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Aslam M, Rajbdad F, Azmat S, Li Z, Boudreaux JP, Thiagarajan R, Yao S, Xu J. A novel method for detection of pancreatic Ductal Adenocarcinoma using explainable machine learning. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 245:108019. [PMID: 38237450 DOI: 10.1016/j.cmpb.2024.108019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND AND OBJECTIVE Pancreatic Ductal Adenocarcinoma (PDAC) is a form of pancreatic cancer that is one of the primary causes of cancer-related deaths globally, with less than 10 % of the five years survival rate. The prognosis of pancreatic cancer has remained poor in the last four decades, mainly due to the lack of early diagnostic mechanisms. This study proposes a novel method for detecting PDAC using explainable and supervised machine learning from Raman spectroscopic signals. METHODS An insightful feature set consisting of statistical, peak, and extended empirical mode decomposition features is selected using the support vector machine recursive feature elimination method integrated with a correlation bias reduction. Explicable features successfully identified mutations in Kirsten rat sarcoma viral oncogene homolog (KRAS) and tumor suppressor protein53 (TP53) in the fingerprint region for the first time in the literature. PDAC and normal pancreas are classified using K-nearest neighbor, linear discriminant analysis, and support vector machine classifiers. RESULTS This study achieved a classification accuracy of 98.5% using a nonlinear support vector machine. Our proposed method reduced test time by 28.5 % and saved 85.6 % memory utilization, which reduces complexity significantly and is more accurate than the state-of-the-art method. The generalization of the proposed method is assessed by fifteen-fold cross-validation, and its performance is evaluated using accuracy, specificity, sensitivity, and receiver operating characteristic curves. CONCLUSIONS In this study, we proposed a method to detect and define the fingerprint region for PDAC using explainable machine learning. This simple, accurate, and efficient method for PDAC detection in mice could be generalized to examine human pancreatic cancer and provide a basis for precise chemotherapy for early cancer treatment.
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Affiliation(s)
- Murtaza Aslam
- Department of Electrical and Computer Engineering, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Fozia Rajbdad
- Department of Electrical and Computer Engineering, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Shoaib Azmat
- Department of Electrical and Computer Engineering, COMSATS University Islamabad, Pakistan
| | - Zheng Li
- Department of Electrical and Computer Engineering, Louisiana State University, Baton Rouge, LA 70803, USA
| | - J Philip Boudreaux
- Department of Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Ramcharan Thiagarajan
- Department of Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Shaomian Yao
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Jian Xu
- Department of Electrical and Computer Engineering, Louisiana State University, Baton Rouge, LA 70803, USA.
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Prinz C, Fehring L, Frese R. MicroRNAs as Indicators of Malignancy in Pancreatic Ductal Adenocarcinoma (PDAC) and Cystic Pancreatic Lesions. Cells 2022; 11:cells11152374. [PMID: 35954223 PMCID: PMC9368175 DOI: 10.3390/cells11152374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 12/04/2022] Open
Abstract
The dysregulation of microRNAs has recently been associated with cancer development and progression in pancreatic ductal adenocarcinoma (PDAC) and cystic pancreatic lesions. In solid pancreatic tumor tissue, the dysregulation of miR-146, miR-196a/b, miR-198, miR-217, miR-409, and miR-490, as well as miR-1290 has been investigated in tumor biopsies of patients with PDAC and was reported to predict cancer presence. However, the value of the predictive biomarkers may further be increased during clinical conditions suggesting cancer development such as hyperinsulinemia or onset of diabetes. In this specific context, the dysregulation of miR-486 and miR-196 in tumors has been observed in the tumor tissue of PDAC patients with newly diagnosed diabetes mellitus. Moreover, miR-1256 is dysregulated in pancreatic cancer, possibly due to the interaction with long non-coding RNA molecules that seem to affect cell-cycle control and diabetes manifestation in PDAC patients, and, thus, these three markers may be of special or “sentinel value”. In blood samples, Next-generation sequencing (NGS) has also identified a set of microRNAs (miR-20a, miR-31-5p, miR-24, miR-25, miR-99a, miR-185, and miR-191) that seem to differentiate patients with pancreatic cancer remarkably from healthy controls, but limited data exist in this context regarding the prediction of cancer presences and outcomes. In contrast to solid pancreatic tumors, in cystic pancreatic cancer lesions, as well as premalignant lesions (such as intraductal papillary neoplasia (IPMN) or mucinous-cystic adenomatous cysts (MCAC)), the dysregulation of a completely different expression panel of miR-31-5p, miR-483-5p, miR-99a-5p, and miR-375 has been found to be of high clinical value in differentiating benign from malignant lesions. Interestingly, signal transduction pathways associated with miR-dysregulation seem to be entirely different in patients with pancreatic cysts when compared to PDAC. Overall, the determination of these different dysregulation “panels” in solid tumors, pancreatic cysts, obtained via fine-needle aspirate biopsies and/or in blood samples at the onset or during the treatment of pancreatic diseases, seems to be a reasonable candidate approach for predicting cancer presence, cancer development, and even therapy responses.
