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Yin YF, Jia QY, Yao HF, Zhu YH, Zheng JH, Duan ZH, Hu CY, Sun YW, Liu DJ, Huo YM, Liu W. OCIAD2 promotes pancreatic cancer progression through the AKT signaling pathway. Gene 2024; 927:148735. [PMID: 38944166 DOI: 10.1016/j.gene.2024.148735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/18/2024] [Accepted: 06/11/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND OCIAD2(Ovarian carcinoma immunoreactive antigen-like protein 2) is a protein reported in various cancers. However, the role of OCIAD2 has not been explored in pan-cancer datasets. The purpose of this research lies in analyzing the expression level and prognostic-related value of OCIAD2 in different human cancers, as well as revealing the underlying mechanism in specific cancer type (pancreatic adenocarcinoma, PAAD). METHODS The correlation between OCIAD2 expression level and clinical relevance in different human cancers was investigated from bioinformatical perspective (GTEx and TCGA). The OCIAD2 expression level and clinical significance in PAAD were explored in GEO datasets and tissue microarray. Functional experiments were used to determine the OCIAD2 cell functions in vitro and in vivo. GSEA, western blot and immunohistochemistry were used to uncover the potential mechanism. RESULTS OCIAD2 expression level was closely correlated with clinical relevance in many cancer types through pan-cancer analysis, and we found OCIAD2 was highly expressed in PAAD and associated with poorer prognosis. OCIAD2 acted as the promotor of Warburg effect and influenced PAAD cells proliferation, migration and apoptosis. Mechanistically, OCIAD2 upregulation may boost glycolysis in PAAD via activating the AKT signaling pathway in PAAD. CONCLUSIONS In PAAD, OCIAD2 promotes Warburg effect via AKT signaling pathway and targeting cancer cells metabolic reprogramming could be a potential treatment.
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Affiliation(s)
- Yi-Fan Yin
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Qin-Yuan Jia
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Hong-Fei Yao
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Yu-Heng Zhu
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Jia-Hao Zheng
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Zong-Hao Duan
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Cheng-Yu Hu
- Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - Yong-Wei Sun
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China
| | - De-Jun Liu
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China.
| | - Yan-Miao Huo
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China.
| | - Wei Liu
- State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China; Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, PR China.
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Chen Y, Xia H, Zhong X. In Vitro evaluation of the anti-pancreatic cancer activity of epimedium herb. Front Pharmacol 2024; 15:1389221. [PMID: 39011503 PMCID: PMC11246921 DOI: 10.3389/fphar.2024.1389221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/13/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction: Pancreatic cancer (PC) is a particularly aggressive malignancy with limited therapeutic options. The search for innovative treatments has focused on traditional Chinese medicine, specifically epimedium. This research investigates epimedium's active ingredients, potential targets, and underlying mechanisms in treating PC. Methods: High-performance liquid chromatography (HPLC) was used to quantify the active components of epimedium and HPLC-Q-TOF-MS was employed for qualitative identification. Potential targets of epimedium's active ingredients were identified using the TCMSP, ETCM, CTD, and Swiss Target Prediction databases. Potential PC-related targets were sourced from DisGeNET, GeneCards, and OMIM databases. A Venn diagram was utilized to identify overlapping PC-related and epimedium targets. Core targets and pathways were elucidated through protein-protein interaction (PPI) network analysis, Gene Ontology (GO) assessments, and Reactome pathway enrichment analyses. Molecular docking techniques investigated interactions between active compounds and these targets. The expression and prognostic implications of target genes were evaluated using GEPIA2 and the Human Protein Atlas (HPA) databases. In vitro studies assessed the impact of epimedium extract (EPE) on Panc-1 cell viability, and Western blot analysis examined the expression levels of key targets. Results: Network pharmacological indicate that epimedium econtains active components such as baohuoside I, icariin, hyperoside, and epimedin B, which have potential therapeutic effects against PC. In vitro assays confirmed that EPE significantly reduced the viability of Panc-1 cells. Western blot analysis revealed a considerable decrease in the expression of key targets in EPE-treated cells, including AKT1, EGFR, p-EGFR, JUN, BCL2, IL6, and SRC. The R-HSA-1280215: Interleukin-4 and Interleukin-13 signaling pathways involving these genes were identified as potential therapeutic targets. Discussion: Epimedium holds promise as a candidate for treating PC. The modulation of interleukin-4 and interleukin-13 signaling pathways could be a pivotal mechanism by which epimedium impedes tumor development. Further research is warranted to validate these findings and explore the clinical applicability of epimedium in PC treatment.
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Affiliation(s)
- Yangfeng Chen
- College of Horticulture, Hunan Agricultural University, Changsha, China
| | - Han Xia
- Changsha Central Hospital, Changsha, China
| | - Xiaohong Zhong
- College of Horticulture, Hunan Agricultural University, Changsha, China
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Qi J, Meng M, Liu J, Song X, Chen Y, Liu Y, Li X, Zhou Z, Huang X, Wang X, Zhou Q, Zhao Z. Lycorine inhibits pancreatic cancer cell growth and neovascularization by inducing Notch1 degradation and downregulating key vasculogenic genes. Biochem Pharmacol 2023; 217:115833. [PMID: 37769714 DOI: 10.1016/j.bcp.2023.115833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Pancreatic cancer is highly metastatic and lethal with an increasing incidence globally and a 5-year survival rate of only 8%. One of the factors contributing to the high mortality is the lack of effective drugs in the clinical setting. We speculated that effective compounds against pancreatic cancer exist in natural herbs and explored active small molecules among traditional Chinese medicinal herbs. The small molecule lycorine (MW: 323.77) derived from the herb Lycoris radiata inhibited pancreatic cancer cell growth with an IC50 value of 1 μM in a concentration-dependent manner. Lycorine markedly reduced pancreatic cancer cell viability, migration, invasion, neovascularization, and gemcitabine resistance. Additionally, lycorine effectively suppressed tumor growth in mouse xenograft models without obvious toxicity. Pharmacological studies revealed that the levels and half-life of Notch1 oncoprotein in the pancreatic cancer cells Panc-1 and Patu8988 were notably reduced. Moreover, the expression of the key vasculogenic genes Semaphorin 4D (Sema4D) and angiopoietin-2 (Ang-2) were also significantly inhibited by lycorine. Mechanistically, lycorine strongly triggered the degradation of Notch1 oncoprotein through the ubiquitin-proteasome system. In conclusion, lycorine effectively inhibits pancreatic cancer cell growth, migration, invasion, neovascularization, and gemcitabine resistance by inducing degradation of Notch1 oncoprotein and downregulating the key vasculogenic genes Sema4D and Ang-2. Our findings provide a new therapeutic candidate and treatment strategy against pancreatic cancer.
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Affiliation(s)
- Jindan Qi
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China; School of Nursing, Soochow University, Suzhou, Jiangsu 215006, PR China
| | - Mei Meng
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Juntao Liu
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Xiaoxiao Song
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Yu Chen
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Yuxi Liu
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Xu Li
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Zhou Zhou
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Xiang Huang
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China
| | - Xiaohua Wang
- School of Nursing, Soochow University, Suzhou, Jiangsu 215006, PR China
| | - Quansheng Zhou
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China; State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Jiangsu 215123, PR China; National Clinical Research Center for Hematologic Diseases, The Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215123, PR China; Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Soochow University, Suzhou, Jiangsu 215123, PR China; 2011 Collaborative Innovation Center of Hematology, Soochow University, Suzhou, Jiangsu 215123, PR China.
| | - Zhe Zhao
- Cyrus Tang Hematology Center, Jiangsu Institute of Hematology, Soochow University, Jiangsu 215123, PR China; CAS Key Laboratory of Nano-Bio Interface, Suzhou Institute of Nano-Tech and Nano-Bionics, Chinese Academy of Sciences, Jiangsu 215123, PR China.
