Pancreatology最新文献

英文中文

Association of the C-reactive protein-to-albumin-to-lymphocyte index with severe acute pancreatitis: A single-center retrospective study of 5,016 patients c反应蛋白-白蛋白-淋巴细胞指数与严重急性胰腺炎的关系：一项5016例患者的单中心回顾性研究

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.006

Xin Xu , Yaoyu Zou , Huajing Ke , Maobin Kuang, Shixuan Xiong, Ling Ding, Xueyang Li, Jingwen Gao, Cong He, Nianshuang Li, Xin Huang, Yupeng Lei, Huifang Xiong, Wenhua He, Lingyu Luo, Liang Xia, Nonghua Lu, Jianhua Wan, Yin Zhu

Background

Acute pancreatitis (AP) is heterogeneous, and single biomarkers lack sufficient accuracy in predicting progression to severe acute pancreatitis (SAP). The C-reactive protein-albumin-lymphocyte (CALLY) index, a novel immune-nutritional marker, has been shown to have prognostic value in various diseases, but its utility in AP is unclear. We evaluated the ability of CALLY to predict SAP compared with that of common inflammatory markers.

Methods

This retrospective cohort study included 5016 AP patients admitted between January 2020 and December 2024 at the First Affiliated Hospital of Nanchang University. Stepwise logistic regression estimated the associations between CALLY and SAP, with weighted restricted cubic spline (RCS) analyses assessed nonlinearity. Predictive performance was evaluated using receiver operating characteristic curves.

Results

Among 5016 AP patients (67.1 % male; median age 50.1 ± 16.2 years), 19 % developed SAP. Lower admission CALLY correlated significantly with increased SAP risk; each standard deviation increases in CALLY reduced SAP risk by 51 % (adjusted OR = 0.49; 95 % CI: 0.32–0.76). RCS analysis revealed a nonlinear inverse association between ln CALLY and the risk of SAP (P < 0.001). CALLY (AUC = 0.764) outperformed the neutrophil-to-lymphocyte ratio (NLR) (AUC = 0.657), platelet-to-lymphocyte ratio (PLR) (AUC = 0.556), neutrophil-to-albumin ratio (NAR) (AUC = 0.699), systemic immune-inflammatory index (SII) (AUC = 0.629), and bedside index for severity in acute pancreatitis (BISAP) (AUC = 0.747). Predictive performance was stronger in younger (<65 years) and hypertriglyceridemic AP patients.

Conclusion

Lower admission CALLY is a predictor of higher SAP risk, outperforming traditional inflammatory markers. It could serve as an early indicator for identifying high-risk patients.

背景：急性胰腺炎（AP）是异质性的，单一生物标志物在预测严重急性胰腺炎（SAP）进展方面缺乏足够的准确性。c反应蛋白-白蛋白淋巴细胞（CALLY）指数是一种新的免疫营养指标，已被证明在多种疾病中具有预后价值，但其在AP中的应用尚不清楚。我们评估了CALLY与常见炎症标记物预测SAP的能力。方法：回顾性队列研究纳入了2020年1月至2024年12月在南昌大学第一附属医院住院的5016例AP患者。逐步逻辑回归估计CALLY和SAP之间的关联，加权限制三次样条（RCS）分析评估非线性。使用受试者工作特征曲线评估预测性能。结果：5016例AP患者中（67.1%为男性，中位年龄50.1±16.2岁），19%发生SAP，较低的入院CALLY与SAP风险增加显著相关；CALLY降低的SAP风险每增加一个标准差增加51%（调整后OR = 0.49; 95% CI: 0.32-0.76）。RCS分析显示ln CALLY与SAP风险呈非线性负相关（P < 0.001）。CALLY （AUC = 0.764）优于中性粒细胞与淋巴细胞比值（NLR）（AUC = 0.657）、血小板与淋巴细胞比值（PLR）（AUC = 0.556）、中性粒细胞与白蛋白比值（NAR）（AUC = 0.699）、全身免疫炎症指数（SII）（AUC = 0.629）和急性胰腺炎床边严重程度指数（BISAP）（AUC = 0.747）。结论：较低入院率的CALLY是较高SAP风险的预测指标，优于传统的炎症指标。它可以作为识别高危患者的早期指标。

