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Bogdanski AM, van Hooft JE, Boekestijn B, Bonsing BA, Wasser MNJM, Klatte DCF, van Leerdam ME. Aspects and outcomes of surveillance for individuals at high-risk of pancreatic cancer. Fam Cancer 2024; 23:323-339. [PMID: 38619782 PMCID: PMC11255004 DOI: 10.1007/s10689-024-00368-1] [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: 01/05/2024] [Accepted: 02/24/2024] [Indexed: 04/16/2024]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related deaths and is associated with a poor prognosis. The majority of these cancers are detected at a late stage, contributing to the bad prognosis. This underscores the need for novel, enhanced early detection strategies to improve the outcomes. While population-based screening is not recommended due to the relatively low incidence of PDAC, surveillance is recommended for individuals at high risk for PDAC due to their increased incidence of the disease. However, the outcomes of pancreatic cancer surveillance in high-risk individuals are not sorted out yet. In this review, we will address the identification of individuals at high risk for PDAC, discuss the objectives and targets of surveillance, outline how surveillance programs are organized, summarize the outcomes of high-risk individuals undergoing pancreatic cancer surveillance, and conclude with a future perspective on pancreatic cancer surveillance and novel developments.
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Affiliation(s)
- Aleksander M Bogdanski
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Jeanin E van Hooft
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Bas Boekestijn
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bert A Bonsing
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin N J M Wasser
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Derk C F Klatte
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Monique E van Leerdam
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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2
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Yang Z, Li S, Zhao C, Zhao Z, Tan J, Zhang L, Huang Y. X-Box binding protein 1 downregulates SIRT6 to promote injury in pancreatic ductal epithelial cells. Immun Inflamm Dis 2024; 12:e1301. [PMID: 38967361 PMCID: PMC11225082 DOI: 10.1002/iid3.1301] [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: 09/12/2023] [Revised: 04/19/2024] [Accepted: 05/19/2024] [Indexed: 07/06/2024] Open
Abstract
OBJECTIVE Acute pancreatitis (AP) stands as a frequent cause for clinical emergency hospital admissions. The X-box binding protein 1 (XBP1) was found to be implicated in pancreatic acinar cell apoptosis. The objective is to unveil the potential mechanisms governed by XBP1 and SIRT6 in the context of AP. METHODS Caerulein-treated human pancreatic duct epithelial (HPDE) cells to establish an in vitro research model. The levels and regulatory role of SIRT6 in the treated cells were evaluated, including its effects on inflammatory responses, oxidative stress, apoptosis, and endoplasmic reticulum stress. The relationship between XBP1 and SIRT6 was explored by luciferase and ChIP experiments. Furthermore, the effect of XBP1 overexpression on the regulatory function of SIRT6 on cells was evaluated. RESULTS Caerulein promoted the decrease of SIRT6 and the increase of XBP1 in HPDE cells. Overexpression of SIRT6 slowed down the secretion of inflammatory factors, oxidative stress, apoptosis level, and endoplasmic reticulum stress in HPDE cells. However, XBP1 negatively regulated SIRT6, and XBP1 overexpression partially reversed the regulation of SIRT6 on the above aspects. CONCLUSION Our study illuminates the role of XBP1 in downregulating SIRT6 in HPDE cells, thereby promoting cellular injury. Inhibiting XBP1 or augmenting SIRT6 levels holds promise in preserving cell function and represents a potential therapeutic avenue in the management of AP.
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Affiliation(s)
- Zhuo Yang
- Intensive Care Unit, Bazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
| | - Shaojun Li
- Acupuncture and Rehabilitation DepartmentBazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
| | - Chuan Zhao
- Intensive Care Unit, Bazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
| | - Zongzheng Zhao
- Intensive Care Unit, Bazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
| | - Juan Tan
- Intensive Care Unit, Bazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
| | - Lu Zhang
- Acupuncture and Rehabilitation DepartmentBazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
| | - Yuanqing Huang
- Intensive Care Unit, Bazhong Hospital of Traditional Chinese MedicineBazhongSichuanChina
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3
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Padula D, Mauro A, Maggioni P, Kurihara H, Di Sabatino A, Anderloni A. Practical approach to acute pancreatitis: from diagnosis to the management of complications. Intern Emerg Med 2024:10.1007/s11739-024-03666-9. [PMID: 38850357 DOI: 10.1007/s11739-024-03666-9] [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] [Received: 01/13/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
The purpose of this review is to provide a practical guide for the clinical care of patients with acute pancreatitis (AP) from the management of the early phases of disease to the treatment of local complications. AP is one of the most frequent causes of gastroenterological admission in emergency departments. It is characterized by a dynamic and unpredictable course and in its most severe forms, is associated with organ dysfunction and/or local complications, requiring intensive care with significant morbidity and mortality. Initial therapy includes adequate fluid resuscitation, nutrition, analgesia, and when necessary critical care support. In recent years, the development of minimally invasive tailored treatments for local complications, such as endoscopic drainage, has improved patients' acceptance and outcomes. Despite this, the management of AP remains a challenge for clinicians. The present review was conducted by the authors, who formulated specific questions addressing the most critical and current aspects of the clinical course of AP with the aim of providing key messages.
