Pancreatology最新文献

英文中文

Future of fluid therapy for acute pancreatitis 急性胰腺炎液体疗法的未来

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.10.006

John Windsor , Enrique de-Madaria , James Buxbaum

引用次数: 0

Pancreatic cancer risk in genetically determined chronic pancreatitis 基因决定的慢性胰腺炎胰腺癌风险。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.11.011

Hans Scherübl

引用次数: 0

Response to: “Defining pancreas delayed graft function: Advancement or premature standardization?” 对“定义胰腺延迟移植功能：进步还是过早标准化？”

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.010

Ruben Bellotti, Franka Messner

引用次数: 0

Pancreatic cancer: An urgent clinical challenge and opportunities for improved care 胰腺癌：迫切的临床挑战和改善护理的机会。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.11.009

Yasuhisa Mori , Tetsuya Takikawa , Takao Ohtsuka

引用次数: 0

Serum autoantibody signatures enable non-invasive early detection of pancreatic cancer 血清自身抗体特征可以实现胰腺癌的无创早期检测。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.11.017

Li Sun , Yuqi Liu , Qian Yang , Jicun Zhu , Tiandong Li , Donglin Jiang , Yin Lu , Ling Liu , Yue Wang , Xiaodan Zhang , Zihan Wang , Hanke Ma , Jianxiang Shi , Keyan Wang , Peng Wang , Chunhua Song , Kaijuan Wang , Hua Ye

Background

Autoantibodies against tumor-associated antigens (TAAs) are promising biomarkers for early immunodiagnosis of cancers. This study was designed to screen and verify tumor-associated autoantibodies (TAAbs) in sera as diagnostic biomarkers for pancreatic cancer (PC).

Methods

Bioinformatics-based data mining and the customized proteome microarray based on cancer driver genes were used to identify the potential TAAs. Enzyme-linked immunosorbent assay (ELISA) was adopted to assess the expression levels of the corresponding autoantibodies in 457 serum samples, followed by a diagnostic model was then constructed using machine learning.

Results

Eleven candidate TAAs (EDNRA, OLR1, SEMA3C, AHNAK2, DHRS9, TMPRSS4, CCL20, SERPINB3, GPRC5A, TMC5 and MBOAT2) were identified through bioinformatics analysis and human protein chips, and further validated by ELISA. The titers of five TAAbs (anti-AHNAK2, anti-CCL20, anti-DHRS9, anti-OLR1, and anti-SERPINB3) that exhibited significant differences between PC and control subjects (P < 0.05), with AUC values ranging from 0.61 to 0.71. The random forest model developed using these five TAAbs exhibited AUCs of 0.83 (48.36 % sensitivity, 90.16 % specificity) and 0.76 (40.74 % sensitivity, 91.60 % specificity) for discriminating PC from healthy controls. Additionally, the model yielded AUCs of 0.86 (48.78 % sensitivity, 90.16 % specificity) and 0.80 (38.89 % sensitivity, 95.06 % specificity) for distinguishing early stage PC from controls in the training and test set, respectively. Notably, combining the random forest model with CA19-9 increased the positive rate to 88.97 %.

Conclusion

Our findings indicated that the rondom froest model based on five autoantibodies might help identify preclinical and early-stage PC.

背景：针对肿瘤相关抗原（TAAs）的自身抗体是癌症早期免疫诊断的有前途的生物标志物。本研究旨在筛选和验证血清中肿瘤相关自身抗体（TAAbs）作为胰腺癌（PC）的诊断生物标志物。方法：采用基于生物信息学的数据挖掘技术和基于癌症驱动基因的定制化蛋白质组芯片技术，对潜在的TAAs进行鉴定。采用酶联免疫吸附法（ELISA）检测457份血清样品中相应自身抗体的表达水平，并利用机器学习建立诊断模型。结果：通过生物信息学分析和人蛋白芯片鉴定出11个候选TAAs (EDNRA、OLR1、SEMA3C、AHNAK2、DHRS9、TMPRSS4、CCL20、SERPINB3、GPRC5A、TMC5和MBOAT2)，并通过ELISA进一步验证。5项抗体（抗ahnak2、抗ccl20、抗dhrs9、抗olr1、抗serpinb3）滴度在PC组与对照组之间存在显著差异（P < 0.05）， AUC值为0.61 ~ 0.71。使用这5种taab建立的随机森林模型区分PC和健康对照的auc分别为0.83（敏感性48.36%，特异性90.16%）和0.76（敏感性40.74%，特异性91.60%）。此外，该模型在训练集和测试集中区分早期PC与对照组的auc分别为0.86（灵敏度48.78%，特异性90.16%）和0.80（灵敏度38.89%，特异性95.06%）。值得注意的是，随机森林模型与CA19-9相结合，阳性率达到88.97%。结论：基于五种自身抗体的随机森林模型可能有助于临床前和早期PC的识别。

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引用次数: 0

Complete pathological response in metastatic pancreatic adenocarcinoma following neoadjuvant therapy 新辅助治疗后转移性胰腺腺癌的完全病理反应。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.11.018

