Pancreatology最新文献

英文中文

ORM2 alleviates pancreatic fibrosis in chronic pancreatitis by modulating autophagy via ZG16 ORM2通过ZG16调节自噬，减轻慢性胰腺炎胰腺纤维化。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.019

Bangwei Huang , Jianguo Gao , Yue Wang , Xin Tan , Ying Zhang , Zijian Si , Xinyi Yang , Xia Liu , Zhaoshen Li , Lianghao Hu , Pengyuan Wang

Background

Chronic pancreatitis (CP) is a progressive fibro-inflammatory disorder with no effective anti-fibrotic treatment. Pancreatic stellate cells (PSCs) play a central role in pancreatic fibrosis by secreting excessive extracellular matrix (ECM) upon activation. Autophagy has been shown to promote PSC activation, yet its regulation remains unclear. This study focuses on ORM2, an acute-phase protein, and investigates whether it attenuates pancreatic fibrosis by modulating autophagy in PSCs.

Methods

A CP mouse model was induced by repeated caerulein injections. Pancreas-specific ORM2 knockout and overexpression were achieved via AAV-mediated strategies. Human PSCs (HPSCs) and primary mouse PSCs were treated with TGF-β1 to induce fibrotic activation in vitro. Autophagic flux was assessed using Western blot, transmission electron microscopy, and LC3B-RFP-GFP reporter assays. Protein-protein interactions were identified using the SPIDER technique and co-IP assay.

Results

ORM2 was significantly downregulated in pancreatic tissue but upregulated in serum and liver during CP. Pancreas-specific ORM2 knockout exacerbated pancreatic fibrosis, while ORM2 overexpression attenuated fibrotic markers (α-SMA, COL1A1, FN) and tissue collagen deposition. ORM2 suppressed TGF-β1-induced fibrotic gene expression and inhibited autophagic flux by blocking autolysosome formation in vitro. SPIDER and co-IP analysis identified ZG16 as an ORM2-binding protein. ZG16 knockout abolished the anti-fibrotic effects of ORM2 in vitro and in vivo.

Conclusion

ORM2 alleviates pancreatic fibrosis in CP by binding to ZG16 and inhibiting autophagy-driven PSC activation. These findings identify ORM2 as a promising therapeutic agent for pancreatic fibrosis.

背景：慢性胰腺炎（CP）是一种进行性纤维炎性疾病，目前尚无有效的抗纤维化治疗方法。胰腺星状细胞（PSCs）激活后通过分泌过量的细胞外基质（ECM）在胰腺纤维化中发挥核心作用。自噬已被证明可以促进PSC的激活，但其调控机制尚不清楚。本研究的重点是ORM2，一种急性期蛋白，并研究它是否通过调节PSCs的自噬来减轻胰腺纤维化。方法：采用重复注射小粒蛋白法建立小鼠CP模型。通过aav介导的策略实现胰腺特异性ORM2敲除和过表达。用TGF-β1处理人PSCs （HPSCs）和小鼠原代PSCs，诱导其体外纤维化活化。采用Western blot、透射电镜和LC3B-RFP-GFP报告基因检测评估自噬通量。使用SPIDER技术和co-IP分析鉴定蛋白质-蛋白质相互作用。结果：胰腺组织中ORM2显著下调，血清和肝脏中ORM2上调，胰腺特异性ORM2敲除加重胰腺纤维化，而ORM2过表达减弱纤维化标志物（α-SMA、COL1A1、FN）和组织胶原沉积。ORM2在体外通过阻断自噬酶体形成抑制TGF-β1诱导的纤维化基因表达，抑制自噬通量。SPIDER和co-IP分析鉴定ZG16为orm2结合蛋白。在体外和体内敲除ZG16均可消除ORM2的抗纤维化作用。结论：ORM2通过与ZG16结合，抑制自噬驱动的PSC激活，减轻CP胰腺纤维化。这些发现确定ORM2是一种很有前途的治疗胰腺纤维化的药物。

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引用次数: 0

Chronic pancreatitis and pancreatic cancer: It is in the genes! 慢性胰腺炎和胰腺癌：这是基因！

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2026.01.002

Kajal Jain PhD , Shallu Midha PhD

引用次数: 0

Letter to Editor: Strengths and methodological considerations for predicting post-pancreatectomy acute pancreatitis 致编辑：预测胰腺切除术后急性胰腺炎的优势和方法学考虑。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.06.008

