Pancreatology最新文献

{"title":"Serum IgG4-negative and IgG4-positive type 1 autoimmune pancreatitis present with different clinicopathological features: An analysis of a nationwide survey in Japan.","authors":"Takanori Sano, Kazuhiro Kikuta, Tetsuya Takikawa, Ryotaro Matsumoto, Kazuichi Okazaki, Yoshifumi Takeyama, Atsushi Masamune","doi":"10.1016/j.pan.2024.11.018","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.018","url":null,"abstract":"<p><strong>Background/objective: </strong>Elevated serum IgG4 (sIgG4) is a useful diagnostic marker of type 1 autoimmune pancreatitis (AIP). This study aimed to clarify the clinicopathological characteristics of the type 1 AIP patients without elevated sIgG4 levels.</p><p><strong>Methods: </strong>We analyzed the clinical data of patients registered in a nationwide epidemiological survey in Japan. AIP was diagnosed according to the International Consensus Diagnostic Criteria. Patients with sIgG4 levels ≥135 mg/dl at the diagnosis were classified as sIgG4-positive AIP, and those with sIgG4 levels <135 mg/dl were as sIgG4-negative AIP.</p><p><strong>Results: </strong>A total of 1285 patients with AIP were enrolled in this study; 1128 (87.8 %) had sIgG4-positive AIP and 157 (12.2 %) had sIgG4-negative AIP. Compared to patients with sIgG4-positive AIP, those with sIgG4-negative AIP more frequently experienced inflammatory bowel diseases (3.8 % vs. 0.4 %), and less frequently developed extrapancreatic lesions (53.5 % vs. 72.3 %), including sclerosing cholangitis (30.6 % vs. 40.7 %) and sialadenitis/dacryoadenitis (5.1 % vs. 24.7 %). Histopathological examinations were performed more frequently in patients with sIgG4-negative AIP. The criterion of abundant IgG4-positive plasma cells was less frequently fulfilled by patients with sIgG4-negative AIP (28.0 % vs. 43.1 %). A Kaplan-Meier analysis showed that relapse occurred less frequently in patients with sIgG4-negative AIP (P = 0.006). Results were similar even if the patients with AIP-not otherwise specified (n = 45) were excluded.</p><p><strong>Conclusions: </strong>Patients with sIgG4-negative type 1 AIP and those with sIgG4-positive type 1 AIP present with different clinicopathological features which suggests heterogeneity of patients with type 1 AIP. Low serum IgG4 levels could indicate low disease activity in type 1 AIP.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792097","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":"Progression of resectable pancreatic ductal adenocarcinoma during surgical delay and effects on survival - A propensity score matched study.","authors":"Bojan Kovacevic, Caroline Ewertsen, Thomas Skårup Kristensen, Luit Penninga, Carsten Palnæs Hansen","doi":"10.1016/j.pan.2024.11.015","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.015","url":null,"abstract":"<p><strong>Background: </strong>Surgery is the only curative treatment for pancreatic cancer, but less than 25 % of the patients present with a resectable tumor at the time of diagnosis. The aim of this study is to evaluate progression during surgical treatment delay and examine any associations between surgical treatment delay and survival.</p><p><strong>Methods: </strong>This is a retrospective, single center propensity score matched study including treatment naïve patients with pancreatic adenocarcinoma between 2018 and 2022. Outcomes included disease progression during surgical treatment delay in patients where follow-up imaging was performed as well as overall and recurrence-free survival for the entire cohort.</p><p><strong>Results: </strong>The study cohort consisted of 290 patients of whom 129 (44.5 %) underwent follow-up imaging. Radiological progression to unresectable disease during surgical delay was seen in 14 cases (10.9 %), with another 17 cases (13.2 %) deemed unresectable during intended resection. Tumor size progression was observed in 29 patients (22.5 %) with an average tumor growth rate of 7.4 mm (95%CI 5.8-8.9, p < 0.001). Median time to surgery was 37 days with no observed associations between treatment delay and overall survival (HR = 1.02, 95%CI 0.76-1.38, p = 0.996), or the risk of recurrence (HR = 1.06, 95%CI 0.77-1.48, p = 0.709).