ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.
Objective To summary the recent progression of imaging methods which mainly applied on the early detection and qualitative diagnosis of pancreatic cancer. Method The newest related literatures between home and abroad were collected and reviewed. Results Ultrasonic, computed tomography, magnetic resonance imaging and positron emission tomography mostly be used on pancreatic cancer detection and diagnosis. Conclusion Each method gets its own advantage even computed tomography seems like dominated on the detection and diagnosis pancreatic cancer, moreover, magnetic resonance imaging has been improved rapidly in recent years which shows its enormous potential.
Objective To explore the application of nutritional and inflammatory markers in the prognosis assessment of resectable pancreatic cancer, and to provide new ideas for the prognosis assessment of patients with pancreatic cancer. Method The recent studies on nutritional and inflammatory markers for prognosis of resectable pancreatic cancer at home and abroad were reviewed. Results Radical pancreaticoduodenectomy was the preferred treatment for patients with resectable pancreatic cancer. Poor nutritional status and severe systemic inflammatory response were closely related to postoperative tumor recurrence and other poor prognosis. Nutritional and inflammatory markers played an important role in evaluating the prognosis of resectable pancreatic cancer. Conclusion Nutritional and inflammatory markers, as simple and economical prognostic indicators, have broad clinical application prospects in the prognostic assessment of resectable pancreatic cancer.
ObjectiveTo investigate the relation between disulfidptosis-related genes (DRGs) and prognosis or immunotherapy response of patients with pancreatic cancer (PC). MethodsThe transcriptome data, somatic mutation data, and corresponding clinical information of the patients with PC in The Cancer Genome Atlas (TCGA) were downloaded. The DRGs mutated in the PC were screened out from the 15 known DRGs. The DRGs subtypes were identified by consensus clustering algorithm, and then the relation between the identified DRGs subtypes and the prognosis of patients with PC, immune cell infiltration or functional enrichment pathway was analyzed. Further, a risk score was calculated according to the DRGs gene expression level, and the patients were categorized into high-risk and low-risk groups based on the mean value of the risk score. The risk score and overall survival of the patients with high-risk and low-risk were compared. Finally, the relation between the risk score and (or) tumor mutation burden (TMB) and the prognosis of patients with PC was assessed. ResultsThe transcriptome data and corresponding clinical information of the 177 patients with PC were downloaded from TCGA, including 161 patients with somatic mutation data. A total of 10 mutated DRGs were screened out. Two DRGs subtypes were identified, namely subtype A and subtype B. The overall survival of PC patients with subtype A was better than that of patients with subtype B (χ2=8.316, P=0.003). The abundance of immune cell infiltration in the PC patients with subtype A was higher and mainly enriched in the metabolic and conduction related pathways as compaired with the patients with subtype B. The mean risk score of 177 patients with PC was 1.921, including 157 cases in the high-risk group and 20 cases in the low-risk group. The risk score of patients with subtype B was higher than that of patients with subtype A (t=14.031, P<0.001). The overall survival of the low-risk group was better than that of the high-risk group (χ2=17.058, P<0.001), and the TMB value of the PC patients with high-risk was higher than that of the PC patients with low-risk (t=5.642, P=0.014). The mean TMB of 161 patients with somatic mutation data was 2.767, including 128 cases in the high-TMB group and 33 cases in the low-TMB group. The overall survival of patients in the high-TMB group was worse than that of patients in the low-TMB group (χ2=7.425, P=0.006). ConclusionDRGs are closely related to the prognosis and immunotherapy response of patients with PC, and targeted treatment of DRGs might potentially provide a new idea for the diagnosis and treatment of PC.