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Wang CA, Li CF, Huang RC, Li YH, Liou JP, Tsai SJ. Suppression of Extracellular Vesicle VEGF-C-mediated Lymphangiogenesis and Pancreatic Cancer Early Dissemination By a Selective HDAC1/2 Inhibitor. Mol Cancer Ther 2021; 20:1550-1560. [PMID: 34210825 DOI: 10.1158/1535-7163.mct-20-0963] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/29/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer characterized by early dissemination and poor drug response. Therefore, it is an unmet medical need to develop new strategies for treatment. As aberrant activation of ERK due to KRAS activating mutation is a driving force for PDAC, a brake system that can terminate ERK signaling represents an ideal druggable target. Herein, we demonstrate that forced expression of dual specificity phosphatase-2 (DUSP2), a specific ERK phosphatase, abrogated tumor formation and loss of Dusp2 facilitated Kras-driven PDAC progression. We report that a selective HDAC1/2 inhibitor (B390) has multifaceted therapeutic potential in PDAC by restoring the expression and function of DUSP2. In vitro study showed that treatment with B390 inhibited growth and migration abilities of PDAC cells, decreased extracellular vesicle-associated VEGF-C expression, and suppressed lymphatic endothelial cell proliferation. In vivo, B390 not only suppressed tumor growth by increasing tumor cell death, it also inhibited lymphangiogenesis and lymphovascular invasion. Taken together, our data demonstrate that B390 was able to alleviate loss of DUSP2-mediated pathologic processes, which provides the proof-of-concept evidence to demonstrate the potential of using selective HDAC1/2 inhibitors in PDAC treatment and suggests reinstating DUSP2 expression may be a strategy to subside PDAC progression.
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Affiliation(s)
- Chu-An Wang
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Feng Li
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Rho-Chi Huang
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yo-Hua Li
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jing-Ping Liou
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Shaw-Jenq Tsai
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Bettaieb L, Brulé M, Chomy A, Diedro M, Fruit M, Happernegg E, Heni L, Horochowska A, Housseini M, Klouyovo K, Laratte A, Leroy A, Lewandowski P, Louvieaux J, Moitié A, Tellier R, Titah S, Vanauberg D, Woesteland F, Prevarskaya N, Lehen’kyi V. Ca 2+ Signaling and Its Potential Targeting in Pancreatic Ductal Carcinoma. Cancers (Basel) 2021; 13:3085. [PMID: 34205590 PMCID: PMC8235326 DOI: 10.3390/cancers13123085] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/02/2021] [Accepted: 06/13/2021] [Indexed: 01/05/2023] Open
Abstract
Pancreatic cancer (PC) is a major cause of cancer-associated mortality in Western countries (and estimated to be the second cause of cancer deaths by 2030). The main form of PC is pancreatic adenocarcinoma, which is the fourth most common cause of cancer-related death, and this situation has remained virtually unchanged for several decades. Pancreatic ductal adenocarcinoma (PDAC) is inherently linked to the unique physiology and microenvironment of the exocrine pancreas, such as pH, mechanical stress, and hypoxia. Of them, calcium (Ca2+) signals, being pivotal molecular devices in sensing and integrating signals from the microenvironment, are emerging to be particularly relevant in cancer. Mutations or aberrant expression of key proteins that control Ca2+ levels can cause deregulation of Ca2+-dependent effectors that control signaling pathways determining the cells' behavior in a way that promotes pathophysiological cancer hallmarks, such as enhanced proliferation, survival and invasion. So far, it is essentially unknown how the cancer-associated Ca2+ signaling is regulated within the characteristic landscape of PDAC. This work provides a complete overview of the Ca2+ signaling and its main players in PDAC. Special consideration is given to the Ca2+ signaling as a potential target in PDAC treatment and its role in drug resistance.
