Pancreatology最新文献

{"title":"Pancreatic atrophy is a predictor for exocrine pancreatic dysfunction: Data from a large cohort of patients with chronic pancreatitis.","authors":"Ingrid Kvåle Nordaas, Audun M Trelsgård, Erling Tjora, Jens Brøndum Frøkjær, Ingfrid S Haldorsen, Søren Schou Olesen, Kristina Zviniene, Antanas Gulbinas, Camilla Nøjgaard, Srdan Novovic, Asbjørn Mohr Drewes, Trond Engjom","doi":"10.1016/j.pan.2024.11.009","DOIUrl":"10.1016/j.pan.2024.11.009","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic atrophy is commonly observed in end-stage chronic pancreatitis (CP). Diagnostic standards for pancreatic atrophy not well established. The present cross-sectional observation study explored two-point pancreatic size measurements in a large CP cohort from the Scandinavian Baltic Pancreatic Club (SBPC) database to validate clinically relevant cutoffs for pancreatic atrophy and explore associations to etiological factors and disease outcomes.</p><p><strong>Methods: </strong>Patients with CP according to M-ANNHEIM diagnostic criteria were included. We measured maximal axial dimension of the pancreatic head and body and recorded presence of calcifications and pancreatic duct changes on cross-sectional imaging. We calculated cutoffs for clinically relevant atrophy related to exocrine pancreatic dysfunction (EPD) defined as fecal elastase (FE) < 200. Associations between pancreatic atrophy and smoke, alcohol, sex, body size and disease outcomes were analysed using multivariate logistic regression.</p><p><strong>Results: </strong>We included 539 CP patients (356 male) from four centres in the SBPC study group. Small pancreatic size represented by sum of two-point maximal axial dimension less than 31 mm for females and 37.5 mm for males predicted EPD with good specificity (males: 0.89 (95 % CI, 0.81, 0.95), females: 0.96 (95 % CI, 0.85, 0.99)) but poor sensitivity (males: 0.38 (95 % CI, 0.31, 0.45), females 0.25 (95 % CI, 0.18, 0.35). Male sex, increasing age and long duration of CP were clearly associated with pancreatic atrophy. Corrected for other factors reducing exocrine capacity, pancreatic atrophy was still strongly associated to EPD.</p><p><strong>Conclusion: </strong>We conclude that following the suggested cutoffs, pancreatic atrophy in CP is independently associated with EPD.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1244-1251"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682451","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":"Rs1347093 regulates microRNA-216/-217 expression and is associated with pancreatic cancer risk.","authors":"Hsin-Hung Huang, Tzu-Yue Shiu, De-Chuan Chan, Chao-Feng Chang, Hsuan-Hwai Lin, Jung-Chun Lin, Peng-Jen Chen, Yu-Lueng Shih, Wei-Kuo Chang, Tsai-Yuan Hsieh","doi":"10.1016/j.pan.2024.10.004","DOIUrl":"10.1016/j.pan.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>Single nucleotide polymorphism (SNP) rs1347093 shows statistically significant association with lung cancer risk, but there is no further rs1347093 expression quantitative trait loci (eQTL) effect information. SNP rs1347093 is located in microRNA-216/-217 (miR-216/-217) locus. In addition, miR-216/-217 have pancreas-enriched expressions. In this study, we examined a potential miR-216/-217 promoter region, and investigated the effect of rs1347093-A allele on the miR-216/-217 promoter activity.</p><p><strong>Methods: </strong>Bioinformatics analysis, quantitative real-time PCR, luciferase reporter assay, Western blotting, and cell counting kit-8 (CCK-8) assay were performed.</p><p><strong>Results: </strong>The miR-216/-217 expressions are down-regulated in pancreatic cancer. In pancreatic cancer patients carrying the rs1347093-A allele, miR-216/-217 expressions were more largely suppressed. We identified a potential promoter region in miR-216/-217 locus and further showed that rs1347093-A allele resulted in significantly reduced promoter activity in pancreatic cancer cells, which could be mediated by MEF2C activities. In terms of mechanism in the pathogenesis of pancreatic cancer, miR-216b-5p expression was down-regulated, thereby preventing it from interacting with beclin-1 mRNA while promoting the survival of pancreatic cancer cells.