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Xu Y, Liu W, Long Z, Wang L, Zhou M, Yin P. Mortality and years of life lost due to pancreatic cancer in China, its provinces, urban and rural areas from 2005 to 2020: results from the national mortality surveillance system. BMC Cancer 2023; 23:893. [PMID: 37735368 PMCID: PMC10512506 DOI: 10.1186/s12885-023-11258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 08/05/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Pancreatic cancer is a growing public health concern in China, and depicting it from different perspectives would provide a comprehensive understanding of its epidemiological characteristics. METHODS Data from the National Mortality Surveillance System (NMSS) in China was used to estimate the number of deaths, years of life lost (YLL), age-standardized mortality rate (ASMR) and age-standardized YLL rate in China, its provinces and urban-rural areas from 2005 to 2020. Joinpoint regression analysis was employed to explore the temporal trends of ASMR and age-standardized YLL rate. Decomposition analysis was conducted to assess the contribution of population growth, population aging and cause-specific mortality rate to the increment of pancreatic cancer deaths. RESULTS A total of 100,427 pancreatic cancer deaths and 2,166,355 pancreatic cancer related YLL were estimated in China in 2020. The overall ASMR significantly increased from 6.6/100 000 in 2005 to 7.4/100 000 in 2020, and was higher in men than that in women. Age-standardized YLL rate showed a similar trend. The mortality rates of pancreatic cancer were generally higher in northeast China than in southwest China. The highest ASMRs were found in Jilin, Zhejiang, Inner Mongolia and Anhui, and the lowest ones in Guangxi, Yunnan, Tibet, and Hainan. The disease burden due to pancreatic cancer presented a significant upward trend in rural areas and a downward trend in urban areas. CONCLUSIONS The burden associated with pancreatic cancer had been increasing in China from 2005 to 2020. The escalating disease burden of pancreatic cancer in rural areas necessitates the implementation of effective control and prevention measures. Relevant provinces should pay greater attention to the prevailing of pancreatic cancer, particularly those exhibiting higher mortality rates.
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Affiliation(s)
- Yangyang Xu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 10050, China
| | - Wei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 10050, China
| | - Zheng Long
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 10050, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 10050, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 10050, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 10050, China.
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He RZ, Zheng JH, Yao HF, Xu DP, Yang MW, Liu DJ, Sun YW, Huo YM. ADAMTS12 promotes migration and epithelial-mesenchymal transition and predicts poor prognosis for pancreatic cancer. Hepatobiliary Pancreat Dis Int 2023; 22:169-178. [PMID: 35508435 DOI: 10.1016/j.hbpd.2022.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND ADAMTS (a disintegrin and metalloproteinase with thrombospondin-like motifs) family, a group of extracellular multifunctional enzymes, has been proven to play a pivotal role in the tumor. In pancreatic cancer, the role and mechanism of this family remain unclear. The present study aimed to figure out the hub gene of ADAMTSs and explore the exact roles in the prognosis and biological functions in pancreatic ductal adenocarcinoma (PDAC). METHODS We used several databases to analyze the ADAMTS family and then screen out the hub genes. The expression of ADAMTS12 in 106 pairs of PDAC tumors and adjacent normal tissues was examined by immunohistochemistry, and its correlations with clinical parameters were further analyzed. The impacts of ADAMTS12 on the migration of PDAC cells were predicted by gene set enrichment analysis and confirmed by transwell assays. The potential impacts of ADAMTS12 on the epithelial-mesenchymal transition (EMT) were identified by database analysis and experimental proof of real-time quantitative polymerase chain reaction (qPCR) and Western blotting. RESULTS Our study found that ADAMTS12 was a crucial gene in PDAC, and it was highly expressed in tumor tissues when compared to that in the adjacent tissues. ADATMS12 had predictive value of a poor prognosis for PDAC. The elevation of ADAMTS12 was parallel to the progression of PDAC. Inhibition of ADAMTS12 suppressed the migration of PDAC cells and interfered with the process of EMT. CONCLUSIONS ADAMTS12 is a crucial member of ADAMTSs in PDAC and a predictor of poor prognosis. Additionally, based on its impacts on migration and metastasis in PDAC and the relationship with EMT, ADAMTS12 plays a role of an oncogene in PDAC and may be a promising target for treatment.
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Affiliation(s)
- Rui-Zhe He
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia-Hao Zheng
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong-Fei Yao
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Da-Peng Xu
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min-Wei Yang
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - De-Jun Liu
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong-Wei Sun
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan-Miao Huo
- State Key Laboratory of Oncogenes and Related Genes, Department of Biliary-Pancreatic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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An End-to-End Data-Adaptive Pancreas Segmentation System with an Image Quality Control Toolbox. JOURNAL OF HEALTHCARE ENGINEERING 2023. [DOI: 10.1155/2023/3617318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
With the development of radiology and computer technology, diagnosis by medical imaging is heading toward precision and automation. Due to complex anatomy around the pancreatic tissue and high demands for clinical experience, the assisted pancreas segmentation system will greatly promote clinical efficiency. However, the existing segmentation model suffers from poor generalization among images from multiple hospitals. In this paper, we propose an end-to-end data-adaptive pancreas segmentation system to tackle the problems of lack of annotations and model generalizability. The system employs adversarial learning to transfer features from labeled domains to unlabeled domains, seeking a dynamic balance between domain discrimination and unsupervised segmentation. The image quality control toolbox is embedded in the system, which standardizes image quality in terms of intensity, field of view, and so on, to decrease heterogeneity among image domains. In addition, the system implements a data-adaptive process end-to-end without complex operations by doctors. The experiments are conducted on an annotated public dataset and an unannotated in-hospital dataset. The results indicate that after data adaptation, the segmentation performance measured by the dice similarity coefficient on unlabeled images improves from 58.79% to 75.43%, with a gain of 16.64%. Furthermore, the system preserves quantitatively structured information such as the pancreas’ size and volume, as well as objective and accurate visualized images, which assists clinicians in diagnosing and formulating treatment plans in a timely and accurate manner.
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Liu X, Yang F, Jia D, Dong X, Zhang Y, Wu Z. Case report: A case study on the treatment using icaritin soft capsules in combination with lenvatinib achieving impressive PR and stage reduction in unresectable locally progressive pancreatic cancer and a literature review. Front Genet 2023; 14:1167470. [PMID: 37152980 PMCID: PMC10156971 DOI: 10.3389/fgene.2023.1167470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Background: Pancreatic cancer is one of the most deadly malignancies in the world. It is characterized by rapid progression and a very poor prognosis. The five-year survival rate of pancreatic cancer in China is only 7.2%, which is the lowest among all cancers and the use of combined paclitaxel albumin, capecitabine, and digital has been the clinical standard treatment for advanced pancreatic cancer since 1997. Also, the application of multidrug combinations is often limited by the toxicity of chemotherapy. Therefore, there is an urgent need for a more appropriate and less toxic treatment modality for pancreatic cancer. Case presentation: The patient was a 79-year-old woman, admitted to the hospital with a diagnosis of unresectable locally advanced pancreatic cancer (T3N0M0, stage IIA), with its imaging showing overgrowth of SMV involvement and unresectable reconstruction of the posterior vein after evaluation. As the patient refused chemotherapy, lenvatinib (8 mg/time, qd) and icaritin soft capsules (three tablets/time, bid) were recommended according to our past experience and a few clinical research cases. The tumor lesion was greatly reduced by 57.5% after the treatment, and the extent of vascular involvement also decreased. The aforementioned medication resulted in a significant downstaging of the patient's tumor. Conclusion: Better results were achieved in the treatment with icaritin soft capsules and lenvatinib in this case. Because of its less toxic effect on the liver and kidney and bone marrow suppression, it was suitable to combine icaritin soft capsules with targeted drugs for treating intermediate and advanced malignancies, which brings hope to patients who cannot or refuse to take chemotherapy.
