Pancreatology最新文献

{"title":"The impact of targeted next-generation DNA sequencing on the diagnostic accuracy of endoscopic ultrasound-guided tissue sampling of focal pancreatic lesions","authors":"Suzane Ribeiro ,&nbsp;Emine Gökce ,&nbsp;Siebe Loontiens ,&nbsp;Luis Abreu de Carvalho ,&nbsp;Clarisse Lecluyse ,&nbsp;Niki Rashidian ,&nbsp;Filip Gryspeerdt ,&nbsp;Frederik Berrevoet ,&nbsp;Anne Hoorens ,&nbsp;Joni Van der Meulen ,&nbsp;Pieter Hindryckx ,&nbsp;Karen Geboes","doi":"10.1016/j.pan.2026.04.003","DOIUrl":"10.1016/j.pan.2026.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Accurate diagnosis of pancreatic lesions remains challenging. This study evaluated the diagnostic value of targeted DNA-based next-generation sequencing (NGS) of tissue obtained by endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) and its contribution to pancreaticobiliary multidisciplinary tumor board (MDTB) discussions.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using a prospectively maintained database at Ghent University Hospital (March 2021–September 2024). Only patients undergoing targeted DNA NGS on EUS-FNA/FNB samples were included and reviewed during MDTB meetings. Diagnostic performance and influence on management were compared with final diagnoses established by clinical follow-up and/or surgical pathology.</div></div><div><h3>Results</h3><div>The final cohort comprised 120 focal pancreatic lesions. Ninety-one percent of solid masses (50/55) were malignancies. Cytopathology alone identified pancreatic cancer (PC) or high-grade dysplasia (HGD) in 27 cases (sensitivity 54%), whereas NGS alone identified 42 (sensitivity 84%). Combined cytopathology and NGS detected 45/50 malignancies (90%). Only two samples were non-diagnostic, yielding an overall diagnostic success of 96% (53/55).</div><div>NGS was technically successful in 33/65 (51%) cystic lesions. Surgery was undertaken in 20 patients, with HGD or carcinoma confirmed in 11 (55%). Molecular profiling combined with cytopathology guided surgical decision-making in 6/11 patients (54%) compared with 3/11 (27%) with cytopathology alone.</div></div><div><h3>Conclusion</h3><div>Targeted NGS improves diagnostic accuracy in solid pancreatic lesions and supports surgical decision-making for cystic lesions. Integration of molecular findings into MDTB discussions enhances precision and timeliness of pancreatic cancer treatment.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 616-626"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675554","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":"Prevalence and natural course of MRI-diagnosed dilated main pancreatic duct: A longitudinal, population-based prospective cohort study with a ten-year follow-up","authors":"Daniel Schmitz ,&nbsp;Fabian Yazdi ,&nbsp;Kevin Claaßen ,&nbsp;Henry Völzke ,&nbsp;Mark O. Wielpütz ,&nbsp;Philip Konietzke ,&nbsp;Ali A. Aghdassi ,&nbsp;Robin Bülow","doi":"10.1016/j.pan.2026.03.016","DOIUrl":"10.1016/j.pan.2026.03.016","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic main duct dilation (PMDD) may indicate an increased risk of developing pancreatic cancer. Little is known about the prevalence and natural course of PMDD in the general population. Therefore, this study aimed to analyse PMDD using magnet resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>Longitudinal MRI combined with magnetic resonance cholangiopancreatography was performed between 2008 and 2021 as part of the prospective population-based Study of Health in Pomerania (SHIP), with 2,2 ± 0,6 MRI per participant on average performed within an average of 10,8 ± 1,2 yrs. PMDD was defined as ≥ 5 mm, and was correlated with clinical and epidemiological data.</div></div><div><h3>Results</h3><div>The prevalence of PMDD was 81/2985 individuals (2.7%). The mean age of these was 55.1 ± 13.2 yrs. Cumulative 5 yr-incidence of newly developed PMDD was 1.1% (22/1935) and 3.0% (15/496) after 10 yrs. Poisson regression analysis revealed strong associated factors of PMDD: active smoking (PR 2.93), diabetes (PR 2.58) and frequent alcohol abuse (PR 1.78) After a median follow-up period of 4.5 years, pancreatic cancer and chronic pancreatitis were diagnosed more frequently in the PMDD group: 2/81 (2.5%) vs. 24/2904 (0.8%) and 8/81 (9.9%) vs. 46/2904 (1.6%). Pancreatic cancer-specific survival was lower in cases of PMDD (HR = 4.96 (95% CI 1.31–18.84)).</div></div><div><h3>Conclusion</h3><div>A PMDD ≥5 mm is a frequent incidental MRI finding in the general population (2.7%). The risk of malignant transformation was higher with PMDD (2.5%) than without (0.8%). Chronic pancreatitis was diagnosed four times as often than pancreatic cancer in follow-up.