Zhen Pengkai, Han Xiaoyi

引用次数: 0

Contrast-enhanced harmonic endoscopic ultrasonography (EUS)-guided tissue acquisition significantly improves diagnostic yield for small liver metastases derived from pancreatic cancer: a prospective study 对比增强谐波超声内镜（EUS）引导下的组织采集显著提高胰腺癌小肝转移的诊断率：一项前瞻性研究。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.001

Tomoya Emori , Masahiro Itonaga , Reiko Ashida , Akiya Nakahata , Takaaki Tamura , Yuki Kawaji , Takashi Tamura , Yasunobu Yamashita , Kazuhiro Fukatsu , Toshio Shimokawa , Masayuki Kitano

Background and aims

We aimed to clarify the value of Contrast-enhanced harmonic EUS-guided tissue acquisition (C-EUS-TA) for pathological confirmation of liver metastases, particularly small metastases, derived from pancreatic cancer.

Methods

Fundamental B-mode EUS (B-EUS) and contrast-enhanced EUS (C-EUS) were compared in detection rates of liver metastases in patients with pancreatic cancer. We also assessed the ability of C-EUS-TA for the sensitivity, specificity, and accuracy of the pathological diagnosis of those liver metastases, and compared those values according to the size of the liver metastases (≤5 mm, 5 mm < size ≤10 mm, and size >10 mm in diameter).

Results

The accuracy of C-EUS for detection of liver metastases was significantly higher than that of B-EUS (91.3 % vs. 71.0 %, p = 0.001). In particular, the diagnostic accuracy of C-EUS for small liver metastases (≤5 mm in diameter) was significantly higher than that of B-EUS (93.9 % vs. 66.7 %, p = 0.016). The overall accuracy of C-EUS-TA for pathological diagnosis of liver metastases was 95.2 %. Interestingly, there was no significant difference in the accuracy of C-EUS-TA among the three lesions sizes (≤5 mm: 90.0 %, 5 mm < size ≤10 mm: 100 %, and size >10 mm in diameter: 95.5 %).

Conclusion

The present study demonstrates the usefulness and high accuracy of C-EUS-TA for diagnosis of suspected liver metastases, particularly small lesions measuring ≤5 mm. Thus, when confirmation of small liver metastases using conventional imaging is difficult, C-EUS-TA may be useful for histological diagnosis.

背景和目的：我们旨在阐明对比增强谐波eus引导下的组织采集（C-EUS-TA）在胰腺癌肝转移，特别是小转移的病理确认中的价值。方法：比较基础b型EUS （B-EUS）与增强造影EUS （C-EUS）对胰腺癌肝转移的检出率。我们还评估了C-EUS-TA对这些肝转移的病理诊断的敏感性、特异性和准确性，并根据肝转移的大小（≤5mm、5mm <≤10mm和直径> 10mm）对这些值进行了比较。结果：C-EUS对肝转移的检测准确率明显高于B-EUS（91.3%比71.0%,p = 0.001）。特别是C-EUS对小肝转移灶（直径≤5mm）的诊断准确率明显高于B-EUS （93.9% vs. 66.7%, p = 0.016）。C-EUS-TA对肝转移病理诊断的总体准确率为95.2%。有趣的是，C-EUS-TA在三种病变大小（≤5mm: 90.0%, 5mm <≤10mm: 100%，直径为> - 10mm: 95.5%）之间的准确性没有显著差异。结论：本研究证明了C-EUS-TA诊断疑似肝转移的有效性和准确性，特别是≤5mm的小病变。因此，当常规影像学难以确诊小肝转移时，C-EUS-TA可能有助于组织学诊断。

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引用次数: 0

Gallstone Pancreatitis: Clinical outcomes and economic impact at a tertiary UK Hepatobiliary centre 胆结石性胰腺炎：临床结果和经济影响在三级英国肝胆中心。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.014

Mina Fouad, Osarumwese Aigbokhae, Prithvirao Sonoo, Samah Quraishi, Oladeji Ibrahim, Sudip Sanyal

Background

Gallstone pancreatitis (GSP) accounts for nearly 50 % of acute pancreatitis admissions in the NHS. Post-COVID-19 delays in laparoscopic cholecystectomy (LC) have amplified the clinical and financial burden. This study evaluates outcomes and preventable costs associated with GSP at a UK tertiary centre.