</p><p><strong>Conclusion: </strong>Progression in tumor size does not seem to affect survival in our study population. In general, surgical treatment delay in up-front resectable patients does not seem to be associated with survival or the risk of recurrence, but the optimal and maximal time to surgery as well as the optimal timing of the follow-up scanning remain unclear.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771047","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":"High prevalence of pancreatic steatosis in pancreatic cancer patients: A meta-analysis and systematic review.","authors":"Cătălina Vlăduț, Corinna Steiner, Matthias Löhr, Dilara Turan Gökçe, Patrick Maisonneuve, Thomas Hank, Daniel Öhlund, Malin Sund, Sanne A Hoogenboom","doi":"10.1016/j.pan.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.010","url":null,"abstract":"<p><strong>Objective: </strong>In the last decade there has been increasing interest in defining pancreatic steatosis (PS) and establishing its association with pancreatic ductal adenocarcinoma (PDAC). However, no consensus guidelines have yet been published on the management of PS. In this systematic review and meta-analysis performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we investigated the association between PS and PDAC.</p><p><strong>Design: </strong>Medical literature between 2007 and 2023 was reviewed for eligible trials investigating the prevalence of PS in patients with PDAC. Eligible studies reporting on PS, assessed via imaging or histology, were included. The primary objective was to determine the association between PDAC and PS by comparing the prevalence of PS in individuals with- and without PDAC. Secondary, an evaluation was conducted to establish whether the method of assessment correlated with the association of PDAC and PS, and the prevalence of PDAC in individuals with PS. Measures of effect size were determined using odds ratios (ORs) and corresponding 95 % confidence intervals (95 % CI).</p><p><strong>Results: </strong>The systematic review identified a total of 23 studies, of which seventeen studies examined PS prevalence among PDAC patients and were included in the meta-analysis. Overall, the pooled prevalence of PS in patients with PDAC was 53.6 % (95 % CI 40.9-66.2). No significant difference in PS prevalence was observed across various diagnostic methods or geographical regions. Overall, the pooled OR for PS in patients with PDAC compared to controls was 3.23 (95 % CI 1.86-5.60).</p><p><strong>Conclusions: </strong>PDAC patients have a high prevalence of PS, and they are significantly more likely to have PS compared to controls. These findings emphasize the need to prioritize a standardized approach to the diagnosis, follow-up, and treatment of PS, with future studies focusing on identifying patients who would benefit from PDAC surveillance programs.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872783","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":"Outcomes of percutaneous versus endoscopic transmural necrosectomy for necrotizing pancreatitis: A propensity score-matched study.","authors":"Ling Ding, Lei Li, Jingwen Rao, Yong Zhu, Liang Xia, Pi Liu, Lingyu Luo, Huifang Xiong, Yang Hu, Yao Wu, Huajing Ke, Xin Huang, Yupeng Lei, Xu Shu, Zhijian Liu, Youxiang Chen, Nonghua Lu, Yin Zhu, Wenhua He","doi":"10.1016/j.pan.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.pan.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Few published studies exist that compare the outcomes of different endoscopic necrosectomy methods for necrotizing pancreatitis (NP). We compared the safety and efficacy of percutaneous versus transmural endoscopic necrosectomy for NP patients.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed adult NP patients who underwent either percutaneous endoscopic necrosectomy (PEN) or endoscopic transmural necrosectomy (ETN), and compared safety and efficacy between the two groups. Propensity score-matched analysis and multivariable logistic regression analysis were conducted.