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Affiliation(s)
- Donatella Padula
- Emergency Department and Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via F Sforza 35, Milan, Italy
| | - Aurelio Mauro
- Gastroenterology and Digestive Endoscopy Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi, 19, Pavia, Italy.
| | - Paolo Maggioni
- Emergency Department and Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via F Sforza 35, Milan, Italy
- Scuola di Specializzazione in Medicina di Emergenza-Urgenza, Università Degli Studi Di Milano, Milan, Italy
| | - Hayato Kurihara
- Emergency Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Anderloni
- Gastroenterology and Digestive Endoscopy Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi, 19, Pavia, Italy
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4
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Azzini E, Furini T, Polito A, Scalfi L, Pinto A, Gasperi V, Savini I. Vitamin Nutritional Status in Patients with Pancreatic Cancer: A Narrative Review. Int J Mol Sci 2024; 25:4773. [PMID: 38732007 PMCID: PMC11084158 DOI: 10.3390/ijms25094773] [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: 02/27/2024] [Revised: 04/09/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Due to the high mortality rate in Western countries, pancreatic cancer is considered one of the big killers, leaving patients and their families with little hope upon diagnosis. Although surgical and drug therapies are critical for cancer patients to improve life expectancy and alleviation of suffering, nutrition plays a key role in improving cancer treatment outcomes. This narrative review, conducted as part of the activities of the Italian Society of Human Nutrition (SINU) working group in oncology, focuses on the prevalence of vitamin malnutrition among pancreatic cancer patients. The results of the literature search show that pancreatic cancer patients are at a heightened risk of water-soluble vitamin deficiencies, particularly of vitamins B1, B3, and B6. Additionally, they also face an increased risk of deficiency of fat-soluble vitamins. Among these vitamins, the potential role of vitamin D in pancreatic cancer has garnered the most attention, with its plasma levels being identified as a significant factor in patient survival. Investigating vitamin nutritional status could provide valuable insights for incorporating nutritional approaches into the prevention and treatment of pancreatic cancer, thereby reducing the exacerbation of symptoms associated with the diagnosis.
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Affiliation(s)
- Elena Azzini
- Council for Agricultural Research and Economics—Research Centre for Food and Nutrition, 00178 Rome, Italy;
| | - Tiziano Furini
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (T.F.); (V.G.)
| | - Angela Polito
- Council for Agricultural Research and Economics—Research Centre for Food and Nutrition, 00178 Rome, Italy;
| | - Luca Scalfi
- Department of Public Health, School of Medicine, Federico II University, 80131 Naples, Italy;
| | - Alessandro Pinto
- Experimental Medicine Department, Food Science and Human Nutrition Research Unit, “Sapienza” University, 00185 Rome, Italy;
| | - Valeria Gasperi
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (T.F.); (V.G.)
| | - Isabella Savini
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (T.F.); (V.G.)
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5
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Kim K. The Role of Endocrine Disruption Chemical-Regulated Aryl Hydrocarbon Receptor Activity in the Pathogenesis of Pancreatic Diseases and Cancer. Int J Mol Sci 2024; 25:3818. [PMID: 38612627 PMCID: PMC11012155 DOI: 10.3390/ijms25073818] [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: 02/20/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
The aryl hydrocarbon receptor (AHR) serves as a ligand-activated transcription factor crucial for regulating fundamental cellular and molecular processes, such as xenobiotic metabolism, immune responses, and cancer development. Notably, a spectrum of endocrine-disrupting chemicals (EDCs) act as agonists or antagonists of AHR, leading to the dysregulation of pivotal cellular and molecular processes and endocrine system disruption. Accumulating evidence suggests a correlation between EDC exposure and the onset of diverse pancreatic diseases, including diabetes, pancreatitis, and pancreatic cancer. Despite this association, the mechanistic role of AHR as a linchpin molecule in EDC exposure-related pathogenesis of pancreatic diseases and cancer remains unexplored. This review comprehensively examines the involvement of AHR in EDC exposure-mediated regulation of pancreatic pathogenesis, emphasizing AHR as a potential therapeutic target for the pathogenesis of pancreatic diseases and cancer.
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Affiliation(s)
- Kyounghyun Kim
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas Medical Sciences, Little Rock, AR 72225, USA
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6
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Madela F, Ferndale L, Aldous C. Diagnostic Differentiation between Pancreatitis and Pancreatic Cancer: A Scoping Review. Diagnostics (Basel) 2024; 14:290. [PMID: 38337806 PMCID: PMC10855106 DOI: 10.3390/diagnostics14030290] [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: 11/23/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Pancreatitis, encompassing acute and chronic forms, and pancreatic cancer pose significant challenges to the exocrine tissue of the pancreas. Recurrence rates and complications following acute pancreatitis episodes can lead to long-term risks, including diabetes mellitus. Chronic pancreatitis can develop in approximately 15% of cases, regardless of the initial episode's severity. Alcohol-induced pancreatitis, idiopathic causes, cigarette smoking, and hereditary pancreatitis contribute to the progression to chronic pancreatitis. Chronic pancreatitis is associated with an increased risk of pancreatic cancer, with older age at onset and smoking identified as risk factors. This scoping review aims to synthesise recent publications (2017-2022) on the diagnostic differentiation between pancreatitis and pancreatic cancer while identifying knowledge gaps in the field. The review focuses on biomarkers and imaging techniques in individuals with pancreatitis and pancreatic cancer. Promising biomarkers such as faecal elastase-1 and specific chemokines offer non-invasive ways to assess pancreatic insufficiency and detect early biomarkers for chronic pancreatitis. Imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), and positron emission tomography (PET), aid in differentiating between chronic pancreatitis and pancreatic cancer. However, accurately distinguishing between the two conditions remains a challenge, particularly when a mass is present in the head of the pancreas. Several knowledge gaps persist despite advancements in understanding the association between pancreatitis and pancreatic cancer, including the correlation between histopathological grading systems, non-invasive imaging techniques, and biomarkers in chronic pancreatitis to determine the risk of progression to pancreatic cancer, as well as differentiating between the two conditions. Further research is necessary to enhance our understanding of these aspects, which can ultimately improve the diagnosis and management of pancreatitis and pancreatic cancer.