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Affiliation(s)
- Louay Bettaieb
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Maxime Brulé
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Axel Chomy
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Mel Diedro
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Malory Fruit
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Eloise Happernegg
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Leila Heni
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Anaïs Horochowska
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Mahya Housseini
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Kekely Klouyovo
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Agathe Laratte
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Alice Leroy
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Paul Lewandowski
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Joséphine Louvieaux
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Amélie Moitié
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Rémi Tellier
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Sofia Titah
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Dimitri Vanauberg
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Flavie Woesteland
- Option Biology, Master Biology-Health, Faculty of Medicine Henry Warembourg, University of Lille, 59120 Loos, France; (L.B.); (M.B.); (A.C.); (M.D.); (M.F.); (E.H.); (L.H.); (A.H.); (M.H.); (K.K.); (A.L.); (A.L.); (P.L.); (J.L.); (A.M.); (R.T.); (S.T.); (D.V.); (F.W.)
| | - Natalia Prevarskaya
- Laboratory of Cell Physiology, INSERM U1003, Laboratory of Excellence Ion Channels Science and Therapeutics, Department of Biology, Faculty of Science and Technologies, University of Lille, 59650 Villeneuve d’Ascq, France;
- University Lille, Inserm, U1003-PHYCEL-Physiologie Cellulaire, F-59000 Lille, France
| | - V’yacheslav Lehen’kyi
- Laboratory of Cell Physiology, INSERM U1003, Laboratory of Excellence Ion Channels Science and Therapeutics, Department of Biology, Faculty of Science and Technologies, University of Lille, 59650 Villeneuve d’Ascq, France;
- University Lille, Inserm, U1003-PHYCEL-Physiologie Cellulaire, F-59000 Lille, France
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Cai Q, Mao Y, Yang Q, Wen H, Lv Y, Zhang R. Are left ventricular muscle area and radiation attenuation associated with overall survival in advanced pancreatic cancer patients treated with chemotherapy? Clin Radiol 2019; 75:238.e1-238.e9. [PMID: 31858988 DOI: 10.1016/j.crad.2019.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/12/2019] [Indexed: 01/08/2023]
Abstract
AIM To evaluate whether cardiac muscle area and radiation attenuation, determined using pre-chemotherapy computed tomography (CT), are associated with therapeutic response and overall survival (OS) in chemotherapy-treated advanced pancreatic cancer (APC) patients. MATERIALS AND METHODS Ninety-eight chemotherapy-treated APC patients who underwent pre-chemotherapy CT between 2009 and 2018 were considered. Left ventricular muscle area (LVMA) and left ventricular muscle radiation attenuation (LVMRA) were measured using pre-chemotherapy arterial-phase CT. OS and progression-free survival (PFS) were analysed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to analyse potential factors affecting OS and PFS. RESULTS Patients with low LVMRA, low LVMA at baseline CT, and multiple metastases had a significantly shorter median OS than patients with high LVMRA, high LVMA, and without multiple metastases (8.8 versus 14 months, p=0.017; 12.2 versus 18.1 months, p=0.038; 7.3 versus 13.5 months, p<0.001, respectively). Patients with low LVMRA and distant metastasis had a shorter median PFS than patients with high LVMRA and those without distant metastasis (4.9 versus 8.3 months, p=0.032; 5.4 versus 9.9 months, p=0.002, respectively). Moreover, the mean LVMRA was the highest in the partial response group (p=0.028). CONCLUSION LVMRA could well predict PFS and OS in chemotherapy-treated APC patients.
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Affiliation(s)
- Q Cai
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Y Mao
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Hepato-biliary-pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Q Yang
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, 510060, Guangzhou, China
| | - H Wen
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, 510060, Guangzhou, China
| | - Y Lv
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, 510060, Guangzhou, China.
| | - R Zhang
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, 510060, Guangzhou, China.