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 607-615"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609604","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":"Impact of sarcopenia and myosteatosis on early and long-term survival after surgical resection of pancreatic ductal adenocarcinoma","authors":"Niels Siegel ,&nbsp;Robert Stollmayer ,&nbsp;Philipp Mayer ,&nbsp;Natalie Altendorf ,&nbsp;Ingmar F. Rompen ,&nbsp;Anna-Katharina König ,&nbsp;Mohammed Al-Saeedi ,&nbsp;Martin Loos ,&nbsp;Markus W. Büchler ,&nbsp;Miriam Klauss ,&nbsp;Thomas Hank","doi":"10.1016/j.pan.2026.04.007","DOIUrl":"10.1016/j.pan.2026.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia and altered body composition are increasingly recognized as prognostic markers in oncology. In pancreatic ductal adenocarcinoma (PDAC), their time-dependent impact on survival remains unclear.</div></div><div><h3>Methods</h3><div>Patients with PDAC who underwent resection at Heidelberg University Hospital between 2013 and 2018 were included. Preoperative CT scans were assessed at the L3 level using the automated Body and Organ Analysis (BOA) tool. Sarcopenia Index (SI) and Myosteatosis Fat Index (MFI) were calculated. Multivariable Cox regression was performed for overall survival at predefined postoperative time points.</div></div><div><h3>Results</h3><div>A total of 723 patients were included. Some 140 patients (19.4%) underwent neoadjuvant therapy, while 583 (80.6%) received upfront surgical resection. The median OS for the entire cohort was 26.0 months (95% CI, 23.4 – 28.3). Patients with a low SI exhibited markedly reduced overall survival compared to those with a high SI (p &lt; 0.001). In multivariate Cox regression analyses, a lower SI was independently associated with increased mortality at 90 days (HR: 0.44, 95% CI: 0.24–0.81) and at 1 year (HR: 0.71, 95% CI: 0.56–0.90). A similar prognostic pattern was observed for the MFI, which also showed independent associations with early mortality. Beyond the first postoperative year, this effect diminished and nodal status, resection margin and CA19-9 levels became the predominant predictors of overall survival.</div></div><div><h3>Conclusions</h3><div>Preoperative sarcopenia and myosteatosis are strong predictors of early mortality after PDAC resection, whereas tumor biology determines long-term outcomes. Automated CT-based body composition analysis may support perioperative risk stratification and targeted prehabilitation strategies.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 627-634"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675424","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 progression of paediatric pancreatitis: Is early chronic pancreatitis underdiagnosed?","authors":"Ujjal Poddar MD, DNB, DM ,&nbsp;Sadhna B. Lal MD, DM","doi":"10.1016/j.pan.2026.04.017","DOIUrl":"10.1016/j.pan.2026.04.017","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 521-522"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818961","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":"Comment on “Effect of albumin infusion in patients with predicted severe acute pancreatitis: A randomized controlled trial”","authors":"Jiaqi Wang ,&nbsp;Kaiyan Liu ,&nbsp;Yaofang Zhang ,&nbsp;Jie Li","doi":"10.1016/j.pan.2025.12.004","DOIUrl":"10.1016/j.pan.2025.12.004","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 653-654"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A community–hospital collaborative diagnostic pathway for earlier detection of pancreatic cancer: Long-term impact of the Onomichi Method","authors":"Keiji Hanada ,&nbsp;Akinori Shimizu ,&nbsp;Shinji Tanaka ,&nbsp;Nobutaka Sasaki","doi":"10.1016/j.pan.2026.04.011","DOIUrl":"10.1016/j.pan.2026.04.011","url":null,"abstract":"<div><h3>Background and aims</h3><div>Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies because opportunities for diagnosis at a curable stage are rarely realized. Population-wide screening is not recommended; therefore, scalable diagnostic strategies for earlier detection are required. We evaluated whether a structured community–hospital diagnostic pathway (the Onomichi Method) could advance diagnostic timing in routine clinical practice.</div></div><div><h3>Methods</h3><div>This observational study analyzed a regional diagnostic pathway implemented in Japan since 2007. The pathway integrates risk assessment in primary care based on medical history, clinical risk factors, blood tests, and abdominal ultrasonography, followed by risk-based triage, tiered referral, endoscopic ultrasonography (EUS), and pancreatic juice cytology using endoscopic nasopancreatic drainage (ENPD). Temporal changes in diagnostic stage distribution and observed survival were evaluated through 2023.</div></div><div><h3>Results</h3><div>Among 29,642 individuals assessed through risk-based primary-care evaluation between 2007 and 2023, 925 pancreatic cancers were diagnosed. The proportion of stage 0/I disease increased from 13.9% in 2007–2015 to 22.1% in 2016–2017 (chi-square test, p = 0.017). Observed 5-year survival improved from 14.9% to 20.7% across diagnostic eras (log-rank test, p = 0.040). Stage-stratified analyses showed no significant survival differences within stage 0/I (p = 0.533) or stage II–IV (p = 0.315) groups.