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Affiliation(s)
- Xiaolong Liu
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feimin Yang
- Department of Nursing, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dunmao Jia
- Department of General Surgery, Affiliated Run Run Shaw Hospital, Jiangshan Branch, Harbin Medical University, Quzhou, China
| | - Xinyu Dong
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yizhuo Zhang
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhengrong Wu
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Zhengrong Wu,
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Systematic Analysis of Molecular Subtypes Based on the Expression Profile of Immune-Related Genes in Pancreatic Cancer. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3124122. [PMID: 36567857 PMCID: PMC9780013 DOI: 10.1155/2022/3124122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 12/23/2022]
Abstract
Immunotherapy has a good therapeutic effect and provides a new approach for cancer treatment. However, only limited studies have focused on the use of molecular typing to construct an immune characteristic index for gene expression in pancreatic adenocarcinoma (PAAD) and to assess the effectiveness of immunotherapy in patients with PAAD. Clinical follow-up data and gene expression profile of PAAD patients were retrieved from The Cancer Genome Atlas (TCGA) database. Based on 184 immune features, molecular subtypes of pancreatic cancer were found by the "ConsensusClusterPlus" package, and the association between clinical features and immune cell subtype distribution was analysed. In addition, the relationship between the proportion of immune subtypes and the expression of immune checkpoints was analysed. The CIBERSORT algorithm was introduced to evaluate the immune scores of different molecular subtypes. We used the tumor immune dysfunction and exclusion (TIDE) algorithm to assess the potential clinical effect of immunotherapy interventions on single-molecule subtypes. In addition, the oxidative stress index was constructed by linear discriminant analysis DNA (LDA), and weighted correlation network analysis was performed to identify the core module of the index and its characteristic genes. Expression of hub genes was verified by immunohistochemical analysis in an independent PAAD cohort. Pancreatic cancer is divided into three molecular subtypes (IS1, IS2, and IS3), with significant differences in prognosis between multiple cohorts. Expression of immune checkpoint-associated genes was significantly reduced in IS3 and higher in IS1 and IS2, suggesting that the three subgroups have different responsiveness to immunotherapy interventions. The results of the CIBERSORT analysis showed that IS1 exhibited the highest levels of immune infiltration, whereas the results of the TIDE analysis showed that the T-cell dysfunction score of IS1 was higher than that of IS2 and IS3. Furthermore, IS3 was found to be more sensitive to 5-FU and to have a higher immune signature index than IS1 and IS2. Based on WGCNA analysis, 10 potential gene markers were identified, and their expression at the protein level was verified by immunohistochemical analysis. Specific molecular expression patterns in pancreatic cancer can predict the efficacy of immunotherapy and influence the prognosis of patients.
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Cao C, Zhao W, Chen X, Shen B, Wang T, Wu C, Rong X. Deciphering the action mechanism of paeoniflorin in suppressing pancreatic cancer: A network pharmacology study and experimental validation. Front Pharmacol 2022; 13:1032282. [PMID: 36339551 PMCID: PMC9630940 DOI: 10.3389/fphar.2022.1032282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Paeoniflorin (PF) is the main active component of Chinese herbaceous peony that has been shown to have an anti-tumor effect. However, there are few studies on the prevention and treatment of pancreatic cancer with PF. Methods: We gathered Microarray data pertaining to paeoniflorin intervention in pancreatic cancer by utilizing the GEO database (GSE97124). Then, the DEGs were filtered by the 33R program. RNA-seq data of pancreatic cancer and normal tissue samples were taken from the TCGA and GTEx databases, respectively, and the WGCNA technique was utilized to examine the pancreatic cancer-specific genes. Paeoniflorin target genes for the treatment of pancreatic cancer were determined based on the overlap between DEGs and WGCNA. GO and KEGG enrichment analyses were then performed on paeoniflorin target genes to discover which biological processes were impacted. Using the 3 hierarchical methods included in the Cytohubba plugin, we re-screened the hub genes in the target genes to find the genes most relevant to paeoniflorin treatment. The overall survival effects of hub genes were confirmed using the TCGA database. Finally, the paeoniflorin targets identified by the network pharmacology analysis were validated using PANC-1 and Capan-2 cells. Results: We identified 148 main potential PF targets, and gene enrichment analysis suggested that the aforementioned targets play a crucial role in the regulation of MAPK, PI3K-AKT, and other pathways. The further screening of the prospective targets resulted in the identification of 39 hub genes. Using the TCGA database, it was determined that around 33.33% of the hub gene’s high expression was linked with a bad prognosis. Finally, we demonstrated that PF inhibits IL-6 and IL-10 expression and p38 phosphorylation in pancreatic cancer cells, thereby reducing inflammation. Conclusion: PF may regulate inflammatory factors mainly through the p38 MAPK signal pathway. These findings provide theoretical and experimental evidence suggesting the PF as a promising natural source of anti-tumor compounds for pancreatic cancer.
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Affiliation(s)
- Chunhao Cao
- Department of Integrated Traditional Chinese and Western Medicine, The First Affiliate Hospital of Chongqing Medical University, Chongqing, China
| | - Wenting Zhao
- Hubei University of Chinese Medicine, Wuhan, China
| | | | - Bin Shen
- Chongqing Medical University, Chongqing, China
| | - Teng Wang
- Chongqing Medical University, Chongqing, China
| | - Chaoxu Wu
- Department of Integrated Traditional Chinese and Western Medicine, The First Affiliate Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Xiaofeng Rong, ; Chaoxu Wu,
| | - Xiaofeng Rong
- Department of Integrated Traditional Chinese and Western Medicine, The First Affiliate Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Xiaofeng Rong, ; Chaoxu Wu,
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10
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Jin Q, Ren Q, Chang X, Lu X, Wang G, He N. Pylorus-preserving versus Pylorus-resecting: Impact on dynamic changes of nutrition and body composition in pancreatic cancer patients before and after pancreatoduodenectomy. Cancer Med 2022; 12:2713-2721. [PMID: 36028989 PMCID: PMC9939197 DOI: 10.1002/cam4.5155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/05/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To investigate if different methods of pancreatoduodenectomy (with or without pyloric preservation) would have different impacts on postoperative nutrition and body composition changes among pancreatic cancer patients. METHODS Demographic and clinicopathological data, perioperative data were collected, body composition (e.g. skeletal muscle cross-sectional area [CSA], visceral fat area [VFA]) were evaluated with abdominal CT before and after surgery. Sarcopenia patients' proportion changes were also recorded. RESULTS The hospital stay in the PRPD group was significantly less than that in the PPPD group (p < 0.05). A significant difference was found in CSA, skeletal muscle index (SMI), VFA, VFA/CSA and albumin (ALB) in both groups between preoperative, 3, and 12 months after surgery. The loss of visceral fat in the PRPD group was more prominent than that in the PPPD group at 3 months and 12 months after surgery (p < 0.05). VFA/CSA was higher in the PPPD group than in the PRPD group (3 months: p < 0.05, 12 months: p < 0.001). The proportion of sarcopenic patients increased significantly over time in the PPPD and PRPD groups (p < 0.001). CONCLUSIONS Postoperative CSA and VFA continued to significantly decrease in both PPPD and PRPD groups, while the incidence of sarcopenia continued to increase. Compared with PRPD, PPPD has a protective effect on visceral fat. PPPD may contribute to better maintaining visceral fat mass and blood ALB levels. CT quantification can be an objective and effective method to evaluate the nutritional status of pancreatic cancer patients during the pre- and postoperative period and can provide a useful objective basis for guiding clinical treatment.