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Chen L, Zhang Y, Cheng Y, Zhang D, Zhu S, Ma X. Prognostic value of circulating cell-free DNA in patients with pancreatic cancer: A systemic review and meta-analysis. Gene 2018; 679:328-334. [PMID: 30227250 DOI: 10.1016/j.gene.2018.09.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/14/2018] [Indexed: 02/05/2023]
Abstract
Because of the deep research about tumorigenesis mechanism, the cognition of cancer has been transferred to molecular level from morphology. Previous articles reported a potential connection between circulating cell-free DNA (cfDNA) and prognosis of pancreatic cancer. A total of 18 related articles including 1243 patients were enrolled to access the relationship between cfDNA and prognosis of pancreatic cancer. The hazard ratio (HR) was used to combine the univariate and multivariate results of included studies. Our result performed that the cfDNA had significant prognostic value in predicting OS (HR = 2.41, 95%CI: 1.93-3.02, I2 = 60%) and PFS (HR = 2.47, 95%CI: 1.80-3.40, I2 = 0%) in univariate analysis. The multivariate analyses about OS (HR = 2.57, 95%CI: 1.95-3.38, I2 = 66%) and PFS (HR = 2.31, 95%CI: 1.47-3.64, I2 = 0%) also showed significance. In conclusion, the cfDNA was a significant prognostic factor for OS and PFS in patients with pancreatic cancer. The mutation (Kras, ERBB2-exon17 and KrasG12V), circulating tumor DNA (ctDNA) presence, hypermethylation and higher concentration of cfDNA were both associated with worse survival results in pancreatic cancer.
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Affiliation(s)
- Linyan Chen
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China; West China School of Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yi Zhang
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China; West China School of Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yuan Cheng
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China; West China School of Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Dan Zhang
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China; West China School of Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Sha Zhu
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China; West China School of Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - Xuelei Ma
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China.
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Vainer N, Dehlendorff C, Johansen JS. Systematic literature review of IL-6 as a biomarker or treatment target in patients with gastric, bile duct, pancreatic and colorectal cancer. Oncotarget 2018; 9:29820-29841. [PMID: 30038723 PMCID: PMC6049875 DOI: 10.18632/oncotarget.25661] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 06/04/2018] [Indexed: 12/21/2022] Open
Abstract
Gastrointestinal cancer (GI) is a major health problem. Patients with gastric, pancreatic, colorectal, bile duct and gall bladder cancer often have advanced disease at the time of diagnosis and are generally difficult to cure, resulting in a dismal prognosis for most patients. Inflammation plays an important role in the development and growth of cancer, which has led to a growing interest in the pro-inflammatory cytokine interleukin 6 (IL-6). The aim of the present review was to evaluate the clinical use of IL-6 as a biomarker or therapeutic target in patients with GI cancer. We did a systematic review of studies (1993-2018), to assess the clinical use of IL-6 as a diagnostic, prognostic or predictive tumor biomarker or as a potential therapeutic target. This review includes 48 studies and 5316 patients. Circulating IL-6 levels appear to be an independent prognostic biomarker in patients with GI cancer, with high IL-6 levels associated with short overall survival (OS). The results for colorectal cancer were too ambiguous to give conclusive results. IL-6 seemed to be a marker for some of the clinical characteristics of GI cancer, and may have a role in the diagnostic workup in general practice. No published studies have examined the use of IL-6 as a therapeutic target in pancreatic, gastric, bile duct or colorectal cancer. In conclusion, high circulating IL-6 was associated with short OS in most studies in GI cancer patients. Whether inhibition of IL-6 would decrease GI cancer symptoms and increase quality of life is unknown.