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引用次数: 0

Response to the letter to the editor regarding “Concealed pancreatic cancer in acute pancreatitis: Early MRCP and EUS surveillance improves prognosis and identifies high-risk patients” 回复关于我们稿件“急性胰腺炎隐蔽性胰腺癌：早期MRCP和EUS监测改善预后并识别高危患者”的致编辑的信。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.005

Kentaro Yamao , Mamoru Takenaka , Akihiro Yoshida , Takuya Ishikawa , Hiroki Kawashima , Masatoshi Kudo

引用次数: 0

Reply to the Letter to Editor regarding Pancreatic cancer risk in Genetically determined chronic pancreatitis 关于基因决定慢性胰腺炎胰腺癌风险的致编辑信的回复。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.009

Tae Jun Song

引用次数: 0

Establishment of simple pancreatic ductal adenocarcinoma identification method: S100P measurement in duodenal fluid obtained during upper gastrointestinal endoscopy 简单胰管腺癌鉴别方法的建立：上消化道内镜下十二指肠液S100P测定。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.020

Noboru Ideno , Keiji Hanada , Shoji Tokunaga , Takao Ohtsuka , Yasuhisa Mori , Kazuo Hara , Akio Katanuma , Masayuki Kitano , Mitsuharu Fukasawa , Suketo So , Kentaro Sudo , Kunihiko Aoyagi , Mamoru Takenaka , Shinichi Hashimoto , Kenoki Ohuchida , Masao Tanaka , Masafumi Nakamura

Background and aims

Establishing an effective screening method for pancreatic ductal adenocarcinoma (PDAC) is important. This study re-evaluated the diagnostic utility of the duodenal fluid (DF) marker S100 calcium-binding protein P (S100P) during upper gastrointestinal endoscopy (GIE).

Methods

Study 1 and Study 2 prospectively enrolled 173 and 36 patients with PDACs, and 237 and 80 controls, respectively. All subjects underwent upper GIE, endoscopic ultrasonography, or endoscopic retrograde cholangiopancreatography at 10 Japanese institutions in Study 1 versus three in Study 2. DF was collected without secretin stimulation, and S100P concentrations were measured. Study 1 identified two potential factors that significantly affected the S100P levels; thus, the sample collection protocol for Study 2 eliminated them.

Results

S100P levels differed significantly between patients with PDAC and controls in Study 1 (median 39.80 ng/ml versus 15.50 ng/ml, respectively; p < 0.001). The area under the receiver operating characteristics curve (AUC) comparing S100P levels between patients with PDAC and controls was 0.642 (95 % confidence interval, 0.584–0.694). Higher values were obtained with trans-nasal endoscopy and immediate storage at −80 °C versus no immediate freezing. In Study 2, S100P levels were significantly higher in the patients with PDAC versus controls (median 33.40 ng/ml versus 5.00 ng/ml, respectively; p < 0.0001). The AUC comparing S100P levels among all 34 patients with PDAC and 76 controls was 0.851 (95 % confidence interval, 0.766–0.921).

Conclusions

This study demonstrated the utility of the S100P in DF analysis for the early diagnosis of PDAC and clarified potential issues related to sample collections in the actual clinical settings.

背景与目的：建立一种有效的胰腺导管腺癌（PDAC）筛查方法具有重要意义。本研究重新评估了十二指肠液（DF）标志物S100钙结合蛋白P （S100P）在上消化道内窥镜检查（GIE）中的诊断价值。方法：研究1和研究2分别前瞻性纳入173例和36例pdac患者，以及237例和80例对照。在研究1中，所有受试者在10家日本机构接受了上消化道造影、内窥镜超声检查或内窥镜逆行胆管造影，而在研究2中只有3家。在不刺激分泌素的情况下收集DF，并测定S100P浓度。研究1确定了显著影响S100P水平的两个潜在因素；因此，研究2的样本采集方案消除了它们。结果：研究1中PDAC患者和对照组的S100P水平差异显著（中位值分别为39.80 ng/ml和15.50 ng/ml, p < 0.001）。PDAC患者与对照组S100P水平比较的受试者工作特征曲线下面积（AUC）为0.642（95%可信区间，0.584-0.694）。经鼻内窥镜检查和-80°C立即保存比不立即冷冻获得更高的值。在研究2中，PDAC患者的S100P水平明显高于对照组（中位数分别为33.40 ng/ml和5.00 ng/ml, p < 0.0001）。34例PDAC患者与76例对照者的S100P水平的AUC比较为0.851（95%可信区间，0.766-0.921）。结论：本研究证明了S100P在DF分析中对PDAC早期诊断的效用，并澄清了实际临床环境中与样本采集相关的潜在问题。