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Affiliation(s)
- Qianna Jin
- Department of Radiology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina,Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Qianqian Ren
- Department of Radiology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina,Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Xiaona Chang
- Department of Pathology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiaoming Lu
- Cancer Center, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Guobin Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Nan He
- Cancer Center, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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11
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Zhu Y, Hu P, Li X, Tian Y, Bai X, Liang T, Li J. Multiscale unsupervised domain adaptation for automatic pancreas segmentation in CT volumes using adversarial learning. Med Phys 2022; 49:5799-5818. [PMID: 35833617 DOI: 10.1002/mp.15827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/28/2022] [Accepted: 05/27/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Computer-aided automatic pancreas segmentation is essential for early diagnosis and treatment of pancreatic diseases. However, the annotation of pancreas images requires professional doctors and considerable expenditure. Due to imaging differences among various institution population, scanning devices and imaging protocols etc., significant degradation in the performance of model inference results is prone to occur when models trained with domain-specific (usually institution-specific) datasets are directly applied to new (other centers/institutions) domain data. In this paper, we propose a novel unsupervised domain adaptation method based on adversarial learning to address pancreas segmentation challenges with the lack of annotations and domain shift interference. METHODS A 3D semantic segmentation model with attention module and residual module is designed as the backbone pancreas segmentation model. In both segmentation model and domain adaptation discriminator network, a multiscale progressively weighted structure is introduced to acquire different field of views. Features of labeled data and unlabeled data are fed in pairs into the proposed multiscale discriminator to learn domain-specific characteristics. Then the unlabeled data features with pseudo-domain label are fed to the discriminator to acquire domain-ambiguous information. With this adversarial learning strategy, the performance of the segmentation network is enhanced to segment unseen unlabeled data. RESULTS Experiments were conducted on two public annotated datasets as source datasets respectively and one private dataset as target dataset, where annotations were not used for the training process but only for evaluation. The 3D segmentation model achieves comparative performance with state-of-the-art pancreas segmentation methods on source domain. After implementing our domain adaptation architecture, the average Dice Similarity Coefficient(DSC) of the segmentation model trained on the NIH-TCIA source dataset increases from 58.79% to 72.73% on the local hospital dataset, while the performance of the target domain segmentation model transferred from the MSD source dataset rises from 62.34% to 71.17%. CONCLUSIONS Correlation of features across data domains are utilized to train the pancreas segmentation model on unlabeled data domain, improving the generalization of the model. Our results demonstrate that the proposed method enables the segmentation model to make meaningful segmentation for unseen data of the training set. In the future, the proposed method has the potential to apply segmentation model trained on public dataset to clinical unannotated CT images from local hospital, effectively assisting radiologists in clinical practice. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yan Zhu
- Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, China
| | - Peijun Hu
- Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, China.,Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, 311100, China
| | - Xiang Li
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.,Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, 310006, China
| | - Yu Tian
- Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, China
| | - Xueli Bai
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.,Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, 310006, China
| | - Tingbo Liang
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.,Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, 310006, China
| | - Jingsong Li
- Engineering Research Center of EMR and Intelligent Expert System, Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, China.,Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, 311100, China
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12
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Lyu P, Hao Z, Zhang H, Li J. Identifying pancreatic cancer‑associated miRNAs using weighted gene co‑expression network analysis. Oncol Lett 2022; 24:297. [DOI: 10.3892/ol.2022.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/25/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Pengfei Lyu
- Department of General Surgery, Shanxi Tumor Hospital, Taiyuan, Shanxi 030000, P.R. China
| | - Zhengwen Hao
- Department of General Surgery, Shanxi Tumor Hospital, Taiyuan, Shanxi 030000, P.R. China
| | - Haoruo Zhang
- Department of General Surgery, Shanxi Tumor Hospital, Taiyuan, Shanxi 030000, P.R. China
| | - Jun Li
- Department of General Surgery, Shanxi Tumor Hospital, Taiyuan, Shanxi 030000, P.R. China
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13
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Weinberg L, Ratnasekara V, Tran AT, Kaldas P, Neal-Williams T, D’Silva MR, Hua J, Yip S, Lloyd-Donald P, Fletcher L, Ma R, Perini MV, Nikfarjam M, Lee DK. The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy. Front Surg 2022; 9:890518. [PMID: 35711711 PMCID: PMC9195500 DOI: 10.3389/fsurg.2022.890518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/13/2022] [Indexed: 12/09/2022] Open
Abstract
Background Understanding the financial implications associated with the complications post-distal pancreatectomy (DP) may be beneficial for the future optimisation of postoperative care pathways and improved cost-efficiency. The primary outcome of this retrospective study was the characterisation of the additional cost associated with postoperative complications following DP. The secondary outcome was the estimation of the prevalence, type and severity of complications post-DP and the determination of which complications were associated with higher costs. Methods Postoperative complications were retrospectively examined for 62 adult patients undergoing distal pancreatectomy at an Australian university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien–Dindo (CVD) classification system. In-hospital cost of index admission was calculated using an activity-based costing methodology and was reported in US dollars at 2021 rates. Regression modelling was used to investigate the relationships among selected perioperative variables, complications and costs. Results 45 patients (72.6%) experienced one or more postoperative complications. The median (IQR) hospital cost in US dollars was 31.6% greater in patients who experienced complications compared to those who experienced no complications ($40,717.8 [27,358.0–59,834.3] vs. $30,946.9 [23,910.8–46,828.1]). Costs for patients with four or more complications were 43.5% higher than for those with three or fewer complications (p = 0.015). Compared to patients with no complications, the median hospital costs increased by 17.1% in patients with minor complications (CVD grade I/II) and by 252% in patients who developed major complication (i.e., CVD grade III/IV) complications. Conclusion Postoperative complications are a key target for cost-containment strategies. Our findings demonstrate a high prevalence of postoperative complications following distal pancreatectomy with number and severity of postoperative complications being associated with increased hospital costs. (Registered in the Australian New Zealand Clinical Trials Registry [No. ACTRN12622000202763]).
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Affiliation(s)
- Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
- Correspondence: Laurence Weinberg
| | | | - Anthony T. Tran
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Peter Kaldas
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | | | | | - Jackson Hua
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Sean Yip
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | | | - Luke Fletcher
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Data Analytics Research and Evaluation (DARE) Centre, Austin Health, Heidelberg, Australia
| | - Ronald Ma
- Business Intelligence Unit, Austin Health, Heidelberg, Australia
| | - Marcos V. Perini
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Mehrdad Nikfarjam
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
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14
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Zhong J, Liao X, Peng S, Cao J, Liu Y, Liu C, Qiu J, Guan X, Zhang Y, Liu X, Peng S. A Visualized Dynamic Prediction Model for Overall Survival in Elderly Patients With Pancreatic Cancer for Smart Medical Services. Front Public Health 2022; 10:885624. [PMID: 35685764 PMCID: PMC9171143 DOI: 10.3389/fpubh.2022.885624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pancreatic cancer (PC) is a highly malignant tumor of the digestive system. The number of elderly patients with PC is increasing, and older age is related to a worse prognosis. Accurate prognostication is crucial in treatment decisions made for people diagnosed with PC. However, an accurate predictive model for the prognosis of these patients is still lacking. We aimed to construct nomograms for predicting the overall survival (OS) of elderly patients with PC. Methods Patients with PC, older than 65 years old from 2010 to 2015 in the Surveillance, Epidemiology, and End Results database, were selected and randomly divided into training cohort (n = 4,586) and validation cohort (n = 1,966). Data of patients in 2016-2018 (n = 1,761) were used for external validation. Univariable and forward stepwise multivariable Cox analysis was used to determine the independent prognostic factors. We used significant variables in the training set to construct nomograms predicting prognosis. The performance of the models was evaluated for their discrimination and calibration power based on the concordance index (C-index), calibration curve, and the decision curve analysis (DCA). Results Age, insurance, grade, surgery, radiation, chemotherapy, T, N, and American Joint Commission on Cancer were independent predictors for OS and thus were included in our nomogram. In the training cohort and validation cohort, the C-indices of our nomogram were 0.725 (95%CI: 0.715-0.735) and 0.711 (95%CI: 0.695-0.727), respectively. The 1-, 3-, and 5-year areas under receiver operating characteristic curves showed similar results. The calibration curves showed a high consensus between observations and predictions. In the external validation cohort, C-index (0.797, 95%CI: 0.778-0.816) and calibration curves also revealed high consistency between observations and predictions. The nomogram-related DCA curves showed better clinical utility compared to tumor-node-metastasis staging. In addition, we have developed an online prediction tool for OS. Conclusions A web-based prediction model for OS in elderly patients with PC was constructed and validated, which may be useful for prognostic assessment, treatment strategy selection, and follow-up management of these patients.