</p><p><strong>Results: </strong>A total of 280 patients were enrolled, among which 142 underwent PEN and 138 underwent ETN. There were differences in baseline characteristics between the two groups, including body mass index, C-reactive protein, systemic inflammatory response syndrome score. The incidences of sepsis, respiratory failure, and intensive care unit stay were higher among patients who underwent PEN than those who underwent ETN (all P < 0.01). Ninety-one pairs were matched with comparable baseline characteristics and severity. The incidence of postoperative complications, open surgery, clinical success, radiological success, collection recurrence, and reintervention were not significantly different between the ETN group and PEN group (all P > 0.05). Multivariate analysis also showed that the approaches (PEN vs ETN) was not associated with postoperative complications or mortality.</p><p><strong>Conclusions: </strong>In real world setting, sicker patients tend to be more effectively managed through PEN compared to ETN. PEN demonstrates comparable efficacy and safety to ETN in the treatment of NP patients.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625951","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":"Comparison between pancreatoblastoma (PB) and solid pseudopapillary neoplasm (SPN) in pediatric patients with enhanced CT","authors":"Lin Chen ,&nbsp;Mengchen Yuan ,&nbsp;Meng Wang,&nbsp;Chenglong Luo,&nbsp;Mengyu Gao,&nbsp;Yamin Wan,&nbsp;Zhigang Zhou","doi":"10.1016/j.pan.2024.09.014","DOIUrl":"10.1016/j.pan.2024.09.014","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>To investigate whether computed tomography features can differentiate pancreatoblastoma (PB) from solid pseudopapillary tumor (SPN) in children.</div></div><div><h3>Materials and methods</h3><div>Clinical and imaging data of 18 cases of PB and 61 cases of SPN confirmed by surgery or biopsy were retrospectively analyzed. All enrolled patients underwent 3 phases (non-contrast, arterial, and portal venous phases) of CT scanning. Qualitative CT analysis (location, margin, solid/cystic component proportion, calcification, hemorrhage, peritumoral vascularity, bile duct dilatation, pancreatic duct dilatation, pancreatic atrophy, vascular invasion, peripancreatic invasion, and distant metastases) and quantitative analysis (maximum tumor diameter, interface between tumor and parenchyma [delta], arterial enhancement ratio [AER], and portal enhancement ratio [PER]) were performed. The general CT morphologic features, age and tumor markers were compared also compared between the groups. Univariate analysis and the F test were conducted to identify features of PB. Then logistic Regression classifier was trained using the top five features with the highest F-value. Moreover, we used 5-fold cross-validation techniques for the validation of our model.</div></div><div><h3>Results</h3><div>PB exhibited a significantly higher frequency of location in the body/tail, larger tumor size, poorly defined margins, calcification, peritumoral vascularity, pancreatic atrophy, and less hemorrhage. In addition, PB had higher AER, PER and lower delta relative to SPN (p &lt; 0.05). PB presented a younger age and higher levels of AFP. Results of the F test indicated that AFP, AER, Age, calcification and pancreatic atrophy were the top five features included in the model that could differentiate pediatric PB from SPN. The combined model of CT and clinical features performed well in differentiating PB from SPN, with an AUC of 0.981 in the training cohort and 0.953 in the validation cohort.</div></div><div><h3>Conclusions</h3><div>AFP, AER, age, calcification and pancreatic atrophy are robust CT and clinical features for differentiating pediatric PB from SPN. A combination of qualitative and quantitative CT features may provide good diagnostic accuracy in differentiating PB from SPN in children.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1152-1159"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268452","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}

