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Goess R, Mutgan AC, Çalışan U, Erdoğan YC, Ren L, Jäger C, Safak O, Stupakov P, Istvanffy R, Friess H, Ceyhan GO, Demir IE. Patterns and Relevance of Langerhans Islet Invasion in Pancreatic Cancer. Cancers (Basel) 2021; 13:cancers13020249. [PMID: 33440856 PMCID: PMC7826785 DOI: 10.3390/cancers13020249] [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: 12/22/2020] [Accepted: 01/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Pancreatic cancer-associated diabetes mellitus (PC-DM) is present in most patients with pancreatic cancer, but its pathogenesis remains poorly understood. Therefore, we aimed to characterize tumor infiltration in Langerhans islets in pancreatic cancer and determine its clinical relevance. METHODS Langerhans islet invasion was systematically analyzed in 68 patientswith pancreatic ductal adenocarcinoma (PDAC) using histopathological examination and 3D in vitro migration assays were performed to assess chemoattraction of pancreatic cancer cells to isletcells. RESULTS Langerhans islet invasion was present in all patients. We found four different patterns of islet invasion: (Type I) peri-insular invasion with tumor cells directly touching the boundary, but not penetrating the islet; (Type II) endo-insular invasion with tumor cells inside the round islet; (Type III) distorted islet structure with complete loss of the round islet morphology; and (Type IV)adjacent cancer and islet cells with solitary islet cells encountered adjacent to cancer cells. Pancreatic cancer cells did not exhibit any chemoattraction to islet cells in 3D assays in vitro. Further, there was no clinical correlation of islet invasion using the novel Islet Invasion Severity Score (IISS), which includes all invasion patterns with the occurrence of diabetes mellitus. However, Type IV islet invasion was related to worsened overall survival in our cohort. CONCLUSIONS We systematically analyzed, for the first time, islet invasion in human pancreatic cancer. Four different main patterns of islet invasion were identified. Diabetes mellitus was not related to islet invasion. However, moreresearch on this prevailing feature of pancreatic cancer is needed to better understand underlying principles.
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Affiliation(s)
- Ruediger Goess
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Ayse Ceren Mutgan
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Umut Çalışan
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Yusuf Ceyhun Erdoğan
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Lei Ren
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
- Department of General Surgery (Gastrointestinal Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Carsten Jäger
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Okan Safak
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Pavel Stupakov
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Rouzanna Istvanffy
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Helmut Friess
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
| | - Güralp O. Ceyhan
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
- Department of General Surgery, HPB-Unit, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul 34684, Turkey
| | - Ihsan Ekin Demir
- Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675 Munich, Germany; (R.G.); (A.C.M.); (U.Ç.); (Y.C.E.); (L.R.); (C.J.); (O.S.); (P.S.); (R.I.); (H.F.); (G.O.C.)
- Department of General Surgery, HPB-Unit, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul 34684, Turkey
- German Cancer Consortium (DKTK), Partner Site Munich, D-81675 Munich, Germany
- CRC 1321 Modelling and Targeting Pancreatic Cancer, D-81675 Munich, Germany
- Correspondence: ; Tel.: +49-89-4140-5868
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Saarela K, Tuomilehto J, Sund R, Keskimäki I, Hartikainen S, Pukkala E. Cancer incidence among Finnish people with type 2 diabetes during 1989-2014. Eur J Epidemiol 2018; 34:259-265. [PMID: 30182324 DOI: 10.1007/s10654-018-0438-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 08/28/2018] [Indexed: 12/19/2022]
Abstract
Diabetes and cancer are common diseases both with enormous impact on health burden globally. The increased risk of several types of cancer among people with type 2 diabetes mellitus has been indicated repeatedly. This study aimed at exploring and describing the association between type 2 diabetes and cancer incidence. A cohort of 428,326 people with type 2 diabetes was identified from the Finnish National Diabetes Register and followed up through a register linkage with the Finnish Cancer Registry for cancer incidence during 1988-2014. A total of 74,063 cases of cancer occurred in this cohort in 4.48 million person-years. This accounted for 16% more than the expected cancer incidence in the Finnish general population; the standardized incidence ratio (SIR) was 1.16 (95% confidence interval [CI] 1.15-1.16). There was a statistically significant excess of cancers of lip (SIR = 1.40, CI = 1.28-1.53), liver (SIR = 2.44, CI = 2.35-2.53), pancreas (SIR = 1.75, CI = 1.70-1.79), stomach (SIR = 1.22, CI = 1.18-1.26), colon (SIR = 1.22, CI = 1.19-1.25), gallbladder and bile ducts (SIR = 1.29, CI = 1.21-1.36), non-melanoma skin (SIR = 1.18, CI = 1.15-1.22), kidney (SIR = 1.42, CI = 1.37-1.47), bladder (SIR = 1.17, CI = 1.13-1.21), and thyroid (SIR = 1.22, CI = 1.12-1.31). There was a small statistically significant decrease in prostate cancer incidence (SIR = 0.95, CI = 0.93-0.96). This study showed an association between type 2 diabetes mellitus and the incidence of cancer at numerous sites in the Finnish population.