Evangelia Florou , Yoh Zen , Saoirse Dolly , Parthi Srinivasan , Andreas Prachalias

引用次数: 0

Association between pancreatic enzyme replacement therapy and mortality in pancreatic cancer: a matched case-control study 胰酶替代治疗与胰腺癌死亡率之间的关系：一项匹配的病例对照研究。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.008

Ana Dugic , Hannes Hagström , Isabella Palmer , Amar Nouri , Hasti Torabzadeh Tari , Lena Schmaderer , Maria Gustafsson Liljefors , Poya Ghorbani , J.-Matthias Löhr , Miroslav Vujasinovic

Background

Malnutrition and pancreatic exocrine insufficiency (PEI) are common among patients with pancreatic cancer. Despite the potential of pancreatic enzyme replacement therapy (PERT) to correct PEI, its association with survival remains uncertain. Our study aimed to evaluate the trend in PERT prescription and its potential association with mortality among patients with pancreatic cancer.

Methods

We included patients with pancreatic ductal adenocarcinoma (PDAC) discussed at a tertiary hospital tumor board between 2008–2012 and 2015–2018. Cases (deceased within one year) were matched 1:1 with controls (alive at one year). Patients were classified as PERT users or non-users based on prescriptions after PDAC diagnosis. Conditional logistic regression assessed the association between PERT usage and all-cause mortality at one-year post-diagnosis.

Results

A total of 1247 patients were included: 756 (61 %) who died within one year and 491 (39 %) who survived. PERT prescriptions increased over time, particularly in the palliative setting (46 % vs. 75 %, p = 0.001). Matching yielded 487 pairs. In the full population, PERT use was associated with lower one-year mortality (adjusted OR 0.49, 95 %CI = 0.34–0.71). Similar associations were seen among subgroups undergoing surgery (aOR 0.34, 95 %CI = 0.16–0.74) and those receiving best supportive care (aOR 0.12, 95 %CI = 0.03–0.33). In the chemotherapy-only subgroup, the direction of effect suggested a potential risk reduction, but without statistical significance (aOR 0.75, 95 %CI = 0.44–1.24).

Conclusion

There is an overall decrease in mortality among PERT-users compared to non-users. The results may be overly optimistic due to potential confounding factors related to patient selection, and randomized controlled studies are needed to confirm these effects.

背景：营养不良和胰腺外分泌功能不全（PEI）在胰腺癌患者中很常见。尽管胰酶替代疗法（PERT）有可能纠正PEI，但其与生存率的关系仍不确定。我们的研究旨在评估胰腺癌患者PERT处方的趋势及其与死亡率的潜在关联。方法：我们纳入了2008-2012年至2015-2018年在三级医院肿瘤委员会讨论的胰腺导管腺癌（PDAC）患者。病例（一年内死亡）与对照组（一年内存活）1:1匹配。根据PDAC诊断后的处方，将患者分为PERT使用者和非PERT使用者。条件逻辑回归评估PERT使用与诊断后一年全因死亡率之间的关系。结果：共纳入1247例患者：1年内死亡756例（61%），存活491例（39%）。PERT处方随着时间的推移而增加，特别是在姑息治疗中（46%对75%，p = 0.001）。配对结果为487对。在整个人群中，PERT的使用与较低的一年死亡率相关（调整后的OR为0.49,95% CI = 0.34-0.71）。在接受手术的亚组（aOR 0.34, 95% CI = 0.16-0.74）和接受最佳支持治疗的亚组（aOR 0.12, 95% CI = 0.03-0.33）中也有类似的关联。在仅化疗亚组中，效应方向提示潜在的风险降低，但无统计学意义（aOR 0.75, 95% CI = 0.44-1.24）。结论：与非使用者相比，pert使用者的死亡率总体上有所下降。由于与患者选择相关的潜在混杂因素，结果可能过于乐观，需要随机对照研究来证实这些影响。

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引用次数: 0

Comment on “Concealed pancreatic cancer in acute pancreatitis: Early MRCP and EUS surveillance improves prognosis and identifies high-risk patients” “急性胰腺炎隐匿性胰腺癌：早期MRCP和EUS监测可改善预后并识别高危患者”评论。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.07.010

Merve Eren Durmus, Gokhan Koker

引用次数: 0

Normal-fat versus fat-restricted diets in patients with acute pancreatitis: A randomized controlled study (NouRish-AP study) 急性胰腺炎患者的正常脂肪与脂肪限制饮食：一项随机对照研究（营养- ap研究）。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.08.011

Nutchakorn Kittisuphat , Narisorn Lakananurak , Pradermchai Kongkam

Background/objectives

International guidelines recommend a low-fat diet (LFD) in patients with acute pancreatitis (AP); however, no randomized controlled trials have compared LFD with a normal fat diet (NFD). The necessity of LFD remains uncertain, with concerns about its palatability and lower energy density potentially leading to reduced intake and quality of life (QoL). This study evaluates the efficacy and safety of NFD versus LFD in patients with mild to moderately severe non-hypertriglyceridemic AP.