Method

A prospective cohort of 185 GSP patients was analysed over 30 months at Nottingham University Hospitals NHS Trust. Patients were stratified into three age groups: 20–49, 50–69, and ≥70 years. Data included demographics, disease severity, LC timing, readmissions, and healthcare costs.

Results

The median length of hospital stay was 4 days (IQR: 2–7), increasing slightly with age and disease severity. Severe pancreatitis occurred in 29.2 % of patients aged ≥70. ICU admissions were highest in the 50–69 years group (9.7 %), with mortality and complication rates peaking in those ≥70 years (16.7 % and 19.4 %, respectively). Median LC waiting times increased through age groups: 61.0, 100.0, and 272.0 days, respectively. Readmission rates rose progressively with age, reaching 43.1 % in the oldest group. Delays beyond 121 days were associated with higher readmission risk. Hot cholecystectomy was most frequent in younger patients (15.7 %). The total cost of inpatient care for GSP reached £1.12 million (median cost of £6663 per patient). Readmissions accounted for 58 % of the total cost (£4250 per episode).

Conclusions

Readmission-related expenditure, largely preventable with timely surgery, represents a key target for intervention. Prioritising early cholecystectomy, particularly within 121 days of index admission, may substantially reduce the financial burden and improve patient outcomes across the NHS.

背景：胆石性胰腺炎（GSP）占近50%的急性胰腺炎入院在NHS。covid -19后腹腔镜胆囊切除术（LC）的延误加剧了临床和经济负担。本研究评估了英国高等教育中心与GSP相关的结果和可预防的成本。方法：对诺丁汉大学医院NHS信托基金的185例GSP患者进行了为期30个月的前瞻性队列分析。患者分为3个年龄组：20-49岁、50-69岁和≥70岁。数据包括人口统计、疾病严重程度、LC时间、再入院和医疗费用。结果：中位住院时间为4天（IQR: 2-7），随年龄和病情严重程度略有增加。≥70岁的患者发生严重胰腺炎的比例为29.2%。ICU住院率在50-69岁组最高（9.7%），死亡率和并发症发生率在≥70岁组最高（分别为16.7%和19.4%）。LC等待时间中位数随着年龄组的增加而增加：分别为61.0、100.0和272.0天。再入院率随着年龄的增长而逐渐上升，在老年组中达到43.1%。延迟超过121天与更高的再入院风险相关。热胆囊切除术在年轻患者中最为常见（15.7%）。GSP的住院护理总费用达到112万英镑（每位患者的平均费用为6663英镑）。再入院费用占总费用的58%（每集4250英镑）。结论：与再入院相关的支出，在很大程度上可以通过及时手术预防，是干预的关键目标。优先考虑早期胆囊切除术，特别是在指数入院后121天内，可以大大减轻经济负担并改善NHS患者的预后。

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引用次数: 0

Response to the letter to the editor regarding “Predictors of acute pancreatitis in patients treated with GLP-1 receptor agonists for weight management” 回复关于“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.2025.12.011

Amin M. Amin , Rand Alsawas , Robert Postlethwaite , Jaime P. Almandoz , Tarek Sawas

引用次数: 0

Pancreatic cancer burden across Southeast Asia from 1990 to 2021: An analysis of incidence and mortality based on the global burden of disease study 2021 1990年至2021年东南亚胰腺癌负担：基于2021年全球疾病负担研究的发病率和死亡率分析

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.09.031

Ye Xin Koh , Yun Zhao , Amy Thien , Yuxin Guo , Hwee Leong Tan , Darren Weiquan Chua , Wei-Liang Loh , Jin Yao Teo , Prema Raj Jeyaraj , London Lucien Peng Jin Ooi , Peng Chung Cheow , Alexander Yaw Fui Chung , Ivan En-Howe Tan , Marianne Kit Har Au , Hiang Khoon Tan , Brian Kim Poh Goh

Background/objectives

Pancreatic cancer is a leading cause of cancer-related deaths globally, with a growing burden in Southeast Asia. This study aimed to assess pancreatic cancer trends, including incidence, mortality, and associated risk factors, across Southeast Asian countries using data from the Global Burden of Disease (GBD) Study 2021.