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Affiliation(s)
- Noomi Vainer
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Dehlendorff
- Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Julia S Johansen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rong D, Mao Y, Hu W, Xu S, Wang J, He H, Li S, Zhang R. Intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic and non-metastatic lymph nodes in pancreatic ductal adenocarcinoma. Eur Radiol 2018; 28:2781-2789. [PMID: 29404768 DOI: 10.1007/s00330-017-5259-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/14/2017] [Accepted: 12/20/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate the diagnostic potential of intravoxel incoherent motion (IVIM) DWI for differentiating metastatic and non-metastatic lymph node stations (LNS) in pancreatic ductal adenocarcinoma (PDAC). METHODS 59 LNS histologically diagnosed following surgical resection from 15 patients were included. IVIM DWI with 12 b values was added to the standard MRI protocol. Evaluation of parameters was performed pre-operatively and included the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Diagnostic performance of ADC, D, D* and f for differentiating between metastatic and non-metastatic LNS was evaluated using ROC analysis. RESULTS Metastatic LNS had significantly lower D, D*, f and ADC values than the non-metastatic LNS (p< 0.01). The best diagnostic performance was found in D, with an area under the ROC curve of 0.979, while the area under the ROC curve values of D*, f and ADC were 0.867, 0.855 and 0.940, respectively. The optimal cut-off values for distinguishing metastatic and non-metastatic lymph nodes were D = 1.180 × 10-3 mm2/s; D* = 14.750 × 10-3 mm2/s, f = 20.65 %, and ADC = 1.390 × 10-3 mm2/s. CONCLUSION IVIM DWI is useful for differentiating between metastatic and non-metastatic LNS in PDAC. KEY POINTS • IVIM DWI is feasible for diagnosing LN metastasis in PDAC. • Metastatic LNS has lower D, D*, f, ADC values than non-metastatic LNS. • D-value from IVIM model has best diagnostic performance, followed by ADC value. • D* has the lowest AUC value.
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Affiliation(s)
- Dailin Rong
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Yize Mao
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Hepato-Biliary-Pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Wanming Hu
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Pathology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Shuhang Xu
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, Guangdong Province, People's Republic of China
| | - Jun Wang
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Hepato-Biliary-Pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
- Department of Ultrasound, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Haoqiang He
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Shengping Li
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Department of Hepato-Biliary-Pancreatic Oncology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
| | - Rong Zhang
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, China.
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9
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Qian CJ, Qi YX, Zhong S, Zeng JP, Chen XY, Yao J. Mitogen-activated protein kinase inhibition enhances the antitumor effects of sporamin in human pancreatic cancer cells. Oncol Lett 2018; 16:1237-1242. [PMID: 30061945 DOI: 10.3892/ol.2018.8746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/17/2018] [Indexed: 01/07/2023] Open
Abstract
Sporamin, a sweet potato tuber storage protein, is a Kunitz-type trypsin inhibitor (TI) that has exhibited antitumor activity through poorly defined mechanisms in a number of types of tumor cells. The present study aimed to analyze the combined effects of sporamin and three mitogen-activated protein kinase (MAPK) inhibitors, PD98059, SP600125 and SB203580, on the pancreatic cancer cell line, PANC-1. Cell proliferation activity was assessed using a 3H-thymidine incorporation assay, and cell viability was analyzed using an MTT assay. Apoptosis was assayed by flow cytometry and fluorescence microscopy. Protein expression levels in PANC-1 cells were determined by western blotting. The results of this analysis demonstrated that sporamin induced a temporary increase in the phosphorylation of MAPKs, including phosphorylated extracellular signal regulated-kinase 1/2, phosphorylated c-Jun amino-terminal protein kinase 1/2 and phosphorylated p38-MAPK, in a concentration-dependent manner. However, treatment with MAPK inhibitors promoted the inhibition of cell proliferation and viability, and the induction of apoptosis in sporamin-treated PANC-1 cells. In conclusion, the present study demonstrated that MAPK inhibition enhanced the antitumor activity of sporamin in PANC-1 cells.
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Affiliation(s)
- Cui-Juan Qian
- Department of Gastroenterology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, Zhejiang 318000, P.R. China.,Institute of Tumor, School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, P.R. China
| | - Yong-Xiao Qi
- Institute of Tumor, School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, P.R. China
| | - Sheng Zhong
- Institute of Tumor, School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, P.R. China
| | - Ju-Ping Zeng
- Institute of Tumor, School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, P.R. China
| | - Xiao-Ying Chen
- Institute of Tumor, School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, P.R. China
| | - Jun Yao
- Institute of Tumor, School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, P.R. China
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10
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Chattaragada MS, Riganti C, Sassoe M, Principe M, Santamorena MM, Roux C, Curcio C, Evangelista A, Allavena P, Salvia R, Rusev B, Scarpa A, Cappello P, Novelli F. FAM49B, a novel regulator of mitochondrial function and integrity that suppresses tumor metastasis. Oncogene 2018; 37:697-709. [PMID: 29059164 PMCID: PMC5808099 DOI: 10.1038/onc.2017.358] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 08/07/2017] [Accepted: 08/12/2017] [Indexed: 12/13/2022]
Abstract
Mitochondrial dysregulation plays a central role in cancers and drives reactive oxygen species (ROS)-dependent tumor progression. We investigated the pro-tumoral roles of mitochondrial dynamics and altered intracellular ROS levels in pancreatic ductal adenocarcinoma (PDAC). We identified 'family with sequence similarity 49 member B' (FAM49B) as a mitochondria-localized protein that regulates mitochondrial fission and cancer progression. Silencing FAM49B in PDAC cells resulted in increased fission and mitochondrial ROS generation, which enhanced PDAC cell proliferation and invasion. Notably, FAM49B expression levels in PDAC cells were downregulated by the tumor microenvironment. Overall, the results of this study show that FAM49B acts as a suppressor of cancer cell proliferation and invasion in PDAC by regulating tumor mitochondrial redox reactions and metabolism.