Methods

This randomized controlled study enrolled patients from July 2022 to April 2023. Participants were randomly assigned to either NFD (30 % of total calories from fat) or LFD (15 % of total calories from fat). The primary outcome was daily energy intake. Secondary outcomes included QoL, complications, length of stay (LOS), and 90-day readmission.

Results

Sixty-five patients were enrolled (33 NFD, 32 LFD). The NFD group had significantly higher energy intake during the first two intervention days (Day 1: 18.7 vs. 12 kcal/kg/day, p = 0.007; Day 2: 18.6 vs. 12.7 kcal/kg/day, p = 0.005) and in the malnourished subgroup (23.2 vs. 15.6 kcal/kg/day, p = 0.024). However, overall energy intake was not significantly different (18.9 vs. 16.5 kcal/kg/day, p = 0.087). NFD resulted in significantly higher QoL scores in the physical (53.9 vs. 39.4, p = 0.019) and mental domains (55.9 vs. 40.7, p = 0.004). No significant differences were found in abdominal pain, triglyceride increment, infections, LOS, or 90-day readmission.

Conclusions

NFD was associated with higher calorie intake during the first two days of oral feeding in patients with mild and moderately severe AP, along with better QoL and no increase in adverse events. Routine LFD prescription may not be necessary, making NFD a viable option for non-hypertriglyceridemic AP patients.

Clinical trial registration

The trial was registered, and the protocol is available online at Thaiclinicaltrials.org (Identifier: TCTR20230926008).

背景/目的：国际指南推荐急性胰腺炎（AP）患者采用低脂饮食（LFD）；然而，没有随机对照试验将低脂饮食与正常脂肪饮食（NFD）进行比较。LFD的必要性仍然不确定，人们担心它的适口性和较低的能量密度可能导致摄入量和生活质量（QoL）的降低。该研究评估了NFD与LFD在轻度至中度非高甘油三酯血症ap患者中的疗效和安全性。方法：该随机对照研究于2022年7月至2023年4月招募患者。参与者被随机分配到NFD（总热量的30%来自脂肪）或LFD（总热量的15%来自脂肪）。主要指标是每日能量摄入。次要结局包括生活质量、并发症、住院时间（LOS）和90天再入院。结果：共纳入65例患者（NFD 33例，LFD 32例）。NFD组在干预前两天的能量摄入显著高于营养不良组（第1天：18.7 vs. 12 kcal/kg/ Day, p = 0.007；第2天：18.6 vs. 12.7 kcal/kg/ Day, p = 0.005）和营养不良组（23.2 vs. 15.6 kcal/kg/ Day, p = 0.024）。然而，总能量摄入没有显著差异（18.9 vs. 16.5 kcal/kg/day, p = 0.087）。NFD导致身体（53.9比39.4,p = 0.019）和精神领域（55.9比40.7,p = 0.004）的生活质量得分显著提高。在腹痛、甘油三酯增加、感染、LOS或90天再入院方面没有发现显著差异。结论：在轻度和中重度AP患者口服喂养的前两天，NFD与较高的卡路里摄入量相关，同时有更好的生活质量，且不良事件没有增加。常规LFD处方可能没有必要，使NFD成为非高甘油三酯血症AP患者的可行选择。临床试验注册：该试验已注册，方案可在泰国临床试验网站（编号：TCTR20230926008）上查询。

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引用次数: 0

Cannabis use in chronic pancreatitis: A narrative review 大麻在慢性胰腺炎中的使用：一个叙述性的回顾。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.017

Darius J. Javidi, Timothy B. Gardner

Chronic pain is a debilitating complication of chronic pancreatitis for which treatment options are limited. The goal of this narrative review was to summarize the existing evidence surrounding use of cannabis and its derivatives in chronic pancreatitis patients. Cannabis use in chronic pancreatitis is increasing and more prevalent in patients who are younger, male, take opioids chronically, and have chronic abdominal pain. In one retrospective study medical cannabis was associated with decreased mean daily opioid use while in a randomized control trial THC did not significantly decrease abdominal pain. Several very low-quality studies showed improved outcomes in hospitalized chronic pancreatitis patients who used cannabis. The existing evidence surrounding cannabis use in chronic pancreatitis is limited and mostly low-quality. Further investigation is warranted to explore whether medical cannabis could represent an effective therapy for patients with chronic pancreatitis.

慢性疼痛是慢性胰腺炎的一种使人衰弱的并发症，治疗方法有限。这篇叙述性综述的目的是总结慢性胰腺炎患者使用大麻及其衍生物的现有证据。大麻在慢性胰腺炎中的使用正在增加，并且在年轻、男性、长期服用阿片类药物和慢性腹痛的患者中更为普遍。在一项回顾性研究中，医用大麻与减少平均每日阿片类药物使用量有关，而在一项随机对照试验中，四氢大麻酚并没有显著减少腹痛。几项非常低质量的研究表明，住院慢性胰腺炎患者使用大麻的结果有所改善。关于大麻在慢性胰腺炎中的使用的现有证据有限，而且大多是低质量的。有必要进一步研究医用大麻是否可以作为慢性胰腺炎患者的有效治疗方法。

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