ObjectiveTo further evaluate the relation between usage of proton pump inhibitor (PPI) and the risk of pancreatic cancer. MethodThe observational studies were systematically searched in the databases of PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov, CNKI, Wanfang, and VIP. The combined odds ratio (OR) and 95% confidence interval (CI) of pancreatic cancer risk were estimated by the corresponding effect model according to the heterogeneous results, and the subgroup analysis, meta-regression, and sensitivity analysis were performed. In addition, the relation between the defined daily dose (DDD) and usage time of PPI and the pancreatic cancer risk were studied by using restricted cubic spline. ResultsA total of 14 studies were included, including 1 601 430 subjects. The meta-analysis result showed that usage of PPI was positively correlated with the risk of pancreatic cancer [I2=98.9%, OR (95%CI)=1.60 (1.21, 2.11), P<0.001]. The subgroup analysis results showed that usage of PPI would increase the risk of pancreatic cancer in the subgroups of literature published before 2018 [OR (95%CI)=1.88 (1.05, 3.38), P=0.034], non-Asian regions [OR (95%CI)=1.37 (1.04, 1.82), P=0.028], case-control studies [OR (95%CI)=1.59 (1.16, 2.18), P=0.004], cohort studies [OR (95%CI)=1.65 (1.13, 2.39), P=0.009], and high-quality studies [OR (95%CI)=1.62 (1.19, 2.20), P=0.002]. The dose-response curve showed that there was a nonlinear relation between the usage of PPI and the risk of pancreatic cancer (χ2linear=2.27, P=0.132; Pnonlinear=0.039). When the usage of PPI was 800 DDD or less, usage of PPI would increase the risk of pancreatic cancer, but there was no statistical significance when the usage of PPI was more than 800 DDD. The time-effect curve showed that there was a linear relation between the usage time of PPI and the risk of pancreatic cancer (χ2linear=6.92, P=0.009), and the risk of pancreatic cancer would increase by 2.3% if the usage of PPI increased by one month [OR=1.02, 95%CI (1.01, 1.04), P=0.009]. The sensitivity analysis confirmed that the results were stable by gradually eliminating each study, the OR (95%CI) of the risk of pancreatic cancer was 1.37 (1.08, 1.74) to 1.66 (1.22, 2.27), and the publication bias was not found by Egger test (P=0.594).ConclusionsFrom the results of this meta-analysis, usage of PPI will increase the risk of pancreatic cancer, and the dosage of PPI and usage time of PPI may be related to the risk of pancreatic cancer. The clinical usage of PPI should be strictly controlled, and the dosage and usage time should also be carefully considered.
ObjectiveTo determine the prognostic significance of change of systemic immune inflammation index (SII) before and after neoadjuvant chemotherapy (NCT) in advanced pancreatic cancer.MethodsThe patients with advanced pancreatic cancer who received the NCT before pancreatectomy and met the inclusion and exclusion criteria of this study from January 2013 to December 2016 in the Panjin Liao-Oil Gem Flower Hospital were retrospectively collected. The patients were designed into an increased SII group (SII before NCT was lower than after NCT) and decreased SII group (SII before NCT was higher than after NCT) according to the change of SII before and after NCT. The laboratory data before and after NCT were collected to calculate the SII and to analyze the relationship between the change of SII before and after NCT and the clinical outcomes. The clinicopathologic characteristics and postoperative 3-year survival rate of the two groups were compared. The Cox regression was used to evaluate the influencing factors of postoperative survival of advanced pancreatic cancer.ResultsAll of 103 patients were included, 42 of whom in the increased SII group and 61 in the decreased SII group. The proportions of the intraoperative tumor size >3 cm, CA19-9>37 U/mL after NCT, and postoperative complications in the increased SII group were significantly higher than those in the decreased SII group (P<0.05). All 103 patients were followed up from 9 to 81 months with median 13 months, the 3-year cumulative survival rate of patients in the increased SII group was significantly lower than that of patients in the decreased SII group (19.0% versus 42.6%, P=0.012). The results of the multivariate analysis showed that the CA19-9>37 U/mL after NCT [HR=2.084, 95%CI (1.140, 3.809), P=0.017], postoperative complications [HR=1.657, 95%CI (1.009, 2.722), P=0.046], the absent of postoperative adjuvant chemotherapy [HR=1.795, 95%CI (1.085, 2.970), P=0.023], and the elevated SII after NCT [HR=1.849, 95%CI (1.111, 3.075), P=0.018] were the independent risk factors affecting postoperative 3-year survival rate of patients with advanced pancreatic cancer.ConclusionsThe change value of SII before and after NCT is an independent risk factor for the prognosis of patient with advanced pancreatic cancer, the elevated SII after NCT is a poor prognosis index in patient with advanced pancreatic cancer. However, the evaluations of larger controlled trials are necessary at multiple institutions before introduction of SII as a prognostic indicator in clinical practice.
Radical surgical resection is still the only potentially curative treatment for pancreatic cancer. With the update of minimally invasive concepts, the laparoscopic and robotic platform has been introduced to pancreatic surgery practice. The recent studies have demonstrated that minimally invasive procedure achieved similar or improved perioperative outcomes compared to the standard open approach. Neo-adjuvant chemotherapy is increasingly being applied in pancreatic surgery, making surgical resection more challenging. Numbers of patients undergoing minimally invasive resection following neo-adjuvant chemotherapy remain low. The author consulted the latest literatures at home and abroad and described the current situation of minimally invasive treatment of pancreatic cancer after neo-adjuvant chemotherapy.