{"title":"Impact of neoadjuvant chemoradiotherapy on pathologic response in pancreatic ductal adenocarcinoma: A systematic review and meta-analysis","authors":"Quoc Riccardo Bao ,&nbsp;Marco Ventin ,&nbsp;Lorenzo Dell’Atti ,&nbsp;Marzia Tripepi ,&nbsp;Isabella Frigerio ,&nbsp;Giovanni Butturini ,&nbsp;Filippo Crimì ,&nbsp;Marco Scarpa ,&nbsp;Salvatore Pucciarelli ,&nbsp;Cristina R. Ferrone ,&nbsp;Gaya Spolverato","doi":"10.1016/j.pan.2024.09.010","DOIUrl":"10.1016/j.pan.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>The impact of chemoradiotherapy on pathologic response, resection margin, and survival benefit is still debated. The aim of this study was to compare the rate of pathologic complete response (pCR) in surgical resection following neoadjuvant chemotherapy vs. chemoradiotherapy, and secondarily, to compare the rate of R0 resection and Overall Survival (OS).</div></div><div><h3>Methods</h3><div>A systematic review on MEDLINE/PubMed, Embase, Cochrane, Web of Science and Google Scholar was conducted for studies published between 2012 and 2024 (PROSPERO CRD42022341467). All studies reporting clinical outcomes of patients with Pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant therapy were considered eligible for inclusion. A meta-analysis comparing the rate of pCR, R0 resection rate, and 3-year OS following Chemotherapy vs chemoradiotherapy in patients was performed. The overall quality of evidence was evaluated using a GRADE approach.</div></div><div><h3>Results</h3><div>Out of 5194 potentially relevant studies, 29 studies were considered eligible for full-text assessment, and 11 studies were included in the systematic review and in the meta-analysis. Of these, five were retrospective single-center, five retrospective multi-center studies, and one was a phase II multi-center RCT. Overall, 1830 Chemotherapy patients and 2299 Chemoradiotherapy patients were included in the meta-analysis. A statistically significant increased rate of pCR and R0 resections were found in chemoradiotherapy patients (OR 3.58, 95 % CI 2.47–5.18, p ≤ 0.00001) (OR 1.49, 95 % CI 1.17–1.90, p = 0.001), whereas 3-year OS (OR 1.07, 95 % CI 0.84–1.36, p = 0.6) did not differ significantly.</div></div><div><h3>Conclusions</h3><div>Chemoradiotherapy may have a positive impact on pathologic response and R0 resection rate, whereas a survival benefit was not reported.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1107-1114"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366202","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":"Oral high-carbohydrate solution as an alternative dietary modality in patients with acute pancreatitis","authors":"See Young Lee ,&nbsp;Jaein Lee ,&nbsp;Jae Hee Cho ,&nbsp;Dong Ki Lee ,&nbsp;Yeseul Seong ,&nbsp;Sung Ill Jang","doi":"10.1016/j.pan.2024.09.019","DOIUrl":"10.1016/j.pan.2024.09.019","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Early enteral feeding is crucial in acute pancreatitis (AP) to preserve the intestinal mucosa, prevent bacterial overgrowth, and prevent progression to pancreatic necrosis, multi-organ failure, and death. However, the optimal early diet remains unclear. This study compared an oral carbohydrate solution (OCS) diet versus a conventional diet (CD) in patients with AP.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 538 patients diagnosed with AP in 2018–2022: 346 received a CD and 192 received an OCS diet. Because of differences in AP severity between groups, we performed 1:1 propensity score matching to obtain comparable groups (n = 182 in each). The CD group progressed from a liquid diet to soft foods and finally solid foods. The OCS group followed the same progression but received OCS instead of a liquid diet. Primary outcomes were the rate of recurrent postprandial pain after initiating the dietary intervention and hospital length of stay (LOS). Secondary outcomes included intensive care unit admission, mortality, 28-day hospital readmission, and AP-related complications.</div></div><div><h3>Results</h3><div>After propensity score matching, baseline characteristics of the OCS and CD groups were comparable. The rate of recurrent pain was significantly higher in the CD group than in the OCS group (13.2 % vs. 3.8 %, p &lt; 0.001), but hospital LOS was similar between groups (CD vs. OCS: 9.2 days vs. 8.7 days, p = 0.533). There were no significant differences in secondary outcomes between groups.