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Affiliation(s)
- Jiang Zhong
- College of Computer Science, Chongqing University, Chongqing, China
| | - XingShu Liao
- College of Computer Science, Chongqing University, Chongqing, China
| | - Shuang Peng
- General Affairs Section, The People's Hospital of Tongnan District, Chongqing, China
| | - Junyi Cao
- Department of Medical Quality Control, First People's Hospital of Zigong City, Zigong, China
| | - Yue Liu
- Department of Pediatrics, First People's Hospital of Zigong City, Zigong, China
| | - Chunyang Liu
- Scientific Research Department, First People's Hospital of Zigong City, Zigong, China
| | - Ju Qiu
- Scientific Research Department, First People's Hospital of Zigong City, Zigong, China
| | - Xiaoyan Guan
- Department of Pediatrics, First People's Hospital of Zigong City, Zigong, China
| | - Yang Zhang
- College of Medical Information, Chongqing Medical University, Chongqing, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shengxian Peng
- Scientific Research Department, First People's Hospital of Zigong City, Zigong, China
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15
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Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review. Support Care Cancer 2022; 30:3691-3700. [PMID: 34993653 DOI: 10.1007/s00520-021-06793-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This review summarizes and synthesizes the available empirical literature on the experiences concerned with the problems and challenges faced by caregivers of patients with pancreatic cancer. METHODS An integrative review method was used, and a literature search was conducted using five databases. We searched the terms "pancreatic cancer," "caregiver," and "experience," and used the Boolean operators OR and AND to combine them. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of the included studies. RESULTS Four qualitative studies, one mixed method, and three quantitative studies met the selection criteria and were included in the review. Informal family caregivers of patients with pancreatic cancer experienced multifaceted roles, lack of information, difficulties in maintaining emotional well-being, and positive coping. The factors associated with their caring experience included the caregivers' demographics, patients' psychological status, and clinical characteristics. CONCLUSION Caregivers of patients with pancreatic cancer have various experiences while providing care. Health care providers should offer opportunities for caregivers to recognize their feelings, provide sufficient information and psychological support, and foster coping strategies to maintain the physical and psychosocial well-being of caregivers.
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16
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Zhu B, Wu X, Guo T, Guan N, Liu Y. Epidemiological Characteristics of Pancreatic Cancer in China From 1990 to 2019. Cancer Control 2021; 28:10732748211051536. [PMID: 34713730 PMCID: PMC8558605 DOI: 10.1177/10732748211051536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Pancreatic cancer is an aggressive cancer and is predicted to become the second leading cause of cancer-related deaths in China. To understand the epidemic trend of pancreatic cancer and formulate targeted preventive measures, it is important to analyze the incidence and mortality of pancreatic cancer. Methods The incidence and mortality data of pancreatic cancer in China were obtained from Global Burden of Disease (GBD) data. We used joinpoint regression analysis to calculate the magnitude and direction of trends, and the age-period-cohort method to analyze the effects of chronological age, time period, and birth cohort. Results The age-standardized rates (ASRs) for both incidence and mortality of pancreatic cancer increased from 1990 to 2019, and were higher in males than females. The incidence and mortality rates have increased year by year in the age group above 25 years. The most common age group was 55–79 years, accounting for approximately 50% of all incident cases. In terms of incidence and mortality rates, the overall net drifts were above 0. The local drifts in all age groups were above 0 in both sexes and males, while the local drifts in the 15–39 age groups were below 0 in females. The longitudinal age curves increased with age, with higher incidence and mortality rates, mainly in older age groups. The period rate ratios increased by year. The cohort rate ratios showed an upward trend before 1970 and fluctuated after 1975. Conclusions The burden of pancreatic cancer is still very high in China, and attention should be paid to the key population that is, males and older people. The results of our study can be used by policy makers to allocate resources efficiently to improve early diagnosis and treatment, improving the awareness of self-protection, and advocating a healthy lifestyle to prevent pancreatic cancer.
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Affiliation(s)
- Bo Zhu
- Department of Cancer Prevention and Treatment, Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Tianyu Guo
- Department of Hepatobiliary surgery, 74665Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Ning Guan
- Center of medical examination, 74665Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Yefu Liu
- Department of Hepatobiliary surgery, 74665Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
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17
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Yang S, Yeoh KW, Wong MCS, Mang OWK, Tse LA. Disparities of birth cohort effects on pancreatic cancer incidence between the United States and urban China. ESMO Open 2021; 6:100240. [PMID: 34416471 PMCID: PMC8377550 DOI: 10.1016/j.esmoop.2021.100240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022] Open
Abstract
Background Pancreatic cancer has been associated with lifestyle factors, but few comparative studies were conducted among countries of different culture and lifestyle habits. This study compared the trends of pancreatic cancer incidence and birth cohort effects in the United States and urban China and explored the potential discrepancies of risk patterns. Materials and methods Age-standardized incidence rates (ASIRs) were calculated using data from national or regional cancer registries of the United States and two large cities of China (Shanghai, Hong Kong). The temporal trends of incidence were assessed by joinpoint regression. The effects of birth cohort and calendar period were identified through age–period–cohort modeling. Results The ASIR in the United States from 1976 to 2015 was 8.26/100 000, which was higher than that in Hong Kong (4.29/100 000) and Shanghai of China (6.63/100 000). Shanghai had lower incidence (4.41/100 000) in 1976-1980 but increased annually by 1.38% in males and 1.67% in females, with a sharper upward trend than the United States and Hong Kong. Males had higher risks than females, with a male-to-female ratio of 1.34, 1.44, and 1.37 in the United States, Hong Kong, and Shanghai, respectively. A significant and prominent increase in incidence rate was observed among successive generations in China particularly for Shanghai, but such a pattern was not apparent in the United States. Conclusions The differences in pancreatic cancer incidence by sex may be multi-factorial involving known risk factors like tobacco smoking and alcohol consumption. The significant birth cohort effects among recent and early generations in the Shanghai population were in line with a society in socioeconomic transition and adoption of Western lifestyle mainly including consumption of calorie-rich foods and physical inactivity. Differences in these risk patterns will have implications on health care efforts and policies for cancer control. The ASIR of pancreatic cancer in the U.S. is higher than that in urban China. Higher risk of pancreatic cancer was observed in the youth of urban China, but this pattern was not prominent in the U.S. The disparities of birth cohort effects are consistent with a society in socioeconomic transition.
