.13) at 3, 5, and 10 years in the training set, and 0.74 (95 % CI: 0.55-0.92), 0.75 (95 % CI: 0.53-0.93), and 0.79 (95 % CI: 0.60-1.00) at 3, 5, and 10 years in the validation set, demonstrating superior efficacy to conventional predictive indicators.</p><p><strong>Conclusions: </strong>This study described the landscape of A-to-I RNA editing in pNENs and revealed its relationship with key clinical features including prognosis. The RNA editing-based nomogram provided a novel tool for prognostic prediction, highlighting the potential of RNA editing as a promising biomarker for risk assessment in pNEN patients.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200525","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":"Effect of oral rifaximin for prevention of infected pancreatic necrosis and mortality in severe acute pancreatitis: An open-label randomized controlled trial.","authors":"Shivam Kalia, Preetam Nath, Anil Chandra Anand, Shivam Gupta, Abhishek Verma, Bipadabhanjan Mallick, Dibyalochan Praharaj, Sarat Chandra Panigrahi, Saroj Kanta Sahu, Suprabhat Giri, Subrat Kumar Acharya","doi":"10.1016/j.pan.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.009","url":null,"abstract":"<p><strong>Introduction: </strong>Infection of pancreatic necrosis is associated with high mortality in patients with acute pancreatitis. Selective gut decontamination may have a favourable impact on outcomes in patients with acute pancreatitis but its efficacy remains unproven. This study aimed to assess the efficacy of rifaximin, a broad-spectrum poorly absorbed oral antibiotic with a highly favourable safety profile in preventing infection of pancreatic necrosis and overall mortality in patients with predicted severe acute pancreatitis.</p><p><strong>Methods: </strong>It was an investigator-initiated open-label randomized controlled trial. Eligible patients hospitalized with predicted severe acute pancreatitis were randomized to standard treatment plus rifaximin 550 mg per oral twice daily for 14 days or standard treatment alone. The primary endpoints of the study were the development of infected pancreatic necrosis and in-hospital mortality.</p><p><strong>Results: </strong>One hundred patients were randomized to standard treatment plus rifaximin versus standard treatment alone. There was no difference in the primary endpoints: incidence of infected pancreatic necrosis (31 versus 35, p = 0.507) and mortality (9 versus 14, p = 0.603) between the two groups. The median length of ICU stay (3 versus 5 days, p = 0.209) and, incidence of organ failure (56 % versus 60 %, p = 0.525), were also similar in the two groups. Patients who received rifaximin had significantly lower median duration of hospitalization (8 days compared to 11.5 days, p = 0.002) than those who did not.</p><p><strong>Conclusion: </strong>Rifaximin did not have a significant effect on either the development of infected pancreatic necrosis or mortality in patients with predicted severe acute pancreatitis. However, the length of hospital stay was significantly shorter in the rifaximin group.</p><p><strong>Clinical trial registration: </strong>This study has been registered in India's clinical trial registry under the registration number CTRI/2020/02/023459).</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177501","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":"Performance of the EndPAC risk score for pancreatic cancer in new onset diabetes patients with missing data - a database study in the British population.","authors":"C Mellenthin, C R Meier, S S Jick, L H Bühler, M Adamina, C Schneider","doi":"10.1016/j.pan.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.017","url":null,"abstract":"<p><strong>Introduction: </strong>New onset diabetes (NOD) can be a first symptom of pancreatic ductal adenocarcinoma (PDAC), but less than 1 % of NOD are caused by PDAC. The EndPAC score tests for PDAC risk in NOD patients. As necessary information is often missing, the aim of our study was to assess the performance of the score using methods that adjust for missing values so the score can be successfully applied to all patients.</p><p><strong>Patients/methods: </strong>We retrospectively followed a British cohort with NOD in the Clinical Practice Research Datalink until they developed PDAC or were censored. We calculated the EndPAC score in all patients and assessed its performance with different imputation methods for missing values. We calibrated the score for the British population.</p><p><strong>Results: </strong>We included 197'092 NOD patients. PDAC occurred in 901 cases within 3 years after the diabetes diagnosis. Complete information to calculate the EndPAC score was available for 9.2 % of the patients. In those, the AUC (Area under the Receiver Operating Curve) of the original EndPAC score was 0.76. Including all patients, using the imputation of the population median for missing values, the AUC was 0.69. It improved to 0.71 after calibration to the UK population.</p><p><strong>Conclusions: </strong>Use of imputation methods enabled us to use the EndPAC score for all NOD patients. However, use of the EndPAC score alone is still not sufficient to select NOD patients for diagnostic workup, with or without complete information. Its use in combination with a biomarker might lead to a better risk-benefit ratio.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113741","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":"Refining lymph node yield standards through scientific discourse: Authors' response.","authors":"Hwee Leong Tan, Yun Zhao, Darren Weiquan Chua, Brian Kim Poh Goh, Ye Xin Koh","doi":"10.1016/j.pan.