</p><p><strong>Conclusions: </strong>This study may reveal the biological relevance underlying rs1347093-A allele with an increase in pancreatic cancer risk. SNP rs1347093 could be meaningful as a novel biomarker for pancreatic cancer risk.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1294-1301"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584023","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 regarding 'Aspirin use and the risk of pancreatic cancer'.","authors":"Shih-Wei Lai, Kuan-Fu Liao","doi":"10.1016/j.pan.2024.11.001","DOIUrl":"10.1016/j.pan.2024.11.001","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1378-1379"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605788","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 regarding 'Prevalence and risk factors of fatigue and its association with quality of life among patients with chronic pancreatitis: A cross-sectional study.'","authors":"Hamna Ameen, F N U Hafeezullah","doi":"10.1016/j.pan.2024.08.016","DOIUrl":"10.1016/j.pan.2024.08.016","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1374-1375"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056360","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 detection of pancreatic cancer: Study design and analytical considerations in biomarker discovery and early phase validation studies.","authors":"Lynette M Smith, Douglas W Mahoney, William R Bamlet, Fang Yu, Suyu Liu, Michael G Goggins, Sourat Darabi, Shounak Majumder, Qiao-Li Wang, Gregory A Coté, Michael J Demeure, Zhen Zhang, Sudhir Srivastava, Akhil Chawla, Grant Izmirlian, Janet E Olson, Brian M Wolpin, Jeanine M Genkinger, Kenneth S Zaret, Randall Brand, Eugene J Koay, Ann L Oberg","doi":"10.1016/j.pan.2024.10.012","DOIUrl":"10.1016/j.pan.2024.10.012","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease that is challenging to detect at an early stage. Biomarkers are needed that can detect PDAC early in the course of disease when interventions lead to the best outcomes. We highlight study design and statistical considerations that inform pancreatic cancer early detection biomarker evaluation.</p><p><strong>Methods: </strong>We describe experimental design strategies in this setting useful for streamlining biomarker evaluation at each Early Detection Research Network (EDRN) phase of biomarker development. We break the early EDRN phases into sub-phases, proposing objectives, study design strategies, and biomarker performance benchmarks.</p><p><strong>Results: </strong>The goal of early detection in populations at high-risk of PDAC is described. Evaluating biomarker behavior in patients under surveillance without disease can winnow candidate biomarkers. Potential resources for biomarker validation studies are described.</p><p><strong>Conclusions: </strong>Multisite and multidisciplinary collaboration can facilitate study design strategies in this lethal but low incidence disease and streamline the path from biomarker discovery to clinical use. Improvements in analytical and experimental design methods could help accelerate biomarker evaluation through the phases of biomarker development.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1265-1279"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625948","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":"The combined effect of hypoxia activation and radiosensitization by a multifunctional nanoplatform system enhances the therapeutic efficacy of chemoradiotherapy in pancreatic cancer.","authors":"Maoen Pan, Xiangqun Fan, Zuwu Wei, Heguang Huang, Ronggui Lin","doi":"10.1016/j.pan.2024.11.003","DOIUrl":"10.1016/j.pan.2024.11.003","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer is a highly malignant tumor, which is still a major global health problem. Chemotherapy and radiotherapy are regularly used in adjuvant therapy for pancreatic cancer but their therapeutic efficacy is limited.</p><p><strong>Methods: </strong>In the present study, nanoparticle（MSN-AuNPs） was used as a drug carrier loaded with tirapazamine(TPZ) and hyaluronic acid (HA) to synthesize a multifunctional nanoplatform HA@TPZ-MSN-AuNPs (HTMA) for hypoxia activation and radiotherapy sensitization, which can be combined with radiotherapy therapy and synergistically enhance the therapeutic effect in pancreatic cancer. The anti-tumor performance of the nano platform was verified by in vivo and in vitro experiments.