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Affiliation(s)
- S Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - K W Yeoh
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - M C-S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - O W-K Mang
- Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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18
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Hu JX, Zhao CF, Chen WB, Liu QC, Li QW, Lin YY, Gao F. Pancreatic cancer: A review of epidemiology, trend, and risk factors. World J Gastroenterol 2021; 27:4298-4321. [PMID: 34366606 PMCID: PMC8316912 DOI: 10.3748/wjg.v27.i27.4298] [Citation(s) in RCA: 185] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/18/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
Despite rapid advances in modern medical technology and significant improvements in survival rates of many cancers, pancreatic cancer is still a highly lethal gastrointestinal cancer with a low 5-year survival rate and difficulty in early detection. At present, the incidence and mortality of pancreatic cancer are increasing year by year worldwide, no matter in the United States, Europe, Japan, or China. Globally, the incidence of pancreatic cancer is projected to increase to 18.6 per 100000 in 2050, with the average annual growth of 1.1%, meaning that pancreatic cancer will pose a significant public health burden. Due to the special anatomical location of the pancreas, the development of pancreatic cancer is usually diagnosed at a late stage with obvious clinical symptoms. Therefore, a comprehensive understanding of the risk factors for pancreatic cancer is of great clinical significance for effective prevention of pancreatic cancer. In this paper, the epidemiological characteristics, developmental trends, and risk factors of pancreatic cancer are reviewed and analyzed in detail.
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Affiliation(s)
- Jian-Xiong Hu
- Intensive Care Unit (ICU), Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
| | - Cheng-Fei Zhao
- School of Pharmacy and Medical Technology, Putian University, Putian 351100, Fujian Province, China
- Key Laboratory of Pharmaceutical Analysis and Laboratory Medicine in University of Fujian Province, Putian University, Putian 351100, Fujian Province, China
| | - Wen-Biao Chen
- Department of Basic Medicine, Quanzhou Medical College, Quanzhou 362011, Fujian Province, China
| | - Qi-Cai Liu
- Department of Reproductive Medicine Centre, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Qu-Wen Li
- Department of Priority Laboratory for Zoonoses Research, Fujian Center for Disease Control and Prevention, Fuzhou 350001, Fujian Province, China
| | - Yan-Ya Lin
- Intensive Care Unit (ICU), Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China
| | - Feng Gao
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
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19
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Li ZY, Sun XY. Recent progress in SRC targeted therapy for pancreatic cancer. Shijie Huaren Xiaohua Zazhi 2021; 29:621-627. [DOI: 10.11569/wcjd.v29.i12.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cancer (PC) is a highly lethal malignancy with a 5-year survival rate of only 10% and is extremely resistant to chemotherapy. Therefore, developing effective therapeutic drugs is urgently needed. SRC is a proto-oncogenic tyrosine protein kinase and highly expressed in more than 70% of PCs. SRC is involved in regulating the proliferation, infiltration, and metastasis of PC cells as well as tumor angiogenesis, thus representing one of the most promising molecular targets for developing novel drugs. Preclinical studies demonstrate that small-molecule SRC inhibitors display significant anti-cancer activities in vitro and in vivo, and have a synergistic effect with conventional chemotherapy drugs against PC. Some SRC inhibitors have been evaluated in clinical trials. This article analyzes the regulatory mechanism of SRC and the recent progress and problems in developing drugs targeting SRC for the treatment of PC. Unfortunately, up to date no SRC inhibitor or regiment containing SRC inhibitors has been approved for the clinical treatment of PC. In the authors' opinion, the introduction of precision medicine principles to carry out SRC inhibitor clinical trials, combination of immunotherapy and SRC inhibitors, seeking more selective and effective SRC inhibitors, and further exploration of the SRC regulatory network may be the future directions for developing SRC-targeted therapies against PC.
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Affiliation(s)
- Zi-Yi Li
- Hepatosplenic Surgery Center, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xue-Ying Sun
- Hepatosplenic Surgery Center, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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20
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Wei X, Zhou X, Zhao Y, He Y, Weng Z, Xu C. A 14-gene gemcitabine resistance gene signature is significantly associated with the prognosis of pancreatic cancer patients. Sci Rep 2021; 11:6087. [PMID: 33731794 PMCID: PMC7969955 DOI: 10.1038/s41598-021-85680-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/03/2021] [Indexed: 02/08/2023] Open
Abstract
To identify a gemcitabine resistance-associated gene signature for risk stratification and prognosis prediction in pancreatic cancer. Pearson correlation analysis was performed with gemcitabine half maximal inhibitory concentration (IC50) data of 17 primary pancreatic cancer lines from Genomics of Drug Sensitivity in Cancer (GDSC) and the transcriptomic data from GDSC and Broad Institute Cancer Cell Line Encyclopedia, followed by risk stratification, expression evaluation, overall survival (OS) prediction, clinical data validation and nomogram establishment. Our biomarker discovery effort identified a 14-gene signature, most of which featured differential expression. The 14-gene signature was associated with poor OS in E-MTAB-6134 (HR 2.37; 95% CI 1.75–3.2; p < 0.0001), pancreatic cancer-Canada (PACA-CA) (HR 1.76; 95% CI 1.31–2.37; p = 0.00015), and 4 other independent validation cohorts: pancreatic cancer-Australia (PACA-AU) (HR 1.9; 95% CI 1.38–2.61; p < 0.0001), The Cancer Genome Atlas (TCGA) (HR 1.73; 95% CI 1.11–2.69; p = 0.014), GSE85916 (HR 1.97; 95% CI 1.14–3.42; p = 0.014) and GSE62452 (HR 1.82; 95% CI 1.02–3.24; p = 0.039). Multivariate analysis revealed that the 14-gene risk score was an independent pancreatic cancer outcome predictor in E-MTAB-6134 (p < 0.001) and TCGA (p = 0.006). A nomogram including the 14-gene was established for eventual clinical translation. We identified a novel gemcitabine resistance gene signature for risk stratification and robust categorization of pancreatic cancer patients with poor prognosis.
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Affiliation(s)
- Xing Wei
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Xiaochong Zhou
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yun Zhao
- Cyrus Tang Hematology Center, Soochow University, Suzhou, 215123, China.,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.,Collaborative Innovation Center of Hematology, Soochow University, Suzhou, 215006, China
| | - Yang He
- MOE Engineering Center of Hematological Disease, Soochow University, Suzhou, 215123, China.,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.,MOH Key Lab of Thrombosis and Hemostasis, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Zhen Weng
- MOE Engineering Center of Hematological Disease, Soochow University, Suzhou, 215123, China. .,Cyrus Tang Hematology Center, Soochow University, Suzhou, 215123, China. .,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China. .,Collaborative Innovation Center of Hematology, Soochow University, Suzhou, 215006, China.
| | - Chunfang Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
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21
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Liu M, Sun X, Zhang Z, Xu X, Yu X, Zhuo Q, Ji S. The clinical characteristics and survival associations of pancreatic neuroendocrine tumors: does age matter? Gland Surg 2021; 10:574-583. [PMID: 33708541 DOI: 10.21037/gs-20-634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Pancreatic neuroendocrine tumor (pNET) is the second most common epithelial neoplasm of the pancreas. As in pancreatic adenocarcinoma (PDAC), patients with different onset ages display different clinical features and prognosis. We grouped pNET patients into the early-onset pNET (EOpNET) and typical age-at-onset pNET (TOpNET) to investigate the effect of onset age on their clinical characteristics and prognosis. Methods Data were collected retrospectively from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015; cohort 1) and the Fudan University Shanghai Cancer Center (FUSCC) (2005-2018; cohort 2). The clinical characteristics were compared using chi-squared tests. Cox proportional hazards regression was used to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs), and overall survival was formulated by Kaplan-Meier curves. Results In total, data from 5,368 and 330 patients were included from the SEER database and the FUSCC, respectively. Gender did not affect survival in the EOpNET group. Tumors located in the tail (HR: 0.721, 95% CI: 0.63-0.83, P<0.001) and body (HR: 0.712, 95% CI: 0.60-0.85, P=0.001) had a lower risk of death compared to tumors in the head of the pancreas in the TOpNET group. The overall survival of the EOpNET group {136 [3-143] months} was better than the TOpNET group {85 [3-143] months} (P<0.001) in the SEER database. Results from the FUSCC group were similar to the SEER cohort. Conclusions The EOpNET group had significantly better overall survival than the TOpNET group, and early surgical resection is encouraged for all pNET patients. In any future personalized treatment of pNET, the patient's onset age should be considered as an important factor in guiding treatment and prognosis.