</div></div><div><h3>Conclusions</h3><div>In patients with AP, OCS diet was associated with a lower rate of recurrent postprandial pain compared to a CD. Thus, OCS appears to be a beneficial dietary alternative for initial management of AP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1003-1011"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366203","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":"Caveolin-1 expression is a predictor of survival and recurrence patterns in resected pancreatic ductal adenocarcinoma","authors":"Yuki Hirose ,&nbsp;Atsushi Oba ,&nbsp;Manabu Takamatsu ,&nbsp;Tsuyoshi Hamada ,&nbsp;Tsuyoshi Takeda ,&nbsp;Tatsunori Suzuki ,&nbsp;Aya Maekawa ,&nbsp;Yuki Kitano ,&nbsp;Shoki Sato ,&nbsp;Kosuke Kobayashi ,&nbsp;Kojiro Omiya ,&nbsp;Yoshihiro Ono ,&nbsp;Takafumi Sato ,&nbsp;Hiromichi Ito ,&nbsp;Takashi Sasaki ,&nbsp;Masato Ozaka ,&nbsp;Kengo Takeuchi ,&nbsp;Naoki Sasahira ,&nbsp;Yosuke Inoue ,&nbsp;Toshifumi Wakai ,&nbsp;Yu Takahashi","doi":"10.1016/j.pan.2024.10.001","DOIUrl":"10.1016/j.pan.2024.10.001","url":null,"abstract":"<div><h3>Background<em>/objective</em></h3><div>Caveolin-1 (Cav1) expressed in cancer cells (cCav1) or cancer-associated fibroblasts (fCav1) exerts either pro- or anti-tumorigenic effects depending on the cancer type or stage of cancer. We aimed to clarify the impact of cCav1 or fCav1 on survival, recurrence patterns, and efficacy of neoadjuvant chemotherapy (NAC) in resected pancreatic ductal adenocarcinoma (PDAC).</div></div><div><h3>Methods</h3><div>Tissue microarrays were constructed including 615 patients who underwent curative resection for PDAC. Cav1 expression was evaluated by immunohistochemistry. Patients were divided into two groups based on Cav1 expression in cancer cells (cCav1_high vs. cCav1_low) or cancer-associated fibroblasts (fCav1_high vs. fCav1_low).</div></div><div><h3>Results</h3><div>Among all 615 patients, 40.7% were cCav1_high and 72.7% were fCav1_high. cCav1_high was associated with worse overall survival (OS) (<em>p</em> = 0.001) and recurrence-free survival (RFS) (<em>p</em> = 0.001) than cCav1_low, and was an independent prognostic factor in multivariate analysis of OS and RFS (OS: <em>p</em> = 0.001, hazard ratio [HR] 1.361; RFS: <em>p</em> = 0.001, HR 1.348). Among 596 patients with resectable/borderline resectable PDAC, cCav1_high patients with NAC showed better OS than those without, while there was no significant difference between cCav1_low patients with NAC and those without. cCav1_high was associated with early recurrence (&lt; 6 months) and liver metastasis after resection. Multivariate analysis revealed cCav1_high as an independent predictor of liver metastasis.</div></div><div><h3>Conclusions</h3><div>cCav1_high correlated with worse survival, early recurrence, and liver metastasis after resection for PDAC, while NAC improved survival in cCav1_high patients. The Evaluation of cCav1 status could provide additional information contributing to the personalized management of PDAC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1021-1030"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472325","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 tumor immune microenvironment in resected treatment-naive pancreatic cancer patients with long-term survival","authors":"Casper W.F. van Eijck ,&nbsp;Jie Ju ,&nbsp;Freek R. van ’t Land ,&nbsp;Maaike Verheij ,&nbsp;Yunlei Li ,&nbsp;Andrew Stubbs ,&nbsp;Michael Doukas ,&nbsp;Karishma Lila ,&nbsp;Lara R. Heij ,&nbsp;Georg Wiltberger ,&nbsp;Lola Alonso ,&nbsp;Núria Malats ,&nbsp;Bas Groot Koerkamp ,&nbsp;Eveline E. Vietsch ,&nbsp;Casper H.J. van Eijck","doi":"10.1016/j.pan.2024.08.014","DOIUrl":"10.1016/j.pan.2024.08.014","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers worldwide. Presently, only a fraction of patients undergo successful surgical resection, the most effective treatment. Enhancing treatment strategies necessitates a deep comprehension of the factors underlying extended survival after surgical resection in patients.