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Affiliation(s)
- Fusi Madela
- Department of Surgery, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (L.F.)
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7
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Zhang X, Detering L, Heo GS, Sultan D, Luehmann H, Li L, Somani V, Lesser J, Tao J, Kang LI, Li A, Lahad D, Rho S, Ruzinova MB, DeNardo DG, Dehdashti F, Lim KH, Liu Y. Chemokine Receptor 2 Targeted PET/CT Imaging Distant Metastases in Pancreatic Ductal Adenocarcinoma. ACS Pharmacol Transl Sci 2024; 7:285-293. [PMID: 38230294 PMCID: PMC10789124 DOI: 10.1021/acsptsci.3c00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 01/18/2024]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and treatment-refractory malignancies. The lack of an effective screening tool results in the majority of patients being diagnosed at late stages, which underscores the urgent need to develop more sensitive and specific imaging modalities, particularly in detecting occult metastases, to aid clinical decision-making. The tumor microenvironment of PDAC is heavily infiltrated with myeloid-derived suppressor cells (MDSCs) that express C-C chemokine receptor type 2 (CCR2). These CCR2-expressing MDSCs accumulate at a very early stage of metastasis and greatly outnumber PDAC cells, making CCR2 a promising target for detecting early, small metastatic lesions that have scant PDAC cells. Herein, we evaluated a CCR2 targeting PET tracer (68Ga-DOTA-ECL1i) for PET imaging on PDAC metastasis in two mouse models. Positron emission tomography/computed tomography (PET/CT) imaging of 68Ga-DOTA-ECL1i was performed in a hemisplenic injection metastasis model (KI) and a genetically engineered orthotopic PDAC model (KPC), which were compared with 18F-FDG PET concurrently. Autoradiography, hematoxylin and eosin (H&E), and CCR2 immunohistochemical staining were performed to characterize the metastatic lesions. PET/CT images visualized the PDAC metastases in the liver/lung of KI mice and in the liver of KPC mice. Quantitative uptake analysis revealed increased metastasis uptake during disease progression in both models. In comparison, 18F-FDG PET failed to detect any metastases during the time course studies. H&E staining showed metastases in the liver and lung of KI mice, within which immunostaining clearly demonstrated the overexpression of CCR2 as well as CCR2+ cell infiltration into the normal liver. H&E staining, CCR2 staining, and autoradiography also confirmed the expression of CCR2 and the uptake of 68Ga-DOTA-ECL1i in the metastatic foci in KPC mice. Using our novel CCR2 targeted radiotracer 68Ga-DOTA-ECL1i and PET/CT, we demonstrated the sensitive and specific detection of CCR2 in the early PDAC metastases in two mouse models, indicating its potential in future clinical translation.
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Affiliation(s)
- Xiaohui Zhang
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Lisa Detering
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Gyu Seong Heo
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Deborah Sultan
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Hannah Luehmann
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Lin Li
- Division
of Oncology, Department of Medicine, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
| | - Vikas Somani
- Division
of Oncology, Department of Medicine, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
| | - Josie Lesser
- Department
of Anthropology, Washington University in
St. Louis, St. Louis, Missouri 63110, United States
| | - Joan Tao
- Department
of Medicine, University of Missouri, Columbia, Missouri 65211, United States
| | - Liang-I. Kang
- Department
of Pathology and Immunology, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
| | - Alexandria Li
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Divangana Lahad
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Shinji Rho
- Department
of Medicine, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Marianna B. Ruzinova
- Department
of Pathology and Immunology, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
| | - David G. DeNardo
- Division
of Oncology, Department of Medicine, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
- Department
of Pathology and Immunology, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
| | - Farrokh Dehdashti
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
| | - Kian-Huat Lim
- Division
of Oncology, Department of Medicine, Washington
University in St. Louis, St. Louis, Missouri 63110, United States
| | - Yongjian Liu
- Department
of Radiology, Washington University in St.