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Affiliation(s)
- Mengqi Liu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Pancreatic Cancer Institute, Fudan University, Shanghai Pancreatic Cancer Institute, Shanghai, China
| | - Xiaoyan Sun
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zheng Zhang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Pancreatic Cancer Institute, Fudan University, Shanghai Pancreatic Cancer Institute, Shanghai, China
| | - Xiaowu Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Pancreatic Cancer Institute, Fudan University, Shanghai Pancreatic Cancer Institute, Shanghai, China
| | - Xianjun Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Pancreatic Cancer Institute, Fudan University, Shanghai Pancreatic Cancer Institute, Shanghai, China
| | - Qifeng Zhuo
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Pancreatic Cancer Institute, Fudan University, Shanghai Pancreatic Cancer Institute, Shanghai, China
| | - Shunrong Ji
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Pancreatic Cancer Institute, Fudan University, Shanghai Pancreatic Cancer Institute, Shanghai, China
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22
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Zhou W, Li SY, Jiang H, Gao L, Li J, Kong XY, Yang L, Fang AQ, Jin ZD, Wang KX. Optimal number of needle passes during EUS-guided fine-needle biopsy of solid pancreatic lesions with 22G ProCore needles and different suction techniques: A randomized controlled trial. Endosc Ultrasound 2021; 10:62-70. [PMID: 33586696 PMCID: PMC7980685 DOI: 10.4103/eus-d-20-00147] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background and Objectives: The sensitivity of EUS-guided fine-needle biopsy (EUS-FNB) varies considerably. The optimal number of passes through a solid pancreatic lesion with a 22G FNB needle during EUS-FNB is controversial. This prospective randomized controlled study aimed to determine the optimal number of needle passes during EUS-FNB of solid pancreatic lesions, with 22G FNB needles and different sampling techniques. Methods: Pancreatic masses were sampled using 22G FNB needles with either the stylet slow-pull (SP) technique or the standard-suction (SS) technique. We determined the number of needle passes required to obtain a diagnostic accuracy of >90%. Differences between the two techniques in terms of technical success rate, cytological acquisition, core tissue acquisition, sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and complications were analyzed. Results: A total of 120 patients were randomly assigned to either SP or SS group. Three patients who were lost to follow-up and one who did not complete 5 passes due to bent needle head were excluded from the study. Fifty-six cases in the SP group and 60 cases in the SS group were included in the analysis. For SP technique, the cumulative accuracy of passes 1, 2, 3, 4, and 5 was 44.83%, 76.79%, 87.50%, 92.86%, and 94.64%, respectively. For SS technique, the cumulative accuracy of passes 1, 2, 3, 4, and 5 was 71.67%, 85.0%, 90.0%, 93.33%, and 95.0%, respectively. For each group, there was no statistically significant difference in accuracy after 3 and 4 passes. After 4 passes, the pooled sensitivity (92.59% vs. 93.10%), accuracy (92.86% vs. 93.10%), and specificity (100% vs. 100%) were similar (P > 0.05) in the SP and SS groups, respectively. In addition, positive cytological diagnoses (83.9% vs. 85.0%) and positive histological diagnoses (71.4% vs. 78.3%) were comparable (P > 0.05) in the SP and SS groups, respectively. No statistically significant factor was found associated with diagnostic sensitivity for each group. Conclusion: When on-site cytological evaluation is unavailable, we recommend that at least 3 passes with 22G ProCore needles be performed during EUS-FNB using the SS technique, at least 4 passes when using SP technique. The SS technique showed potential advantages over SP technique in tissue acquisition and diagnostic capabilities.
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Affiliation(s)
- Wei Zhou
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Shi-Yu Li
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Hui Jiang
- Department of Pathology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Li Gao
- Department of Pathology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Jun Li
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Xiang-Yu Kong
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Li Yang
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Ai-Qiao Fang
- Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Zhen-Dong Jin
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Kai-Xuan Wang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, China
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23
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Adams SH. Historical analysis of inverse correlation between soil-transmitted helminthiasis and pancreatic cancer. Proc AMIA Symp 2020; 34:250-259. [PMID: 33678958 PMCID: PMC7901387 DOI: 10.1080/08998280.2020.1836712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 12/09/2022] Open
Abstract
In this descriptive epidemiological study, the soil-transmitted helminth (STH) burden and pancreatic cancer (PC) mortality rates of different countries and peoples are compared to demonstrate an inverse correlation. Formerly ubiquitous helminth infection possibly played a significant role in defending the human host against PC until the advancement of modern hygiene, with helminth eradication in recent times in developed countries and urban centers. It is posited that a high rate of infection by STH in developing countries and rural areas protects the human host from the development of PC, possibly by immune modulation. This hypothesis is used to explain increased PC rates in minority groups in the United States who had decreased helminth exposure in the late 20th century.
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Affiliation(s)
- Steven H Adams
- College of Medicine, State University of New York Upstate Medical University, Syracuse, New York
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24
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Wang M, Xu Y, Yang M, Jiang D, Chen Y, Jiang J, Chen Z, Yang L, Huang D. Conversion Therapy for Advanced Pancreatic Cancer: The Case Series and Literature Review. Front Pharmacol 2020; 11:579239. [PMID: 33117173 PMCID: PMC7573973 DOI: 10.3389/fphar.2020.579239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022] Open
Abstract
Background Pancreatic cancer has a high incidence and mortality. Most patients are in an advanced stage at the time of initial diagnosis and cannot be cured by a single surgery. The ASCO clinical practice guideline emphasized the overall management and multidisciplinary comprehensive treatment which put forward the concept of conversion therapy. In this paper, the real-world observation and study were carried out to explore the conversion effect of chemotherapy in patients with advanced pancreatic cancer and their long-term survival. Methods The subjects of this study are advanced pancreatic cancer patients who visited the oncology department of Zhejiang Provincial People’s Hospital from 2015 to 2019. Collected and summarized the cases, and selected 5 representative patients for analysis, all of them received standard treatment (FOLFIRINOX, AS, AG, or GS). The progress, clinical evaluation, adverse reactions, and prognosis of these patients after conversion therapy were analyzed and discussed in conjunction with relevant literature. Results Five patients with advanced pancreatic cancer received conversion therapy with an average survival time of 29.8 months, two of them received surgical treatment, and postoperative evaluations were pathological complete response (pCR). The tolerance of chemotherapy was good in five patients, and no serious adverse reactions of grade 3 or 4 occurred. Conclusion Conversion therapy for patients with advanced pancreatic cancer strives for surgical opportunities of radical resection, prolongs survival and improves quality of life.