</p><p><strong>Result: </strong>First, the HA@TPZ-MSN-AuNPs (HTMA) was successfully synthesized. Drug release experiments showed that acidic environment and hyaluronidase promoted drug release in the nanoplatform. In vitro experiments, CCK-8, live-dead staining, clonal formation assay and flow cytometry confirmed the combined anti-tumor effect of hypoxia activation and radiotherapy sensitization with HTMA. In the drug uptake experiment, the nanoplatform showed the function of targeting and binding pancreatic cancer cells. In vivo, HTMA demonstrated good antitumor properties and good biocompatibility.</p><p><strong>Conclusions: </strong>The nanoplatform had a good targeting effect and synergistic anti-tumor effect. The combination of hypoxia activation and radiotherapy sensitization is a promising strategy for the treatment of pancreatic cancer.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1302-1313"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625965","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":"Utilization of relative evaluation of pancreatic perfusion CT parameters to support appropriate pancreatic adenocarcinoma diagnosis.","authors":"Yoshihiro Konno, Kazuho Takisawa, Masafumi Kanoto, Yoshiki Ishii, Yoshie Obata, Tetsuya Ishizawa, Akiko Matsuda, Yasuharu Kakizaki","doi":"10.1016/j.pan.2024.11.008","DOIUrl":"10.1016/j.pan.2024.11.008","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of relative evaluation of perfusion computed tomography (PCT) parameters in the diagnosis of pancreatic adenocarcinoma (PAC).</p><p><strong>Methods: </strong>Of the 117 patients in which PCT was performed (May 2019 to June 2023), 99 patients with mass lesions (MLs), including 50 PAC and 11 patients with mass-forming pancreatitis (MFP), and 15 patients without MLs but with main pancreatic duct (MPD) abnormalities, including 6 PAC and 7 no diagnosis of malignancy (NDM) cases were enrolled in this study. Parameter values were obtained from parametric maps of blood flow (BF), blood volume (BV), and mean transit time (MTT) for the ML and abnormal MPD part (AMP), pancreas and spleen. Diagnostic performance was evaluated based on receiver operating characteristic analysis for absolute values and relative values for pancreas and spleen.</p><p><strong>Results: </strong>BF_ML, BV_ML, BF_ML/Pancreas, BF_ML/Spleen, BV_ML/Pancreas and BV_ML/Spleen were significantly lower in PAC than MFP cases. Areas under the curve (AUCs) for BF_ML, BF_ML/Pancreas, BF_ML/Spleen were 0.71 (sensitivity, 54 %; specificity, 91 %), 0.80 (sensitivity, 74 %; specificity, 82 %) and 0.79 (sensitivity, 68 %; specificity. 91 %), respectively. The AUCs for BV_ML, BV_ML/Pancreas, BV_ML/Spleen were 0.72 (sensitivity, 48 %; specificity, 100 %), 0.85 (sensitivity, 76 %; specificity, 91 %) and 0.87 (sensitivity, 76 %; specificity, 91 %), respectively, with significantly better diagnostic performance on relative evaluation (P < 0.05). BV_AMP/Spleen and MTT_AMP/Spleen were significantly higher in PAC than NDM cases, with AUCs of 1 (100 % sensitivity and specificity) and 0.91 (sensitivity, 86 %; specificity, 100 %), respectively.</p><p><strong>Conclusions: </strong>Relative evaluation of PCT parameters is expected to contribute to more appropriate diagnosis of PAC.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1314-1321"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649026","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":"Meta-analysis of routine abdominal drainage versus no drainage following distal pancreatectomy: Does the best available evidence overcome \"HPB surgeon's paranoia\"?","authors":"Shahin Hajibandeh, Omar Es Mostafa, Yeswanth Akula, Nader Ghassemi, Shahab Hajibandeh, Anand Bhatt, Damien Durkin, Tejinderjit S Athwal, Richard W Laing","doi":"10.1016/j.pan.2024.11.012","DOIUrl":"10.1016/j.pan.2024.11.012","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate comparative outcomes of routine abdominal drainage versus no drainage after distal pancreatectomy (DP).