Pancreatology最新文献

{"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}

{"title":"Development of an experimental model of severe acute pancreatitis with organ failure","authors":"Manpreet Uppal ,&nbsp;Sudheer Kumar Neredimelli ,&nbsp;Harlokesh Narayan Yadav ,&nbsp;Rajni Yadav ,&nbsp;Sudip Kumar Datta ,&nbsp;Soumya Jagannath Mahapatra ,&nbsp;Anand Narayan Singh ,&nbsp;Tony George Jacob ,&nbsp;Pramod Kumar Garg ,&nbsp;Peush Sahni","doi":"10.1016/j.pan.2026.03.008","DOIUrl":"10.1016/j.pan.2026.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Severe acute pancreatitis (AP) is associated with organ failure. The current animal models of severe AP assess organ failure through surrogate markers such as histopathological evidence of necrosis or biochemical mediators of inflammation, which do not directly measure organ dysfunction seen in human AP. We developed a rat model of severe AP and measured clinically relevant end points of cardiovascular, respiratory and renal failure.</div></div><div><h3>Methods</h3><div>Adult male Wistar rats were divided into 3 groups. Group 1 included sham-operated rats, group 2 included rats with pancreatic duct ligation, and group 3 included rats with pancreatic duct ligation + intraperitoneal L-arginine administration. The common carotid artery was cannulated prior to intervention and at 48 h post-intervention to measure invasive blood pressure, heart rate, arterial blood gases, pH, and renal and liver function tests. The pancreas, lung, and kidney tissues were subjected to histopathology.</div></div><div><h3>Results</h3><div>The development of AP was confirmed by the elevation of serum amylase levels and histopathological evidence of significant pancreatic injury in Group 2 and Group 3 rats. Both groups developed systemic organ dysfunction involving the cardiovascular system with hypotension, bradycardia, and raised lactate levels, and respiratory failure - Type 1 in Group 2 rats and Type 2 in Group 3 rats. None of the animals developed renal failure.</div></div><div><h3>Conclusions</h3><div>Our experimental models of severe AP in rats assessed clinically relevant and translatable parameters of organ dysfunction. Although the model does not reproduce human etiologic context, it may help researchers to evaluate the benefits of therapeutic interventions targeting systemic inflammation.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 387-396"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514132","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":"Event timing inaccuracies in a retrospective study of low-dose aspirin and acute pancreatitis","authors":"Hung-Da Chen ,&nbsp;Joshua Wang","doi":"10.1016/j.pan.2025.11.006","DOIUrl":"10.1016/j.pan.2025.11.006","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 507-508"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534435","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":"Longitudinal clinical characteristics of misfolding-induced hereditary pancreatitis caused by PRSS1 p.L104P variant in a Hungarian family","authors":"Barbara Anna Bokor ,&nbsp;Szilárd Váncsa ,&nbsp;Árpád V. Patai ,&nbsp;Péter Hegyi ,&nbsp;Balázs Csaba Németh","doi":"10.1016/j.pan.2026.02.003","DOIUrl":"10.1016/j.pan.2026.02.003","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 489-491"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197771","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":"Clinical outcomes of hypertriglyceridemia-associated acute pancreatitis: a prospective multicenter Italian cohort","authors":"Giulia De Marchi ,&nbsp;Nicolò de Pretis ,&nbsp;Gabriele Capurso ,&nbsp;Raffaele Pezzilli ,&nbsp;Alberto Zambon ,&nbsp;Clara Agnolon ,&nbsp;Clara Benedetta Conti ,&nbsp;Luca Gianotti ,&nbsp;Sara Massironi ,&nbsp;Marta Stegagnini ,&nbsp;Andrea Galli ,&nbsp;Tommaso Innocenti ,&nbsp;Laura Apadula ,&nbsp;Luca Giampaolo ,&nbsp;Fabio Farinati ,&nbsp;Edoardo Giovanni Giannini ,&nbsp;Davide Checchin ,&nbsp;Anna Giacomin ,&nbsp;Chiara Canalis ,&nbsp;Francesco Covotta ,&nbsp;Luca Frulloni","doi":"10.1016/j.pan.2026.03.004","DOIUrl":"10.1016/j.pan.2026.03.004","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 501-503"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459360","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":"SMAD3 activation in pancreatic stellate cells correlates with PTGDR2 expression and favorable stromal features in pancreatic cancer","authors":"Naohiro Hirano ,&nbsp;Koetsu Inoue ,&nbsp;Shuichi Aoki ,&nbsp;Shingo Yoshimachi ,&nbsp;Hideaki Sato ,&nbsp;Mitsuhiro Shimura ,&nbsp;Hajime Taniguchi ,&nbsp;Masahiro Iseki ,&nbsp;Daisuke Douchi ,&nbsp;Keigo Murakami ,&nbsp;Shimpei Maeda ,&nbsp;Takayuki Miura ,&nbsp;Masaharu Ishida ,&nbsp;Masamichi Mizuma ,&nbsp;Atsushi Masamune ,&nbsp;Michiaki Unno","doi":"10.1016/j.pan.2026.03.007","DOIUrl":"10.1016/j.pan.2026.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer is characterized by a dense tumor microenvironment enriched with cancer-associated fibroblasts (CAFs), which display context-dependent tumor-promoting and tumor-restraining properties. However, the molecular basis of stromal heterogeneity remains incompletely understood.</div></div><div><h3>Methods</h3><div>We examined stromal responses of pancreatic stellate cells (PSCs), a major source of CAFs, using an orthotopic mouse co-implantation model, RNA sequencing, conditioned medium–based functional assays, and immunohistochemical analysis of resected pancreatic cancer specimens.