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Affiliation(s)
- Mingxing Wang
- Department of Medical Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, China
| | - Yunyun Xu
- Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Min Yang
- The Qingdao University Medical College, Qingdao, China
| | - Dingyi Jiang
- The Qingdao University Medical College, Qingdao, China
| | - Yunwang Chen
- The Qingdao University Medical College, Qingdao, China
| | - Jiahong Jiang
- Department of Medical Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zheling Chen
- Department of Medical Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Liu Yang
- Department of Medical Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Dongsheng Huang
- Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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25
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Cheng T, Zhang Z, Shen H, Jian Z, Li J, Chen Y, Shen Y, Dai X. Topically applicated curcumin/gelatin-blended nanofibrous mat inhibits pancreatic adenocarcinoma by increasing ROS production and endoplasmic reticulum stress mediated apoptosis. J Nanobiotechnology 2020; 18:126. [PMID: 32891174 PMCID: PMC7487882 DOI: 10.1186/s12951-020-00687-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/30/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Pancreatic adenocarcinoma (PDAC) is one of the most fatal malignancies. Surgical resection supplemented by chemotherapy remains the major therapeutic regimen, but with unavoidable resistance and systemic toxic reaction. Curcumin is a known safe natural compound that can effectively eliminate pancreatic adenocarcinoma cells in vitro, making it a promising candidate for substitution in subsequent chemotherapy. However, due to its extremely low bioavailability caused by its insolubility and circular elimination, curcumin had an unexpectedly modest therapeutic effect in clinical trials. RESULTS Here, we electrospun curcumin/gelatin-blended nanofibrous mat to largely improve curcumin's bioavailability by local controlled-release. With characterization by scanning electron microscopy, fluorescence microscopy, Fourier transform infrared spectroscopy, X-ray diffraction and high-performance liquid chromatography, it was revealed that curcumin was uniformly dispersed in the fiber of the mats with nanoscopic dimensions and could be continuously released into the surrounding medium for days. The cancer inhibitory effects of nano-curcumin and underlying mechanisms were further explored by assays using pancreatic adenocarcinoma cell and experiments using xenograft model. The results showed the released nano-curcumin could effectively inhibit pancreatic adenocarcinoma cell proliferation not only in vitro, but more importantly in vivo. This cytotoxic effect of nano-curcumin against pancreatic adenocarcinoma was achieved through provoking the production of intracellular reactive oxygen species and activating endoplasmic reticulum stress, which leads to enhanced cell apoptosis via decreased phosphorylation of signal transducer and activator of transcription 3. CONCLUSIONS Clinically, curcumin/gelatin-blended nanofibrous mat could be a promising, secure, efficient and affordable substitutional agent for the elimination of residual cancer cells after tumor resection. Moreover, our strategy to obtain curcumin released from nanofibrous mat may provide a universally applicable approach for the study of the therapeutic effects and molecular mechanisms of other potential medicines with low bioavailability.
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Affiliation(s)
- Tao Cheng
- Department of General Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210000, China
| | - Zhiheng Zhang
- Department of Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, 81675, Munich, Germany
| | - Hua Shen
- Department of Plastic Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Ziying Jian
- Department of Hematology and Oncology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 21000, China
| | - Junsheng Li
- Department of General Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210000, China
| | - Yujun Chen
- Bio-ID Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yi Shen
- Bio-ID Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Xinyi Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200011, China.
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26
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Baum C, Soliman AS, Brown HE, Seifeldin IA, Ramadan M, Lott B, Nguyen A, El-Ghawalby A, Hablas A. Regional Variation of Pancreatic Cancer Incidence in the Nile Delta Region of Egypt over a Twelve-Year Period. J Cancer Epidemiol 2020; 2020:6031708. [PMID: 32733561 PMCID: PMC7376424 DOI: 10.1155/2020/6031708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/03/2020] [Accepted: 06/19/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Pancreatic cancer is one of the deadliest forms of cancer, with incidence rates rising in many countries around the world. Geographic variation in pancreatic cancer incidence has not been studied extensively, especially in low- and middle-income countries. The aim of this study was to characterize the distribution of pancreatic cancer incidence in the central Nile Delta region of Egypt and to examine differences by urban and rural patient residence using the nation's only population-based cancer registry. METHODS Utilizing the Gharbiah province population-based cancer registry, data were abstracted for 1,089 pancreatic cancer cases diagnosed over twelve years from 1999 to 2010. Age- and sex-specific incidence rates were calculated and compared for urban and rural areas of the eight districts of Gharbiah. RESULTS Age-adjusted incidence of pancreatic cancer within Gharbiah varied considerably by urban/rural patient residence and by district. Incidence rates were 1.3 times higher in urban compared to rural areas (4.45 per 100,000 in urban areas and 3.43 per 100,000 in rural areas). The highest incidence rates were observed in urban centers of Kotour, El Santa, and Kafr El-Zayat districts (12.94, 8.32, and 7.89, respectively). CONCLUSION Incidence rates varied greatly by urban and rural areas and by district of residence in the Nile Delta region of Egypt. Future studies should examine potential environmental risk factors that may contribute to the geographic distribution of pancreatic cancer in this region.
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Affiliation(s)
- Christina Baum
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Amr S. Soliman
- Department of Community Health and Social Medicine, City University of New York Medical School, New York City, NY 10031, USA
| | - Heidi E. Brown
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | | | | | - Breanne Lott
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - An Nguyen
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Ahmed El-Ghawalby
- Department of Surgery, Liver Transplantation Unit, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Mansoura, Egypt
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27
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Shun SC. Proposing a Comprehensive Prehabilitation Model for Individuals with Operable Pancreatic Cancer. Asia Pac J Oncol Nurs 2020; 7:255-258. [PMID: 32642496 PMCID: PMC7325771 DOI: 10.4103/apjon.apjon_18_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/04/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Shiow-Ching Shun
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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28
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Laoveeravat P, Thavaraputta S, Vutthikraivit W, Suchartlikitwong S, Mingbunjerdsuk T, Motes A, Nugent K, Rakvit A, Islam E, Islam S. Proton pump inhibitors and histamine-2 receptor antagonists on the risk of pancreatic cancer: a systematic review and meta-analysis. QJM 2020; 113:100-107. [PMID: 31503318 DOI: 10.1093/qjmed/hcz234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 08/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Proton pump inhibitors (PPI) and histamine-2 receptor antagonists (H2RA) have been widely used for multiple purposes. Recent studies have suggested an association between these medications and the risk of pancreatic cancer. However, the results have been inconclusive. AIM We, therefore, conducted a study to assess the risk of developing pancreatic cancer in patients who used PPI and H2RA. DESIGN A systematic review and meta-analysis. METHODS A literature search was performed using MEDLINE and EMBASE databases from inception through February 2019. Studies that reported risk ratio comparing the risk of pancreatic cancer in patients who received PPI or H2RA versus those who did not receive treatments were included. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effect generic inverse variance method. Sensitivity analysis, excluding one study at a time, was performed. RESULTS After screening abstracts from the searching methods, seven studies (six case-control studies and one cohort study) were included in the analysis with total 546 199 participants. Compared to patients who did not take medications, the pooled RR of developing pancreatic cancer in patients receiving PPI and H2RA were 1.73 (95% CI: 1.16-2.57) and 1.26 (95% CI: 1.02-1.57), respectively. However, the sensitivity analysis of PPI changed the pooled RR to 1.87 (95% CI: 1.00-3.51) after a study was dropped out. Likewise, H2RA sensitivity analysis also resulted in non-significant pooled RR. CONCLUSIONS This meta-analysis did not find the strong evidence for the associations between the use of PPI and H2RA and pancreatic cancer.
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Affiliation(s)
- P Laoveeravat
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Thavaraputta
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - W Vutthikraivit
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - S Suchartlikitwong
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - T Mingbunjerdsuk
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - A Motes
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - K Nugent
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - A Rakvit
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Division of Gastroenterology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - E Islam
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - S Islam
- From the Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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30
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The current surgical treatment of pancreatic cancer in China: a national wide cross-sectional study. JOURNAL OF PANCREATOLOGY 2019. [DOI: 10.1097/jp9.0000000000000012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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