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Affiliation(s)
- Katri Saarela
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
| | - Jaakko Tuomilehto
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Dasman Diabetes Institute, Dasman, Kuwait
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reijo Sund
- Department of Social Research, University of Helsinki, PO Box 33, 00014, Helsinki, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ilmo Keskimäki
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
| | - Sirpa Hartikainen
- School of Pharmacy, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland
| | - Eero Pukkala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Unioninkatu 22, 00130, Helsinki, Finland
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Qin W, Chen AH, Gan QQ, Li KF, Xia N. Effect of hyperglycemia on infiltration and metastasis of pancreatic cancer. Shijie Huaren Xiaohua Zazhi 2015; 23:4975-4981. [DOI: 10.11569/wcjd.v23.i31.4975] [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
AIM: To evaluate the effect of hyperglycemia on pancreatic cancer infiltration and metastasis.
METHODS: One hundred and eleven patients with pancreatic cancer were selected as participants. Among them, 31 patients with hyperglycemia were included in a research group, and 80 patients with normal glycemia were included in a control group. Serological indicators related to tumor [including α-fetoprotein (AFP), carcino-embryonic antigen (CEA), carbohydrate antigen 125 (CA125), CA19-9, CA724, CA15-3, CA242 and serum ferritin], Ki67 proliferation index and clinicopathological features (including tumor volume, tumor differentiation degree, chronic inflammation of the pancreas tissue adjacent to carcinoma, nerves surrounding lymphocytes, neural invasion of cancer tissue, lymph node metastasis, venous cancer embolism and distant organ metastasis) were compared between the two groups.
RESULTS: Compared with the control group, the research group showed a significant difference in CA724, serum ferritin, Ki67 proliferation index, tumor differentiation degree, chronic inflammation of the pancreas tissue adjacent to carcinoma, nerves surrounding lymphocytes, neural invasion of cancer tissue, lymph node metastasis, venous cancer embolism and distant organ metastasis (P < 0.05). However, the differences in AFP, CEA, CA125, CA19-9, CA15-3, CA242 and tumor volume between the two groups were not significant (P > 0.05).
CONCLUSION: Hyperglycemia may contribute to the malignant progression of pancreatic cancer through enhancing tumor infiltration and metastasis. Thus, blood glucose should be well monitored for pancreatic cancer patients with hyperglycemia in order to improve their life of quality and prognosis.
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Liu Z, Du R, Long J, Guo K, Ge C, Bi S, Xu Y. microRNA-218 promotes gemcitabine sensitivity in human pancreatic cancer cells by regulating HMGB1 expression. Chin J Cancer Res 2015; 27:267-78. [PMID: 26157323 DOI: 10.3978/j.issn.1000-9604.2015.04.06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/24/2015] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the effect of gemcitabine (GEM) on microRNA-218 (miR-218) expression in human pancreatic cancer cells. METHODS Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed to examine the differences in miR-218 expression between the GEM-sensitive BxPC-3 pancreatic cancer cells and GEM-resistant PANC-1 cells. The effect of GEM on the expression of miR-218 in PANC-1 cells was also investigated. PANC-1 cells were transfected either with HMGB1 siRNA to knock down the expression of HMGB1 or with the recombinant HMGB1 expression vector (pcDNA3.1-HMGB1) to overexpress HMGB1. The effect of ectopic expression of HMGB1 on the apoptosis of miR-218-transfected and GEM-treated PANC-1 cells was examined by flow cytometric analysis. RESULTS The miR-218 expression level was lower in GEM-resistant PANC-1 cells compared to GEM-sensitive BxPC-3 cells (P<0.05). The percentage of apoptotic PANC-1 cells was significantly increased in the miR-218 mimic + GEM group compared to the mimic ctrl + GEM group and the normal control group (P<0.01). The HMGB1 expression level was markedly decreased in PANC-1 cells transfected with HMGB1 siRNA but was significantly increased in PANC-1 cells transfected with the recombinant HMGB1 expression vector, pcDNA3.1-HMGB1 (P<0.01). The proportion of apoptotic PANC-1 cells was significantly lower in the miR-218 mimic + GEM + pcDNA3.1-HMGB1 group compared to the miR-218 mimic + GEM + HMGB1 siRNA group (P<0.01). CONCLUSIONS The expression level of miR-218 was downregulated in the GEM-resistant cell line. miR-218 promoted the sensitivity of PANC-1 cells to GEM, which was achieved mainly through regulating the expression of HMGB1 in PANC-1 cells.