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Affiliation(s)
- M S Chattaragada
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - C Riganti
- Department of Oncology, University of Turin, Turin, Italy
| | - M Sassoe
- Department of Neurosciences, ‘Rita Levi Montalcini’, University of Turin, Turin, Italy
| | - M Principe
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - M M Santamorena
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - C Roux
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - C Curcio
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - A Evangelista
- Department of Clinical Epidemiology, Azienda Universitaria Ospedaliera Città della Salute e della Scienza and CPO Piemonte, Turin, Italy
| | - P Allavena
- Laboratory of Molecular Gastroenterology, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
| | - R Salvia
- Department of Surgery, The Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - B Rusev
- Department of Pathology and Public Health & ARC-NET Research Center, University and Hospital Trust of Verona, Verona, Italy
| | - A Scarpa
- Department of Pathology and Public Health & ARC-NET Research Center, University and Hospital Trust of Verona, Verona, Italy
| | - P Cappello
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
- Molecular Biotechnology Center, University of Turin, Turin, Italy
| | - F Novelli
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
- Center for Experimental Research and Medical Studies, Azienda Universitaria Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
- Molecular Biotechnology Center, University of Turin, Turin, Italy
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11
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Berry W, Algar E, Kumar B, Desmond C, Swan M, Jenkins BJ, Croagh D. Endoscopic ultrasound-guided fine-needle aspirate-derived preclinical pancreatic cancer models reveal panitumumab sensitivity in KRAS wild-type tumors. Int J Cancer 2017; 140:2331-2343. [PMID: 28198009 DOI: 10.1002/ijc.30648] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/11/2017] [Accepted: 02/07/2017] [Indexed: 01/06/2023]
Abstract
Pancreatic cancer (PC) is largely refractory to existing therapies used in unselected patient trials, thus emphasizing the pressing need for new approaches for patient selection in personalized medicine. KRAS mutations occur in 90% of PC patients and confer resistance to epidermal growth factor receptor (EGFR) inhibitors (e.g., panitumumab), suggesting that KRAS wild-type PC patients may benefit from targeted panitumumab therapy. Here, we use tumor tissue procured by endoscopic ultrasound-guided fine-needle aspirate (EUS-FNA) to compare the in vivo sensitivity in patient-derived xenografts (PDXs) of KRAS wild-type and mutant PC tumors to panitumumab, and to profile the molecular signature of these tumors in patients with metastatic or localized disease. Specifically, RNASeq of EUS-FNA-derived tumor RNA from localized (n = 20) and metastatic (n = 20) PC cases revealed a comparable transcriptome profile. Screening the KRAS mutation status of tumor genomic DNA obtained from EUS-FNAs stratified PC patients into either KRAS wild-type or mutant cohorts, and the engraftment of representative KRAS wild-type and mutant EUS-FNA tumor samples into NOD/SCID mice revealed that the growth of KRAS wild-type, but not mutant, PDXs was selectively suppressed with panitumumab. Furthermore, in silico transcriptome interrogation of The Cancer Genome Atlas (TCGA)-derived KRAS wild-type (n = 38) and mutant (n = 132) PC tumors revealed 391 differentially expressed genes. Taken together, our study validates EUS-FNA for the application of a novel translational pipeline comprising KRAS mutation screening and PDXs, applicable to all PC patients, to evaluate personalized anti-EGFR therapy in patients with KRAS wild-type tumors.