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引用次数: 0

Letter to editor: “Defining pancreas delayed graft function - Advancement or premature standardization?” 致编辑：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.2025.07.011

Zain Mazhar, Hafsa Riaz, Muhammad Kashif

引用次数: 0

The “fat” fad in acute pancreatitis: Healing pancreas with fat 急性胰腺炎的“脂肪”风潮：用脂肪治愈胰腺。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.11.021

Namrata Singh PhD , Soumya Jagannath Mahapatra MD, DM

引用次数: 0

Clinical features and evolution of paraduodenal (groove) pancreatitis: A multicenter study 十二指肠旁沟型胰腺炎的临床特征和演变：一项多中心研究。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.11.019

Giacomo Emanuele Maria Rizzo , Matteo Tacelli , Stefano Francesco Crinò , Maria Cristina Conti Bellocchi , Nicolo De Pretis , Antonio Amodio , Cecilia Binda , Chiara Coluccio , Andrea Anderloni , Antonio Facciorusso , Matteo Brunacci , Germana de Nucci , Gianpiero Manes , Alberto Fantin , Elisa Stasi , Paola Salacone , Lucia Crocella’ , Mario Luciano Brancaccio , Federica De Marchi , Paolo Giorgio Arcidiacono , Luca Barresi

Introduction

The pathogenesis and natural history of paraduodenal (groove) pancreatitis (PP) remain unclear, and treatment includes medical therapy, interventional endoscopy, and surgery. This is a multicenter study to explore the burden of the disease, its clinical course, and response to treatment.

Methods

Data were retrospectively collected from both academic and nonacademic Italian centers. All patients diagnosed with PP were included in the study. Data were recorded at the time of diagnosis and follow-up.

Results

208 patients (87.5 % male) from 16 centers were recruited. The median age at diagnosis was 50.5 (IQR 13 years), and the mean time from clinical presentation to diagnosis was 18 (±29) months. 90.6 % (n = 107) had a history of alcohol abuse and 90.7 % (n = 185) had smoked. Thirty-six patients (17.9 %) had diabetes at diagnosis, while 80 patients (41.5 %) had chronic pancreatitis. Six (3 %) patients were diagnosed with pancreatic cancer after a mean time of 10.3 (±10.8) months from the PP diagnosis. Forty-nine patients (24.9 %) had pancreatic exocrine insufficiency (PEI) at diagnosis, while 45(24.3 %) developed PEI during follow-up. Conservative treatment was administered in 103 (54.5 %) cases, surgery in 52 (27.5 %), and endoscopic therapy in 34 (18 %). The mean follow-up was 41.1 (±31.92) months.

Conclusions

Alcohol consumption and smoking are major risk factors for PP. Diabetes and PEI commonly develop in these patients. Conservative treatment strategies are often successful.

摘要十二指肠旁沟性胰腺炎（PP）的发病机制和自然史尚不清楚，治疗方法包括药物治疗、介入内镜检查和手术。这是一项多中心研究，旨在探讨该疾病的负担、临床病程和对治疗的反应。方法：回顾性收集意大利学术和非学术中心的数据。所有诊断为PP的患者均纳入研究。在诊断和随访时记录数据。结果：从16个中心招募了208例患者（87.5%为男性）。诊断时中位年龄为50.5岁（IQR 13岁），从临床表现到诊断的平均时间为18（±29）个月。90.6% （n = 107）有酗酒史，90.7% （n = 185）有吸烟史。36例（17.9%）患者在诊断时患有糖尿病，80例（41.5%）患者患有慢性胰腺炎。6例（3%）患者在PP诊断后平均10.3（±10.8）个月后被诊断为胰腺癌。49例（24.9%）患者在诊断时出现胰腺外分泌功能不全（PEI），而45例（24.3%）患者在随访期间出现PEI。103例（54.5%）采用保守治疗，52例（27.5%）采用手术治疗，34例（18%）采用内窥镜治疗。平均随访41.1（±31.92）个月。结论：饮酒和吸烟是PP的主要危险因素。糖尿病和PEI通常在这些患者中发生。保守治疗策略通常是成功的。