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Affiliation(s)
- Zhe Liu
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
| | - Ruixia Du
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
| | - Jin Long
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
| | - Kejian Guo
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
| | - Chunlin Ge
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
| | - Shulong Bi
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
| | - Yuanhong Xu
- 1 Department of Pancreatic Surgery, First Hospital of China Medical University, Shenyang 110001, China ; 2 Department of Otorhinolaryngology, Fengtian Hospital, Shenyang Medical University, Shenyang 110024, China
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He Y, Zheng R, Li D, Zeng H, Zhang S, Chen W. Pancreatic cancer incidence and mortality patterns in China, 2011. Chin J Cancer Res 2015; 27:29-37. [PMID: 25717223 DOI: 10.3978/j.issn.1000-9604.2015.02.05] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 01/15/2015] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The National Central Cancer Registry (NCCR) collected population-based cancer registration data in 2011 from all cancer registries in China. The incidence and mortality rates for pancreatic cancer were compiled and pancreatic cancer incident new cases and deaths were estimated. METHODS A total of 234 cancer registries submitted cancer data to NCCR. Data from 177 cancer registries were qualified and compiled for cancer statistics in 2011. Pancreatic cancer cases were extracted and analyzed from the national database. The pooled data were stratified by area (urban/rural), gender and age group (0, 1-4, 5-9, 10-14…85+). Pancreatic cancer incident cases and deaths were estimated using age-specific rates and national population in 2010. The national census in 2000 and Segi's population were used for age-standardized rates. RESULTS All 177 cancer registries (77 in urban and 100 in rural areas) covered 175,310,169 populations (98,341,507 in urban and 76,968,662 in rural areas). The morphology verified pancreatic cancer cases (MV%) accounting for 40.52% and 4.33% of pancreatic cancer incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio (M/I) of 0.91. The estimated number of newly diagnosed pancreatic cancer cases and deaths were 80,344 and 72,723 in 2011, respectively. The crude incidence rate was 5.96/100,000 (males 6.57/100,000, females 5.32/100,000). The age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 4.27/100,000 and 4.23/100,000 respectively, ranking 10(th) among all cancers. Pancreatic cancer incidence rate and ASIRC were 7.03/100,000 and 4.94/100,000 in urban areas whereas they were 4.84/100,000 and 3.56/100,000 in rural areas. The incidence rate of pancreatic cancer of 33 cancer registries increased from 3.24/100,000 in 2003 to 3.59/100,000 in 2011 with an annual percentage change (APC) of 1.44. The pancreatic cancer mortality rate was 5.40/100,000 (males 5.88/100,000, females 4.89/100,000), ranking 6(th) among all cancers. The age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 3.81/100 000 and 3.79/100 000. The pancreatic cancer mortality and ASMRC were 6.47/100,000 and 4.48/100,000 in urban areas, and 4.27/100,000 and 3.08/100,000 in rural areas, respectively. The mortality rates of pancreatic cancer showed an approximately 1.14-fold increase, from 2.85/100,000 in 2003 to 3.26/100,000 in 2011, with an APC of 1.68. CONCLUSIONS The burden of pancreatic cancer is increasing in China. Identification of high-risk population and adequate treatment and prevention are important.
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Affiliation(s)
- Yutong He
- 1 Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China ; 2 National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China
| | - Rongshou Zheng
- 1 Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China ; 2 National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China
| | - Daojuan Li
- 1 Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China ; 2 National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China
| | - Hongmei Zeng
- 1 Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China ; 2 National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China
| | - Siwei Zhang
- 1 Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China ; 2 National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China
| | - Wanqing Chen
- 1 Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China ; 2 National Office for Cancer Prevention and Control, National Cancer Center, Beijing 100021, China
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