Louis, St. Louis, Missouri 63110, United States
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8
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Pande R, Liu W, Raza SS, Papamichail M, Suthananthan AE, Bartlett DC, Marudanayagam R, Dasari BVM, Sutcliffe RP, Roberts KJ, Wadhwani S, Chatzizacharias N. Staging Computed Tomography Parameters Predict the Need for Vein Resection during Pancreaticoduodenectomy in Resectable Pancreatic Ductal Adenocarcinoma. Diagnostics (Basel) 2024; 14:135. [PMID: 38248012 PMCID: PMC10814156 DOI: 10.3390/diagnostics14020135] [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: 12/11/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Surgery-first approach is the current standard of care for resectable pancreatic ductal adenocarcinoma (PDAC), and a proportion of these cases will require venous resection. This study aimed to identify parameters on staging computed tomography (CT) that predict the need for venous resection during pancreaticoduodenectomy (PD) for resectable PDAC. METHODS We conducted a retrospective analysis of prospectively collected data on patients who underwent PD for resectable staged PDAC (as per NCCN criteria) between 2011 and 2020. Staging CTs were independently reviewed by two specialist radiologists blinded to the clinical outcomes. Univariate and multivariate risk analyses were performed. RESULTS In total, 296 PDs were included. Venous resection was performed in 62 (21%) cases. There was a higher rate of resection margin positivity in the vein resection group (72.6% vs. 48.7%, p = 0.001). Tumour at the neck of the pancreas, superior mesenteric vein involvement of ≥10 mm and pancreatic duct dilatation were identified as independent predictors for venous resection. DISCUSSION Staging CT parameters can predict the need for venous resection during PD for resectable cases of PDAC. This may assist in surgical planning, patient selection and counselling. Future efforts should concentrate on validating these results or identifying additional predictors in a multicentre and prospective setting.
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Affiliation(s)
- Rupaly Pande
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Wingyan Liu
- Department of Radiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (W.L.); (S.W.)
| | - Syed S. Raza
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Michail Papamichail
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Arul E. Suthananthan
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - David C. Bartlett
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Ravi Marudanayagam
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Bobby V. M. Dasari
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Robert P. Sutcliffe
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
| | - Keith J. Roberts
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
| | - Sharan Wadhwani
- Department of Radiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (W.L.); (S.W.)
| | - Nikolaos Chatzizacharias
- Department of HPB and Liver Transplant Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TT, UK; (R.P.); (S.S.R.); (M.P.); (A.E.S.); (D.C.B.); (R.M.); (B.V.M.D.); (R.P.S.); (K.J.R.)
- College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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9
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Cook ME, Bruun NH, Davidsen L, Drewes AM, Olesen SS. Multistate Model of the Natural History of Inflammatory Pancreatic Diseases: A Nationwide Population-based Cohort Study. Gastroenterology 2023; 165:1547-1557.e4. [PMID: 37659669 DOI: 10.1053/j.gastro.2023.08.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/18/2023] [Accepted: 08/26/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND & AIMS Understanding the nature of inflammatory pancreatic diseases is essential for planning health care system requirements and interventions. The aim of this study was to quantify the trajectories of inflammatory pancreatic diseases and their association with pancreatic cancer in a population-based setting. METHODS National health registries were used to identify all Danish residents (18 years or older) in the period from 2000 through 2018 with incident cases of acute pancreatitis (AP), recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. We used a multistate model to examine transitions from a healthy state to intermediate states of acute pancreatic inflammation (AP and RAP) to chronic states (CP and pancreatic cancer) and, ultimately, death. Results were reported as transition incidence rates per 1000 person-years with 95% CIs. RESULTS There were 4,663,864 individuals included (mean age, 46 years; 51% were women). During a mean follow-up of 16.8 years, 31,396 individuals were diagnosed with incident AP, 5546 with RAP, 8898 with CP, and 18,182 with pancreatic cancer. The cumulative incidence of pancreatitis (acute and chronic) during the study period was 0.80% (95% CI, 0.79%-0.80%). The transition incidence rates to CP were 12.1 (95% CI, 8.1-18.1) from AP, 46.8 (95% CI, 31.6-69.3) from RAP, and 0.07 (95% CI, 0.04-0.13) from a healthy state. Similar patterns were observed for transitions to pancreatic cancer. Most patients diagnosed with CP (64.2%) and pancreatic cancer (96.4%) transitioned directly from a healthy state. Among patients with pancreatitis, 41.0% (95% CI, 40.5%-41.5%) died during follow-up. CONCLUSIONS The study findings revealed an increased risk of CP and pancreatic cancer in patients with a history of AP. However, most patients with CP and pancreatic cancer transitioned directly from a healthy state.
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Affiliation(s)
- Mathias Ellgaard Cook
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Line Davidsen
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Schou Olesen
- Centre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Bin Wang, Yuan C, Qie Y, Dang S. Long non-coding RNAs and pancreatic cancer: A multifaceted view. Biomed Pharmacother 2023; 167:115601. [PMID: 37774671 DOI: 10.1016/j.biopha.2023.115601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/17/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023] Open
Abstract
Pancreatic cancer (PC) is a highly malignant disease with a 5-year survival rate of only 10%. Families with PC are at greater risk, as are type 2 diabetes, pancreatitis, and other factors. Insufficient early detection methods make this cancer have a poor prognosis. Additionally, the molecular mechanisms underlying PC development remain unclear. Increasing evidence suggests that long non-coding RNAs (lncRNAs) contribute to PC pathology,which may control gene expression by recruiting histone modification complexes to chromatin and interacting with proteins and RNAs. In recent studies, abnormal regulation of lncRNAs has been implicated in PC proliferation, metastasis, invasion, angiogenesis, apoptosis, and chemotherapy resistance suggesting potential clinical implications. The paper reviews the progress of lncRNA research in PC about diabetes mellitus, pancreatitis, cancer metastasis, tumor microenvironment regulation, and chemoresistance. Furthermore, lncRNAs may serve as potential therapeutic targets and biomarkers for PC diagnosis and prognosis. This will help improve PC patients' survival rate from a lncRNA perspective.