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引用次数: 0

Patterns of treatment and survival in borderline resectable and locally advanced pancreatic cancer 边缘可切除和局部晚期胰腺癌的治疗模式和生存期。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.007

Oskar Franklin , Thomas F. Stoop , Salvador Rodriguez Franco , Toshitaka Sugawara , Hiroyuki Ishida , Asif Halimi , Kathryn Colborn , Ana Gleisner , Richard D. Schulick , Marco Del Chiaro

Background

Treatment options for pancreatic cancer with major arterial involvement has evolved in the last decades with the introduction of multi-agent chemotherapies. This study aimed to explore treatment patterns of surgical and oncological treatment for clinical stage T4 pancreatic cancer in the United States.

Methods

The study included clinical T4M0 pancreatic cancer cases treated between 2004 and 2021 in the US National Cancer Database. Treatment patterns and overall survival were evaluated and divided into three time periods (2004–2010, 2011–2016, 2017–2021). Odds of resection were assessed with multivariable logistic regression.

Results

In total, 47,345 cases were analyzed, of which 4222 (8.9 %) underwent surgery. The median age was 68 years, 49 % were male and 77.0 % reported non-hispanic white race. The proportion of patients that received no treatment decreased from 31.2 % to 23.6 % and the proportion that received both chemotherapy and surgery increased from 4.4 % to 11.1 %. Among patients that received upfront chemotherapy (n = 28,445), single-agent chemotherapy dominated in 2004 but was almost completely replaced by multi-agent chemotherapy by 2021. Median overall survival improved; for non-resected patients from 10.8 months in 2004–2010 to 14.9 months in 2017–2021 (p < .001), and for resected patients from 25.2 to 32.7 months (p < .001). Variables associated with higher odds of resection included private insurance and center volume, whereas age, race/ethnicity, clinical N1-2 and a body/tail tumor location was associated with lower odds.

Conclusions

Treatment for pancreatic cancer with major arterial involvement has shifted towards an increased use of multi-agent chemotherapy and surgical resection, with an associated improved overall survival.

背景：在过去的几十年里，随着多药化疗的引入，主要动脉受累的胰腺癌的治疗选择已经发生了变化。本研究旨在探讨美国临床期T4胰腺癌的手术和肿瘤治疗模式。方法：该研究纳入了美国国家癌症数据库中2004年至2021年间治疗的临床T4M0胰腺癌病例。评估治疗模式和总生存率，并将其分为三个时间段（2004-2010年、2011-2016年、2017-2021年）。采用多变量logistic回归评估切除几率。结果：共分析47,345例，其中4222例（8.9%）行手术治疗。中位年龄为68岁，49%为男性，77.0%为非西班牙裔白人。未接受治疗的比例从31.2%下降到23.6%，同时接受化疗和手术的比例从4.4%上升到11.1%。在接受前期化疗的患者中（n = 28,445）， 2004年单药化疗占主导地位，但到2021年几乎完全被多药化疗所取代。中位总生存期提高；对于未切除的患者，从2004-2010年的10.8个月到2017-2021年的14.9个月（p < 0.001），对于切除的患者，从25.2个月到32.7个月（p < 0.001）。与较高的切除几率相关的变量包括私人保险和中心体积，而年龄、种族/民族、临床N1-2和身体/尾部肿瘤位置与较低的切除几率相关。结论：主要动脉受累的胰腺癌的治疗已经转向增加多药化疗和手术切除的使用，与之相关的总生存率提高。

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引用次数: 0

Letter to the Editor regarding “Predictors of acute pancreatitis in patients treated with GLP-1 receptor agonists for weight management” 致编辑关于“GLP-1受体激动剂治疗体重管理患者急性胰腺炎的预测因素”的信。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.08.019

Jinyu Wu , Wen Wang , Kuncheng Yang

引用次数: 0

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

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