</div></div><div><h3>Methods</h3><div>This study aims to identify the important factors of PDAC patients’ long-term survival with metatranscriptomics and multiplex immunofluorescence (IF) staining analyses. Specifically, differences in tumor immune microenvironment (TIME) were investigated between treatment-naïve PDAC short-term survivors (STS, overall survival &lt;6 months) and long-term survivors (LTS, overall survival &gt;5 years).</div></div><div><h3>Results</h3><div>As a result, we detected 589 over-expressed genes, including <em>HOXB9</em>, <em>CDA</em>, and <em>HOXB8</em>, and 507 under-expressed genes, including <em>AMY2B</em>, <em>SCARA5</em>, and <em>SLC2A2</em> in LTS. Most of the Reactome overbiological pathways enriched in our data were over-expressed in LTS, such as RHO GTPase Effectors and Cell Cycle Checkpoints. Eleven microbiomes significantly differed between LTS and STS, including <em>Sphingopyxis</em> and <em>Capnocytophaga</em>. Importantly, we demonstrate that the TIME profile with an increased abundance of memory B cells and the reduction of M0 and pro-tumoral M2 macrophages are associated with a good prognosis in PDAC.</div></div><div><h3>Conclusions</h3><div>In this study, we delved into the TIME with metatranscriptomics and IF staining analyses to understand the prerequisite of prolonged survival in PDAC patients. In LTS, several biological pathways were overexpressed, and specific microbiomes were identified. Furthermore, apparent differences in driven immune factors were found that provide valuable insights into developing new treatment strategies.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1057-1065"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110810","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}

{"title":"Prevalence and spectrum of germline pathogenic variants in cancer susceptibility genes among mexican patients with exocrine pancreatic cancer","authors":"José Luis Rodríguez-Olivares ,&nbsp;Tamara N. Kimball ,&nbsp;Joanne M. Jeter ,&nbsp;Héctor De-La-Mora-Molina ,&nbsp;Isaac Núñez ,&nbsp;Jeffrey N. Weitzel ,&nbsp;Yanin Chávarri-Guerra","doi":"10.1016/j.pan.2024.09.018","DOIUrl":"10.1016/j.pan.2024.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Although universal germline genetic testing is recommended for patients with exocrine pancreatic cancer (PC), access to genetic testing remains limited in low- and middle-income countries. This study aims to narrow the gap in our understanding of the spectrum of germline pathogenic and likely pathogenic variants (PVs) in cancer susceptibility genes in the Mexican population.</div></div><div><h3>Methods</h3><div>The landscape of PVs in cancer susceptibility genes was identified by next-generation sequencing multigene panel assays among patients with PC who were enrolled in the Clinical Cancer Genomics Community Research Network prospective registry in Mexico City.</div></div><div><h3>Results</h3><div>From August 2019 to April 2023, 137 patients underwent genetic testing. The median age at diagnosis was 60 years (range 36–85), 58.4 % were women, and 38.7 % were metastatic at diagnosis. The frequency of germline PVs was 16 % (n = 22): <em>ATM</em> 36.4 % (n = 8), <em>CDKN2A</em>/p16^INK4A 27.3 % (n = 6), <em>BRCA2</em> 9.1 % (n = 2), <em>PALB2</em> 9.1 % (n = 2), <em>CHEK2</em> 9.1 % (n = 2), <em>TP53</em> 4.5 % (n = 1), and <em>NF1</em> 4.5 % (n = 1). Additionally, 2 carriers of monoallelic germline variants in <em>MUTYH</em> were identified. No significant differences were observed between carriers and non-carriers in terms of family history of pancreatic cancer.</div></div><div><h3>Conclusions</h3><div>We identified a significant frequency of actionable germline PVs in Mexicans with PC, wherein the majority were in a broad spectrum of genes associated with the homologous recombination DNA repair mechanism. Most pancreatic cancer associated PVs were detected in non-<em>BRCA</em> genes, so our findings support the recommendation of multigene panel testing for genetic cancer risk assessment of Mexican individuals with PC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1049-1056"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351778","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}