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Affiliation(s)
- Bin Wang
- General Surgery Department, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Chang Yuan
- General Surgery Department, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu 212000, China
| | - Yinyin Qie
- General Surgery Department, Yixing People's Hospital, Wuxi, Jiangsu 214200, China
| | - Shengchun Dang
- General Surgery Department, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu 212000, China; Siyang Hospital, Suqian, Jiangsu 223700, China.
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11
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Rho S, Martin S, Nigogosyan Z, Kushnir V, Mintz AJ, Hu ZI. Pancreatic tail cancer in the setting of pancreatitis with a review of the literature: A case report. Clin Case Rep 2023; 11:e8023. [PMID: 37830064 PMCID: PMC10565090 DOI: 10.1002/ccr3.8023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/26/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
Environmental risk factors for pancreatic cancer include acute and chronic pancreatitis, obesity, and tobacco use. Differentiating a pancreatic neoplasm in a patient with pancreatitis can be challenging due to their similar presentations. A 57-year-old African American man with a history of congestive heart failure, pancreatitis, and incomplete pancreas divisum presented with an epigastric abdominal pain that radiated to his back. Imaging showed necrotizing pancreatitis, a developing splenic infarct, and a mass at the pancreas tail. The patient was discharged with pain medications and was recommended follow-up imaging after resolution of his pancreatitis. He was readmitted to the emergency department 2 weeks later with recurrent acute abdominal pain. Computed tomography scan of abdomen and pelvis followed by magnetic resonance imaging and endoscopic ultrasound revealed an infiltrative pancreatic tail mass. Biopsy of the mass confirmed a locally advanced pancreatic tail adenocarcinoma. Chronic pancreatitis is associated with pancreatic cancer. Practitioners should be aware of the co-existence of chronic pancreatitis and pancreatic cancer, and the initial steps to evaluate a malignancy in chronic pancreatitis.
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Affiliation(s)
- Shinji Rho
- School of MedicineWashington University School of MedicineSt. LouisMissouriUSA
| | - Sooyoung Martin
- Department of RadiologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Zack Nigogosyan
- Department of RadiologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Vladimir Kushnir
- Department of GastroenterologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Aaron J. Mintz
- Department of RadiologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Zishuo Ian Hu
- Department of Medicine, Division of Oncology, Section of Medical OncologyWashington University School of MedicineSt. LouisMissouriUSA
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12
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Wang Q, Šabanović B, Awada A, Reina C, Aicher A, Tang J, Heeschen C. Single-cell omics: a new perspective for early detection of pancreatic cancer? Eur J Cancer 2023; 190:112940. [PMID: 37413845 DOI: 10.1016/j.ejca.2023.112940] [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: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 07/08/2023]
Abstract
Pancreatic cancer is one of the most lethal cancers, mostly due to late diagnosis and limited treatment options. Early detection of pancreatic cancer in high-risk populations bears the potential to greatly improve outcomes, but current screening approaches remain of limited value despite recent technological advances. This review explores the possible advantages of liquid biopsies for this application, particularly focusing on circulating tumour cells (CTCs) and their subsequent single-cell omics analysis. Originating from both primary and metastatic tumour sites, CTCs provide important information for diagnosis, prognosis and tailoring of treatment strategies. Notably, CTCs have even been detected in the blood of subjects with pancreatic precursor lesions, suggesting their suitability as a non-invasive tool for the early detection of malignant transformation in the pancreas. As intact cells, CTCs offer comprehensive genomic, transcriptomic, epigenetic and proteomic information that can be explored using rapidly developing techniques for analysing individual cells at the molecular level. Studying CTCs during serial sampling and at single-cell resolution will help to dissect tumour heterogeneity for individual patients and among different patients, providing new insights into cancer evolution during disease progression and in response to treatment. Using CTCs for non-invasive tracking of cancer features, including stemness, metastatic potential and expression of immune targets, provides important and readily accessible molecular insights. Finally, the emerging technology of ex vivo culturing of CTCs could create new opportunities to study the functionality of individual cancers at any stage and develop personalised and more effective treatment approaches for this lethal disease.
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Affiliation(s)
- Qi Wang
- Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Berina Šabanović
- Pancreatic Cancer Heterogeneity, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy
| | - Azhar Awada
- Pancreatic Cancer Heterogeneity, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy; Molecular Biotechnology Center, University of Turin (UniTO), Turin, Italy
| | - Chiara Reina
- Pancreatic Cancer Heterogeneity, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy
| | - Alexandra Aicher
- Precision Immunotherapy, Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Jiajia Tang
- Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University School of Medicine, Shanghai, China; South Chongqing Road 227, Shanghai, China.
| | - Christopher Heeschen
- Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Pancreatic Cancer Heterogeneity, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy; South Chongqing Road 227, Shanghai, China.