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Affiliation(s)
- William Berry
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia.,Department of Molecular Translational Science, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Elizabeth Algar
- Genetics and Molecular Pathology Laboratory, Monash Health, Clayton, VIC, 3168, Australia.,Centre for Cancer Research, Hudson Institute of Medical Research, Monash University, Clayton, VIC, 3168, Australia
| | - Beena Kumar
- Department of Anatomical Pathology, Monash Health, Clayton, VIC, 3168, Australia
| | - Christopher Desmond
- Department of Gastroenterology, Monash Health, Clayton, VIC, 3168, Australia
| | - Michael Swan
- Department of Gastroenterology, Monash Health, Clayton, VIC, 3168, Australia
| | - Brendan J Jenkins
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, VIC, 3168, Australia.,Department of Molecular Translational Science, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Daniel Croagh
- Department of Surgery (School of Clinical Sciences at Monash Health), Monash University, Clayton, VIC, 3800, Australia
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12
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He M, Qiao Z, Wang Y, Kuai Q, Li C, Wang Y, Jiang X, Wang X, Li W, He M, Ren S, Yu Q. Chidamide Inhibits Aerobic Metabolism to Induce Pancreatic Cancer Cell Growth Arrest by Promoting Mcl-1 Degradation. PLoS One 2016; 11:e0166896. [PMID: 27875574 PMCID: PMC5119787 DOI: 10.1371/journal.pone.0166896] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/04/2016] [Indexed: 01/05/2023] Open
Abstract
Pancreatic cancer is a fatal malignancy worldwide and urgently requires valid therapies. Previous research showed that the HDAC inhibitor chidamide is a promising anti-cancer agent in pancreatic cancer cell lines. In this study, we elucidate a probable underlying anti-cancer mechanism of chidamide involving the degradation of Mcl-1. Mcl-1 is frequently upregulated in human cancers, which has been demonstrated to participate in oxidative phosphorylation, in addition to its anti-apoptotic actions as a Bcl-2 family member. The pancreatic cancer cell lines BxPC-3 and PANC-1 were treated with chidamide, resulting in Mcl-1 degradation accompanied by induction of Mcl-1 ubiquitination. Treatment with MG132, a proteasome inhibitor reduced Mcl-1 degradation stimulated by chidamide. Chidamide decreased O2 consumption and ATP production to inhibit aerobic metabolism in both pancreatic cancer cell lines and primary cells, similar to knockdown of Mcl-1, while overexpression of Mcl-1 in pancreatic cancer cells could restore the aerobic metabolism inhibited by chidamide. Furthermore, chidamide treatment or Mcl-1 knockdown significantly induced cell growth arrest in pancreatic cancer cell lines and primary cells, and Mcl-1 overexpression could reduce this cell growth inhibition. In conclusion, our results suggest that chidamide promotes Mcl-1 degradation through the ubiquitin-proteasome pathway, suppressing the maintenance of mitochondrial aerobic respiration by Mcl-1, and resulting in inhibition of pancreatic cancer cell proliferation. Our work supports the claim that chidamide has therapeutic potential for pancreatic cancer treatment.
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Affiliation(s)
- Mu He
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
- Microbiology Laboratory, Shunyi District Center for Disease Control and Prevention, Beijing, China
| | - Zhixin Qiao
- Medical Research Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yanbing Wang
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Qiyuan Kuai
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Changlan Li
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Yu Wang
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Xingwei Jiang
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Xuanlin Wang
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Weijing Li
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Min He
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Suping Ren
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
- * E-mail: (QY); (SR)
| | - Qun Yu
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China
- * E-mail: (QY); (SR)
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13
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Wang G, Li ZB, Qu FZ, Sun B. R0 resection of pancreatic head carcinoma: Definition of surgical margins and influencing factors. Shijie Huaren Xiaohua Zazhi 2016; 24:1315-1320. [DOI: 10.11569/wcjd.v24.i9.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Early diagnosis of pancreatic head carcinoma is difficult. Once diagnosed, it often has been in the advanced stage, the prognosis is poor, and five-year survival does not exceed 6%. R0 resection is the only way to obtain long-term survival in patients with pancreatic head cancer. Numerous clinical studies have shown that lack of retroperitoneal tissue dissection is the important reason for being unable to achieve R0 resection in pancreatic cancer patients. The proposed mesopancreas and total mesopancreas excision (TMpE) concept provides a better definition of retroperitoneal dissection, thereby increasing the rate of R0 resection effectively.
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