</div></div><div><h3>Results</h3><div>Co-implantation of PSCs with pancreatic cancer cells was associated with smaller primary tumor volumes and selective activation of SMAD3 in PSCs. Cancer cell–derived conditioned medium activated SMAD3 signaling in PSCs but not in cancer cells, suggesting cell type–specific pathway activation. Transcriptomic analysis identified prostaglandin D2 receptor 2 (PTGDR2) as a gene upregulated in association with SMAD3 activation, and its expression decreased following SMAD3 inhibition. Functional assays showed that SMAD3 activation was associated with modulation of PTGDR2 and inflammatory gene expression in PSCs. In clinical samples, higher p-SMAD3 expression in CAFs correlated with favorable overall survival.</div></div><div><h3>Conclusions</h3><div>SMAD3 activation in PSCs was observed in association with PTGDR2 expression, altered inflammatory profiles, and reduced tumor growth <em>in vivo</em>. These findings support the presence of distinct stromal phenotypes in pancreatic cancer and warrant further investigation into CAF modulation strategies.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 459-468"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575093","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":"Prospective observational study on the impact of hepatic steatosis, hepatic fibrosis, and metabolic syndrome on the outcome of patients with acute pancreatitis","authors":"Abhirup Chatterjee ,&nbsp;Surinder Singh Rana ,&nbsp;Vaneet Jearth ,&nbsp;Ajay Duseja ,&nbsp;Jimil Shah ,&nbsp;Mandeep Kang ,&nbsp;Kamal Kishore ,&nbsp;Rajesh Gupta","doi":"10.1016/j.pan.2026.02.001","DOIUrl":"10.1016/j.pan.2026.02.001","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 486-488"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166221","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":"Prospective long-term assessment of pulmonary impairment in chronic pancreatitis: A comparative study with healthy controls (RespPanc)","authors":"Amer Hadi ,&nbsp;Mikkel Parsberg Werge ,&nbsp;Lise Lotte Gluud ,&nbsp;Ejvind Frausing ,&nbsp;John Gásdal Karstensen ,&nbsp;Srdan Novovic","doi":"10.1016/j.pan.2026.02.005","DOIUrl":"10.1016/j.pan.2026.02.005","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 495-497"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220690","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":"Pancreatic mucinous cystic neoplasms (MCN) during pregnancy grow rapidly and undergo malignant transformation: A series of 69 operated cases","authors":"Olga V. Korhonen ,&nbsp;Cristina Verdejo Gil ,&nbsp;Judith Millastre Bocos ,&nbsp;Margaret G. Keane ,&nbsp;Anne Antila ,&nbsp;Linda N. Nilsson ,&nbsp;Awad Shamali ,&nbsp;Monica Marijnissen-van Zanten ,&nbsp;Marco Del Chiaro ,&nbsp;Johanna Laukkarinen","doi":"10.1016/j.pan.2026.03.018","DOIUrl":"10.1016/j.pan.2026.03.018","url":null,"abstract":"<div><h3>Background</h3><div>The diagnosis of mucinous cystic neoplasm (MCN) during pregnancy is rare and presents unique challenges. We analyzed all reported cases of pregnancy-associated MCNs to assess malignant potential and identify predictive factors.</div></div><div><h3>Methods</h3><div>A total of 69 patients with MCN were included: 65 from systematic literature search and 4 cases from our institutional databases. Data included patient demographics, symptoms, diagnostics, surgical management, histopathology, and clinical outcomes.</div></div><div><h3>Results</h3><div>The median age was 33 years (range 20–47). 74% (49/66) presented with symptoms. Tumor-related complications occurred in 27% (16/60), including acute pancreatitis in eight and cyst rupture in four. Median MCN diameter at diagnosis was 12.0 cm (1.5–30). Median tumor growth during pregnancy was 2.5 cm (0.5–20) over a median period of 2.75 months (1–78). All patients underwent surgical resection: 29% (20/69) in second trimester and 59% (41/69) postpartum. Postoperative complications occurred in four patients, all including pancreatic fistula or fluid collection. Fetal complications were reported in eight cases, without tumor-related mortality. 20% (13/66) had invasive adenocarcinoma (IC), 14% (9/66) high-grade dysplasia (HGD), and rates were similar if resected during pregnancy or postpartum. Symptomatic presentation and high-risk imaging features significantly correlated with malignant MCN. During the median follow-up of 24 months (2–154), local recurrence occurred in three patients and one patient died.</div></div><div><h3>Conclusions</h3><div>Pregnancy-related MCNs were typically large, symptomatic, and grew rapidly. A third of tumors harbored IC or HGD. Prompt surgical resection, typically during the second trimester appears safe, with a low rate of maternal and fetal complications.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 444-450"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594011","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":"Aspirin use and acute pancreatitis mortality","authors":"Kuan-Fu Liao ,&nbsp;Shih-Wei Lai","doi":"10.1016/j.pan.2025.10.008","DOIUrl":"10.1016/j.pan.2025.10.008","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"26 3","pages":"Pages 509-510"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431916","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}