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13
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Kozłowska M, Śliwińska A. The Link between Diabetes, Pancreatic Tumors, and miRNAs-New Players for Diagnosis and Therapy? Int J Mol Sci 2023; 24:10252. [PMID: 37373398 DOI: 10.3390/ijms241210252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Despite significant progress in medicine, pancreatic cancer is one of the most tardily diagnosed cancer and is consequently associated with a poor prognosis and a low survival rate. The asymptomatic clinical picture and the lack of relevant diagnostic markers for the early stages of pancreatic cancer are believed to be the major constraints behind an accurate diagnosis of this disease. Furthermore, underlying mechanisms of pancreatic cancer development are still poorly recognized. It is well accepted that diabetes increases the risk of pancreatic cancer development, however the precise mechanisms are weakly investigated. Recent studies are focused on microRNAs as a causative factor of pancreatic cancer. This review aims to provide an overview of the current knowledge of pancreatic cancer and diabetes-associated microRNAs, and their potential in diagnosis and therapy. miR-96, miR-124, miR-21, and miR-10a were identified as promising biomarkers for early pancreatic cancer prediction. miR-26a, miR-101, and miR-200b carry therapeutic potential, as they not only regulate significant biological pathways, including the TGF-β and PI3K/AKT, but their re-expression contributes to the improvement of the prognosis by reducing invasiveness or chemoresistance. In diabetes, there are also changes in the expression of microRNAs, such as in miR-145, miR-29c, and miR-143. These microRNAs are involved, among others, in insulin signaling, including IRS-1 and AKT (miR-145), glucose homeostasis (hsa-miR-21), and glucose reuptake and gluconeogenesis (miR-29c). Although, changes in the expression of the same microRNAs are observed in both pancreatic cancer and diabetes, they exert different molecular effects. For example, miR-181a is upregulated in both pancreatic cancer and diabetes mellitus, but in diabetes it contributes to insulin resistance, whereas in pancreatic cancer it promotes tumor cell migration, respectively. To conclude, dysregulated microRNAs in diabetes affect crucial cellular processes that are involved in pancreatic cancer development and progression.
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Affiliation(s)
- Małgorzata Kozłowska
- Student Scientific Society of Civilization Diseases, Medical University of Lodz, 251 Pomorska, 92-213 Lodz, Poland
| | - Agnieszka Śliwińska
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
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Ma DM, Dong XW, Han X, Ling Z, Lu GT, Sun YY, Yin XD. Pancreatitis and Pancreatic Cancer Risk. Technol Cancer Res Treat 2023; 22:15330338231164875. [PMID: 36972517 PMCID: PMC10052482 DOI: 10.1177/15330338231164875] [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: 03/29/2023] Open
Abstract
Purpose: The present retrospective study aimed to explore the relationship between pancreatitis and pancreatic cancer in the population cohort of the UK Biobank (UKB) (https://www.ukbiobank.ac.uk). Methods: From the 500 thousand population cohort of UKB, according to the age and gender of patients with pancreatic cancer 1:10, matching the control without pancreatic cancer, the binary Logistic regression model was used to analyze the relationship between pancreatitis and pancreatic cancer, and subgroup analyses were used to identify potential effect modifiers. Results: A total of 1538 patients with pancreatic cancer were compared with 15 380 controls. In the fully adjusted model, patients with pancreatitis had a significantly increased risk of pancreatic cancer compared with no pancreatitis. The risk of pancreatitis and pancreatic cancer increased with the age of pancreatitis, and the risk of pancreatic cancer was highest in the 61 to 70 age group. In addition, in the first 3 years of acute pancreatitis, the risk of pancreatic cancer increased significantly with the increase in the duration of the disease (odds ratio [OR] 29.13, 95% confidence interval [CI]: 16.34-51.93), after 3 years, the trend of increase decreased. After more than 10 years, there was no significant correlation between the risk of acute pancreatitis and pancreatic cancer. However, patients with chronic pancreatitis were significantly associated with an increased risk of pancreatic cancer only in the first 3 years (OR 28.14, 95% CI: 14.86-53.31). Conclusion: Pancreatitis may associate with an increased risk of pancreatic cancer. The older the age of pancreatitis, the higher the risk of pancreatic cancer. The risk of pancreatic cancer increases significantly in the first 3 years of the course of pancreatitis. This may provide an alternative strategy for the early identification of individuals at high risk of pancreatic cancer.