</p><p><strong>Methods: </strong>A systematic search of MEDLINE, CENTRAL and Web of Science and bibliographic reference lists were conducted (last search: 20th April 2024). All comparative studies reporting outcomes of DP with routine abdominal drainage and no drainage were included and their risk of bias were assessed. Overall perioperative complications, clinically-relevant postoperative pancreatic fistula (CR-POPF), delayed gastric emptying (DGE), postoperative haemorrhage, surgical site infections (SSIs), need for radiological intervention, reoperation, re-admission, and postoperative mortality were the evaluated outcome parameters.</p><p><strong>Results: </strong>Eight comparative studies (2 randomised and 6 observational) reporting 8164 patients who underwent DP with (n = 6394) or without (n = 1770) routine abdominal drainage were included. Routine abdominal drainage was associated with significantly higher rates of CR-POPF (OR 2.87; 95 % CI 2.34-3.52, p < 0.00001), radiological intervention (OR 1.33; 95 % CI 1.10-1.61, p = 0.0003), SSIs (OR 2.47; 95 % CI 1.29-4.72, p = 0.006) or re-admission (OR 1.54; 95 % CI 1.30-1.82, P < 0.00001) compared to no use of drain. However, there was no significant difference in C-D III or higher postoperative morbidities (OR 1.25; 95 % CI 0.98-1.60, p = 0.08), DGE (OR 1.17; 95 % CI 0.81-1.67, p = 0.41), reoperation (OR 1.11; 95 % CI 0.80-1.54, P = 0.53), postoperative haemorrhage (OR 0.59; 95 % CI 0.18-2.00, P = 0.40), or mortality (RD 0.0; 95 % CI -0.01-0.01, p = 0.76) between two groups.</p><p><strong>Conclusions: </strong>The meta-analysis of best available evidence indicates safety of \"no drain policy\" in distal pancreatectomy considering its lower risk of CR-POPF, re-intervention and hospital re-admission. More randomised evidence is required to overcome the \"HPB surgeon's paranoia\".</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1360-1372"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731810","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 regarding 'Exploring the Role of Neoadjuvant Therapy for Resectable Pancreatic Cancer'.","authors":"Aasim Akthar Ahmed, Tarun Kumar Suvvari, Jibin Johnson, Feba Wilson, Vimal Thomas","doi":"10.1016/j.pan.2024.11.002","DOIUrl":"10.1016/j.pan.2024.11.002","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1380-1381"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682441","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":"Timing of lumen-apposing metal stents removal in pancreatic fluid collections: Could we go beyond?","authors":"S Stigliano, G Marocchi, F Baldaro, B Neri, G Del Vecchio Blanco, E Troncone, F M Di Matteo","doi":"10.1016/j.pan.2024.10.011","DOIUrl":"10.1016/j.pan.2024.10.011","url":null,"abstract":"<p><strong>Background and aims: </strong>Lumen-apposing metal stents (LAMS) are the mainstay treatment for pancreatic fluid collections (PFC). A 4-weeks interval for LAMS removal has been suggested to avoid adverse events (AEs). Primary aim is to evaluate the AEs rate in patients with LAMS removal <4 and >4 weeks from placement and possible associated factors.</p><p><strong>Methods: </strong>Retrospective study on patients underwent EUS-guided drainage of PFC with LAMS at two Italian centers between January 2017 and November 2023. PFC and LAMS features were collected. AEs were defined as bleeding, obstruction and buried LAMS.</p><p><strong>Results: </strong>108 patients were enrolled (62.9 % males; mean age 61 ± 14 years old). In 38 % PFC was in pancreatic head. In 64.8 % of patients LAMS ≥15 mm was used. Mean time of LAMS indwelling was 71 ± 87 days and in 73.1 % of patients the LAMS was removed after 4 weeks. AE occurred in 8.3 % of patients and the most common (77.8 %) was bleeding. There was no association between LAMS indwelling >4 weeks (8/9 vs 65/93 p = 0.44) and the rate of AE. A comparable mean time of LAMS persistence (108 ± 96 vs 67 ± 86 p = 0.18) between patients with and without AE was observed. PFC in the head (7/9 vs 33/93 p = 0.02) and LAMS ≥15 mm (9/9 vs 58/93 p = 0.03) were associated with a higher rate of AE.</p><p><strong>Conclusion: </strong>When needed, LAMS removal >4 weeks appears to be as safe as LAMS removal within 4 weeks. LAMS ≥15 mm and Head location were associated with higher rate of AE and thus should arouse more caution.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":"1252-1256"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564643","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}