ObjectiveTo investigate the working principles, recent advances, and combined therapeutic efficacy of irreversible electroporation (IRE) in pancreatic cancer treatment when integrated with conventional therapies (e.g., surgery, chemotherapy, radiotherapy, immunotherapy), and to evaluate its potential for improving patient survival outcomes and quality of life. MethodsA comprehensive analysis of recent IRE researches in pancreatic cancer was performed, elucidating therapeutic mechanisms, technical merits, clinical limitations, and combinatorial effects with conventional therapies through examination of clinical trials and prospective studies. ResultsIRE induces irreversible nanopores in tumor cell membranes via high-intensity electric fields, disrupting membrane integrity and triggering apoptotic cell death. Notably, it promotes immunogenic cell death, activating dendritic cells and initiating tumor-specific immune responses. When combined with surgery, chemotherapy, radiotherapy, or immunotherapy, IRE enhances therapeutic efficacy, prolongs survival in locally advanced pancreatic cancer patients, reduces postoperative recurrence rates, and significantly improves quality of life. ConclusionsAs a non-thermal ablation technique, IRE demonstrates unique advantages in localized pancreatic cancer treatment, particularly for surgically ineligible patients, and serves as a potent adjunct to traditional therapies. With technological refinements and accumulating clinical evidence, IRE is poised to play an increasingly pivotal role in future oncology practice.
ObjectiveTo explore the significance of mesenchymal epithelial transition factor (MET) as a clinical prognostic evaluation index for patients with pancreatic cancer based on bioinformatics analysis.MethodsThe GSE28735 and GSE62452 gene chips from GEO database were downloaded and the difference of MET gene expression between cancer and adjacent cancerous tissues were analyzed by bioinformatics. We downloaded pancreatic cancer gene chip from TCGA database to analyze the correlation between MET gene expression and clinicopathological features of pancreatic cancer patients and prognosis risk. Finally, the possible molecular mechanism of MET involved in pancreatic carcinogenesis was analyzed by GO and KEGG enrichment analysis.ResultsThe expression level of MET gene in pancreatic cancer tissues was significantly higher than that in adjacent cancerous tissues (P<0.001). The overall survival and disease-free survival of pancreatic cancer patients in the high MET gene expression group were lower than those in the low expression group (P<0.001). The expression level of MET gene was related to the age of pancreatic cancer patients, T stage, and histological grading of tumors (P<0.05), and high MET gene expression, age >65 years, and N1 stage were independent risk factors affecting the prognosis of pancreatic cancer patients. KEGG enrichment analysis showed that MET was mainly related to PI3K/AKT signaling pathway, FAK signaling pathway, and cancer transcription dysregulation and so on.ConclusionMET may be a valuable tumor marker for pancreatic cancer and can predict the poor prognosis of patients with pancreatic cancer.
ObjectiveTo investigative current status and hotspot issues of pancreatic cancer imaging research.MethodsThe literatures focusing on pancreatic cancer and published from 2001 to 2020 were retrieved from the core database of Web of Science. The quantitative analysis of literatures was then conducted by using the CiteSpace software based on the bibliometric method. The research trend was then summarized systematically and the potential research fronts and focuses were explored.ResultsA total of 2111 articles in the field of pancreatic cancer imaging research were retrieved. The clustering of co-citation of pancreatic cancer included vascular resection, irreversible electroporation, autoimmune pancreatitis, sporadic pancreatic cancer, sarcopenia, pancreas, stereotactic body radiation therapy, metastatic pancreatic cancer, familial pancreatic cancer, abdominal ultrasonography, fibroblast, early diagnosis, time trends in survival, radiomics, pancreatitis, gemcitabine, concurrent chemoradiotherapy, adjuvant chemotherapy, and microbubbles. The burst keywords in the field of pancreatic cancer after 2016 included FOLFIRINOX, skeletal muscle, sarcopenia, and texture analysis. The hot keywords clustering had prognosis, fine needle aspiration, positron emission tomography, vascular invasion, angiogenesis, unresectable, liver transplant, extend pancreatectomy, transplantation, paclitaxel, metastatic colorectal cancer, colorectal cancer, microsatellite stable, radiomics, hospital volume, occult metastasis, risk factor.ConclusionIt might be the trend of imaging research to study the prognosis, risk factors, and quantitative sarcopenia of pancreatic cancer by using radiomics.