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Affiliation(s)
- Dong-Mei Ma
- Department of Oncology, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Xiao-Wu Dong
- Pancreatic Center, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
- Yangzhou Key Laboratory of Pancreatic Diseases, Yangzhou, China
| | - Xiao Han
- Department of Oncology, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Zhi Ling
- Department of Oncology, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Guo-Tao Lu
- Pancreatic Center, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
- Yangzhou Key Laboratory of Pancreatic Diseases, Yangzhou, China
| | - Yun-Yun Sun
- Pancreatic Center, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
- Yangzhou Key Laboratory of Pancreatic Diseases, Yangzhou, China
| | - Xu-Dong Yin
- Department of Oncology, 587863Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
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15
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Zardab M, Balarajah V, Banerjee A, Stasinos K, Saad A, Imrali A, Hughes C, Roberts R, Vajrala A, Chelala C, Kocher HM, Dayem Ullah AZM. Differentiating Ductal Adenocarcinoma of the Pancreas from Benign Conditions Using Routine Health Records: A Prospective Case-Control Study. Cancers (Basel) 2022; 15:cancers15010280. [PMID: 36612275 PMCID: PMC9818842 DOI: 10.3390/cancers15010280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 01/03/2023] Open
Abstract
The study aimed to develop a prediction model for differentiating suspected PDAC from benign conditions. We used a prospective cohort of patients with pancreatic disease (n = 762) enrolled at the Barts Pancreas Tissue Bank (2008-2021) and performed a case-control study examining the association of PDAC (n = 340) with predictor variables including demographics, comorbidities, lifestyle factors, presenting symptoms and commonly performed blood tests. Age (over 55), weight loss in hypertensive patients, recent symptoms of jaundice, high serum bilirubin, low serum creatinine, high serum alkaline phosphatase, low red blood cell count and low serum sodium were identified as the most important features. These predictors were then used for training several machine-learning-based risk-prediction models on 75% of the cohort. Models were assessed on the remaining 25%. A logistic regression-based model had the best overall performance in the validation cohort (area-under-the-curve = 0.90; Spiegelhalter's z = -1·82, p = 0.07). Setting a probability threshold of 0.15 guided by the maximum F2-score of 0.855, 96.8% sensitivity was reached in the full cohort, which could lead to earlier detection of 84.7% of the PDAC patients. The prediction model has the potential to be applied in primary, secondary and emergency care settings for the early distinction of suspected PDAC patients and expedited referral to specialist hepato-pancreatico-biliary services.
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Affiliation(s)
- Mohamed Zardab
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Vickna Balarajah
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Abhirup Banerjee
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Konstantinos Stasinos
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
| | - Amina Saad
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Ahmet Imrali
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Christine Hughes
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Rhiannon Roberts
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Ajith Vajrala
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Claude Chelala
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Hemant M. Kocher
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Correspondence: (H.M.K.); (A.Z.M.D.U.); Tel.: +44-207-882-6364 (A.Z.M.D.U.)
| | - Abu Z. M. Dayem Ullah
- Barts Pancreas Tissue Bank, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Correspondence: (H.M.K.); (A.Z.M.D.U.); Tel.: +44-207-882-6364 (A.Z.M.D.U.)
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16
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Increasing Stress to Induce Apoptosis in Pancreatic Cancer via the Unfolded Protein Response (UPR). Int J Mol Sci 2022; 24:ijms24010577. [PMID: 36614019 PMCID: PMC9820188 DOI: 10.3390/ijms24010577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
High rates of cell proliferation and protein synthesis in pancreatic cancer are among many factors leading to endoplasmic reticulum (ER) stress. To restore cellular homeostasis, the unfolded protein response (UPR) activates as an adaptive mechanism through either the IRE1α, PERK, or ATF6 pathways to reduce the translational load and process unfolded proteins, thus enabling tumor cells to proliferate. Under severe and prolonged ER stress, however, the UPR may promote adaptation, senescence, or apoptosis under these same pathways if homeostasis is not restored. In this review, we present evidence that high levels of ER stress and UPR activation are present in pancreatic cancer. We detail the mechanisms by which compounds activate one or many of the three arms of the UPR and effectuate downstream apoptosis and examine available data on the pre-clinical and clinical-phase ER stress inducers with the potential for anti-tumor efficacy in pancreatic cancer. Finally, we hypothesize a potential new approach to targeting pancreatic cancer by increasing levels of ER stress and UPR activation to incite apoptotic cell death.
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Chen X, Ning J, Li Q, Kuang W, Jiang H, Qin S. Prediction of acute pancreatitis complications using routine blood parameters during early admission. Immun Inflamm Dis 2022; 10:e747. [PMID: 36444624 PMCID: PMC9695081 DOI: 10.1002/iid3.747] [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: 08/17/2022] [Revised: 10/16/2022] [Accepted: 11/06/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There have been many reports on biomarkers for predicting the severity of acute pancreatitis (AP), but few studies on biomarkers for predicting complications; some simple and inexpensive indicators, in particular, are worth exploring. METHODS We retrospectively collected clinical data of 809 AP patients, including medical history and results of routine blood tests, and grouped them according to the occurrence of complications. Differences in clinical characteristics between groups with and without complications were compared using t-test or χ2 test. Receiver operating curve (ROC) and area under the curve were calculated to evaluate the ability of predicting the occurrence of complications for the routine blood parameters with statistical differences. Then, through univariate and multivariate analyses, independent risk factors closely associated with complications were identified. Finally, we built a three-parameter prediction system and evaluated its ability to predict AP complications. RESULTS Compared with the group without complications, the patients in the complication group had higher white blood cells, neutrophils, C-reactive protein, and erythrocyte sedimentation rate (ESR), and lower red blood cells and hemoglobin (Hb) (all p < .05), and most of them had severe pancreatitis. In addition, pseudocysts were more common in patients with alcoholic etiology, recurrence, low BMI, and high platelet (PLT) and plateletocrit. Acute respiratory failure was more common in patients with first onset and high mean PLT volume (MPV). Sepsis was more common in patients with lipogenic etiology, high MPV, and low lymphocytes. Infectious pancreatic necrosis was more common in patients with alcoholic etiology. Acute renal failure was more common in patients with monocytes and high MPV and low PLT. Multivariate analysis showed that PLT and ESR were risk factors for pseudocyst development. The ROC showed that the combination of Hb, PLT and ESR had a significantly higher predictive ability for pseudocyst than the single parameter. CONCLUSION Routine blood parameters can be used to predict the complications of AP. A predictive model combining ESR, PLT, and Hb may be an effective tool for identifying pseudocysts in AP patients.