</div></div><div><h3>Conclusions</h3><div>A community–hospital diagnostic pathway integrating primary care and advanced endoscopy was associated with a shift toward earlier pancreatic cancer diagnosis. Improved overall survival primarily reflected diagnostic stage migration rather than stage-specific therapeutic advances. These findings highlight the importance of structured community–hospital diagnostic pathways for improving the timeliness of pancreatic cancer diagnosis in routine clinical practice.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 587-593"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717661","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":"Impact of socioeconomic deprivation on patient outcomes in chronic pancreatitis","authors":"Eoin Keating ,&nbsp;Freda Tuor ,&nbsp;Wilson Cheng ,&nbsp;Asbjørn Mohr Drewes ,&nbsp;Sanjay Pandanaboyana ,&nbsp;Manu Nayar","doi":"10.1016/j.pan.2026.03.019","DOIUrl":"10.1016/j.pan.2026.03.019","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 641-643"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521715","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":"Reply to the Letter to the Editor regarding microbiome-genetic interplay in intraductal papillary mucinous neoplasms of the pancreas","authors":"Kosuke Fukuda,&nbsp;Yuto Hozaka,&nbsp;Takao Ohtsuka","doi":"10.1016/j.pan.2026.04.016","DOIUrl":"10.1016/j.pan.2026.04.016","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 649-650"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856840","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":"Dose–response analysis of tirzepatide and acute pancreatitis: An international systematic review and quantitative meta-analysis of randomised trials","authors":"Olivia Benny ,&nbsp;Anurag Agarwal ,&nbsp;Harvey Alecock ,&nbsp;Raksha Ganapathy Subramani ,&nbsp;Anoushka Pawar ,&nbsp;Zubayer Shams ,&nbsp;Mohammad Kermansaravi ,&nbsp;Sjaak Pouwels ,&nbsp;Wah Yang ,&nbsp;Chidubem Gerald Obi ,&nbsp;Peter Cripps ,&nbsp;Alethea Tang ,&nbsp;Edgar Gelber ,&nbsp;Anil lala ,&nbsp;Khaldoun Nadi ,&nbsp;Adel Mahmoud ,&nbsp;Mohammed Hammoda ,&nbsp;Hashim Al-Sarireh ,&nbsp;Richard Egan ,&nbsp;Daniel Hanratty ,&nbsp;Suhaib JS. Ahmad","doi":"10.1016/j.pan.2026.03.021","DOIUrl":"10.1016/j.pan.2026.03.021","url":null,"abstract":"<div><h3>Background</h3><div>Tirzepatide, a dual GIP/GLP-1 receptor agonist for type 2 diabetes and obesity, carries a theoretical risk of pancreatitis. Whether risk varies by dose is uncertain.</div></div><div><h3>Methods</h3><div>Randomised controlled trials (RCTs) reporting outcomes from Tirzepatide 5, 10, and 15 mg once weekly were systematically reviewed. The primary outcome was acute pancreatitis, interpreted against the Revised Atlanta criteria where available. Pooled risk ratios (RRs) were calculated using Mantel–Haenszel random-effects models with a small continuity correction for single-zero trials; double-zero trials were excluded as non-informative. Sensitivity analyses excluded single-zero studies. Poisson generalised linear mixed models (GLMMs) with study-level random intercepts assessed robustness and explored age/sex as moderators. Risk of bias used RoB 2.0.</div></div><div><h3>Results</h3><div>Nineteen RCTs (n = 15,471) met inclusion criteria. Acute pancreatitis was exceedingly rare (0.22%). Head-to-head dose comparisons showed no significant differences: 10 mg vs 5 mg (RR 0.78, 95% CI 0.29–2.09), 15 mg vs 5 mg (RR 0.70, 0.27–1.82), and 15 mg vs 10 mg (RR 1.13, 0.42–3.02); sensitivity analyses were concordant. GLMMs yielded similar inferences; age and sex did not materially modify risk. Most RoB 2.0 domains were low risk, with some concerns for missing data/selective reporting. All trials were industry-funded with short-to-moderate follow-up; funnel plots were underpowered.</div></div><div><h3>Conclusions</h3><div>Across RCTs, acute pancreatitis with Tirzepatide is rare and shows no demonstrable dose–response between 5 and 15 mg. Precision remains limited; clinicians should maintain vigilance, optimise modifiable risks, individualise dosing, and contribute to post-marketing surveillance.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 552-565"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609556","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":"Knowledge, preferences, and potential barriers to additional testing among patients identified as increased risk of pancreatic cancer through machine-learning algorithms: a cross-sectional survey study","authors":"Kush Yadav ,&nbsp;Tiffany Q. Luong ,&nbsp;Eva Lustigova ,&nbsp;Christie Jeon ,&nbsp;Wansu Chen ,&nbsp;Mercedes A. Munis ,&nbsp;Devon Klein ,&nbsp;Jessica Moore ,&nbsp;Bechien U. Wu","doi":"10.1016/j.pan.2026.03.017","DOIUrl":"10.1016/j.pan.2026.03.017","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 4","pages":"Pages 638-640"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778332","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}