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.015","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086710","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":"Early versus delayed removal of lumen apposing metal stent after cystogastrostomy: a systematic review and meta-analysis.","authors":"Anshuman Elhence, Prabhaker Mishra, Praveer Rai","doi":"10.1016/j.pan.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.016","url":null,"abstract":"<p><strong>Background: </strong>Lumen apposing metal stents (LAMS) for cystogastrostomy are preferred in view of a quicker procedure and wider port for drainage in patients with pancraetic fluid collections. However, late removal of LAMS beyond 4 weeks is thought to be associated with complications such as bleeding. We aimed to synthesize data from studies comparing early (≤4 weeks) versus delayed removal of LAMS.</p><p><strong>Methods: </strong>A comprehensive literature review of three major databases (Medline, Embase and Scopus) was done for articles comparing outcomes of early versus late removal of LAMS. The relative risk (RR) of adverse events was pooled using inverse variance weighting and random effects meta-analysis. The quality of studies was assessed using Newcastle Ottawa scale (NOS) and the publication bias was assessed with a funnel-plot. The protocol was registered on PROSPERO (CRD420251022113).</p><p><strong>Results: </strong>Literature search of three databases showed 982 articles of which 4 were selected as per the inclusion criteria. All the studies scored ≥7 on the NOS. There was no publication bias (Egger's test p = 0.53). The random effects model showed a pooled RR of adverse events of 1.13 (95 % confidence interval (CI) 0.59 to 2.17, I² = 38 %) in the delayed-removal group. The RR of bleeding was 1.41 (95 % CI 0.23 to 8.80, I² = 35 %) in the delayed removal group as compared to the early removal group. Leave-out-one sensitivity analysis confirmed the robustness of results.</p><p><strong>Conclusions: </strong>Delayed removal of LAMS even beyond 4 weeks may not be associated with an increased risk of complications. The timing of removal should be guided by radiologic and clinical responses.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092206","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":"Refining the prognostic utility of CA19-9 in neoadjuvant therapy for pancreatic cancer: Emphasizing serial monitoring and subgroup differentiation.","authors":"Guowen Jiang, Meng Zhao, Dong Xia","doi":"10.1016/j.pan.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.012","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086727","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":"Letter to the editor: A call for caution in interpreting gender and racial disparities in acute necrotizing pancreatitis outcomes.","authors":"Di Wu, Yan Jia, Yilin Huang, Jie Peng","doi":"10.1016/j.pan.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.014","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","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":"Letter to the editor: Re-examining lymph node yield thresholds in pancreatic cancer: Nuances beyond subgroup differences.","authors":"Yuqing You, Jinyan Guo, Weifeng Yao","doi":"10.1016/j.pan.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.011","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086774","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":"An explainable prediction model for lymphovascular invasion and its prognostic value in resected pancreatic ductal Adenocarcinoma:A two-center study.","authors":"Linxia Wu, Lei Chen, Chunyuan Cen, Die Ouyang, Licai Zhang, Hongying Wu, Xin Li, Heshui Wu, Ping Han, Chuansheng Zheng","doi":"10.1016/j.pan.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.pan.2025.09.008","url":null,"abstract":"<p><strong>Background: </strong>Lymphovascular invasion (LVI) is an independent risk factor for poor prognosis in pancreatic ductal adenocarcinoma (PDAC). This study aimed to develop and validate an explainable machine learning (ML)-based prediction model for LVI and assessed its prognostic value in patients with PDAC.</p><p><strong>Methods: </strong>In this two-center retrospective study, a total of 262 patients (141 in the training cohort, 61 in the internal validation cohort, and 60 in the external validation cohort) with PDAC who underwent CECT examination were included. Preoperative indicators, including clinical characteristics, imaging findings and laboratory parameters, were utilized to construct prediction models with 10 ML algorithms. The Shapley Additive explanation method was further applied to explain the feature importance. Lastly, the association of the model-based risk stratification with disease-free survival (DFS) and overall survival (OS) was examined via Cox regression analysis.</p><p><strong>Results: </strong>The light gradient boosting machine (LightGBM) model demonstrated the best discriminative ability among the 10 ML models in the internal validation cohort. After feature removal according to feature importance ranking, a final explainable LightGBM model was derived with 10 features. The final model could accurately predict LVI in the internal (AUC = 0.814) and external (AUC = 0.795) validation groups. The model-based LVI risk stratification was an independent predictor of both DFS (all P < 0.001) and OS (all P < 0.001), demonstrating good prognostic performance across all subgroups.</p><p><strong>Conclusion: </strong>The explainable LightGBM model is an effective, non-invasive, and visualizable computer-aided tool for predicting the LVI status in patients with PDAC.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092160","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}