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Affiliation(s)
- Xiubing Chen
- Department of GastroenterologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Jing Ning
- Department of GastroenterologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Qing Li
- Department of GastroenterologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Wenxi Kuang
- Department of GastroenterologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Haixing Jiang
- Department of GastroenterologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Shanyu Qin
- Department of GastroenterologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
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Shin S, Choi JH, Lee KE, Yoon JH, Lee W. Risk and Status of Gastrointestinal Cancer According to the International Standard Industrial Classification in Korean Workers. Cancers (Basel) 2022; 14:cancers14205164. [PMID: 36291948 PMCID: PMC9600415 DOI: 10.3390/cancers14205164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary The risk of developing cancers varies depending on occupation, which is a well-known fact. It is crucial to investigate the risk of developing gastrointestinal (GI) cancer in the entire industry. In this study, we calculated the standardized incidence ratios (SIRs) of GI cancer by all industrial sectors as classified in the Korean Standard Industrial Classification (KSIC). There were noticeable differences among industries in the risk of GI cancer. The SIR of all GI cancer was highest among miners and quarriers, and second highest among transportation workers. These results suggest that further research is required to identify the risk factors present in each industry that contribute to the development of GI cancers. We believe this study can help to create tailored cancer prevention strategies for different industrial sectors. Abstract To compare the risk of developing gastrointestinal (GI) cancer according to industrial groups, we performed a retrospective cohort study using the database of the Korea National Health Insurance Service (NHIS). We calculated the age-standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) for the types of GI cancers according to the Korean Standard Industrial Classification (KSIC) compared with the whole employee population. The highest SIR for all GI cancer was found in the “Mining and quarrying” section (SIR, 1.30; 95% CI, 1.14–1.47), followed by the “Transportation and storage” section (SIR, 1.27; 95% CI, 1.24–1.30). Miners and quarriers had the highest risk of developing gastric cancer (SIR, 1.29; 95% CI, 1.06–1.55) and cancer of the liver and intrahepatic bile ducts (SIR, 1.48; 95% CI, 1.17–1.86). Transportation workers had the highest SIR of cancer of the lip, oral cavity, and pharynx (SIR, 1.27; 95% CI, 1.13–1.43) and cancers of the rectum, anus, and anal canal (SIR, 1.27; 95% CI, 1.19–1.35). There were distinct GI cancers with an elevated risk in each industry group. Our findings imply that distinct cancer prevention programs should be developed for each industrial sector.
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Affiliation(s)
- Soonsu Shin
- Department of Preventive Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea
| | - Jun-Hyeok Choi
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan 44429, Korea
| | - Kyung-Eun Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan 44429, Korea
| | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (J.-H.Y.); (W.L.); Tel.: +82-2-2228-1579 (J.-H.Y.); +82-32-460-8866 (W.L.)
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
- Correspondence: (J.-H.Y.); (W.L.); Tel.: +82-2-2228-1579 (J.-H.Y.); +82-32-460-8866 (W.L.)
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Tanji Y, Furukawa K, Shirai Y, Haruki K, Onda S, Gocho T, Ikegami T. Pancreatic intraepithelial neoplasia with carcinoma in situ with repeated distally localized pancreatitis: a case report. Surg Case Rep 2022; 8:18. [PMID: 35064845 PMCID: PMC8783946 DOI: 10.1186/s40792-022-01369-x] [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: 12/06/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Acute pancreatitis could be an early symptom of pancreatic cancer. However, repeated pancreatitis caused by pancreatic cancer is very rare. Case presentation A 69-year-old man was referred to our hospital with severe abdominal pain, and serial imaging studies showed acute distally localized pancreatitis with a pseudocyst. Although he had successful conservative medical treatment followed by discharge from the hospital, he was re-admitted with severe abdominal pain for recurrent distal pancreatitis with splenic artery aneurysm followed by its rupture. No pancreas mass was detected by imaging studies including endoscopic ultrasound and cytologic studies of the pancreas juice did not show any malignant cells, although slight dilatation of distal pancreas duct was observed only in the initial computed tomography. Because of the episodes of repeated distally localized pancreatitis caused by possible pancreatic ductal neoplasm, we planned and performed laparoscopy-assisted distal pancreatectomy after full-informed consent. Pathological examination revealed pancreatic intraepithelial neoplasia (PanIN) with carcinoma in situ in the distal main pancreas duct. The post-surgical course of the patient was uneventful and he was discharged 10 days after surgery from recurrent disease for over a year. Conclusions We encountered a case of repeated episodes of acute distally localized pancreatitis, for which distal pancreatectomy was performed, resulting in pathological diagnosis of PanIN with carcinoma in situ.
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