Methods

We analyzed pancreatic cancer incidence, mortality, and age-standardized incidence (ASIR) and mortality (ASMR) rates from 1990 to 2021 across Southeast Asia. The analysis included 15 countries grouped according to GBD's classification. We calculated the estimated annual percentage change (EAPC) in ASIR and ASMR and the mortality-to-incidence ratio (MIR). We examined the correlation between cancer trends and the sociodemographic index (SDI). Additionally, risk factors contributing to pancreatic cancer mortality were assessed.

Results

Between 1990 and 2021, pancreatic cancer incidence increased by 288.65 %, while mortality rose by 287.07 % across Southeast Asia. Higher-SDI countries exhibited lower MIRs, while lower-SDI countries experienced higher MIRs. Metabolic risks and high fasting plasma glucose were the leading contributors to pancreatic cancer mortality, particularly in high-SDI countries, while smoking remained a significant risk in lower-SDI nations.

Conclusion

The substantial rise in pancreatic cancer burden across Southeast Asia highlights the need for improved healthcare infrastructure, especially in lower-SDI countries. Regional collaboration and targeted interventions focusing on early detection, treatment access, and modifiable risk factors are crucial to reducing pancreatic cancer mortality. Strengthening healthcare systems and public health initiatives will be vital to address this growing regional and global health challenge.

背景/目的：胰腺癌是全球癌症相关死亡的主要原因，在东南亚的负担越来越重。本研究旨在利用2021年全球疾病负担（GBD）研究的数据，评估东南亚国家的胰腺癌趋势，包括发病率、死亡率和相关危险因素。方法：我们分析了1990年至2021年东南亚地区的胰腺癌发病率、死亡率、年龄标准化发病率（ASIR）和死亡率（ASMR）。根据GBD的分类，该分析包括15个国家。我们计算了ASIR和ASMR的估计年百分比变化（EAPC）以及死亡率与发病率比（MIR）。我们研究了癌症趋势与社会人口指数（SDI）之间的相关性。此外，还评估了导致胰腺癌死亡率的危险因素。结果：1990年至2021年，东南亚地区胰腺癌发病率上升288.65%，死亡率上升287.07%。高sdi国家的MIRs较低，而低sdi国家的MIRs较高。代谢风险和高空腹血糖是胰腺癌死亡的主要原因，特别是在高sdi国家，而吸烟仍然是低sdi国家的重要风险。结论：东南亚地区胰腺癌负担的大幅上升凸显了改善医疗基础设施的必要性，特别是在低sdi国家。以早期发现、治疗可及性和可改变的危险因素为重点的区域合作和有针对性的干预措施对于降低胰腺癌死亡率至关重要。加强卫生保健系统和公共卫生行动对于应对这一日益严重的区域和全球卫生挑战至关重要。

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引用次数: 0

Role of bioimpedance spectroscopy analysis to assess hydration status in the early phase of acute pancreatitis 生物阻抗谱分析在评估急性胰腺炎早期水合状态中的作用。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.003

Morten Laksáfoss Lauritsen , Mikkel Parsberg Werge , Mirjana Cihoric , Henrik Løvendahl Jørgensen , Nicolai Bang Foss , John Gásdal Karstensen , Amer Hadi , Lise Lotte Gluud , Srdan Novovic

引用次数: 0

Analgesic phenotypes in acute pancreatitis: Clustering analysis of two prospective global cohort studies 急性胰腺炎镇痛表型：两项前瞻性全球队列研究的聚类分析。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.013

Chris Varghese , Cecilie Siggaard Knoph , Nejo Joseph , Stacey Culp , Enrique de-Madaria , John A. Windsor , Asbjørn Mohr Drewes , Georgios I. Papachristou , Sanjay Pandanaboyana , the PAINAP Collaborative and APPRENTICE Study Groups

Introduction

Pain management in acute pancreatitis (AP) is of critical therapeutic and prognostic significance. We aimed to identify patient phenotypes in AP based on pain management strategies and evaluate their prognostic impact.

Methods

Data from two major international prospective cohort studies of AP patients (PAINAP study, n = 2119 and APPRENTICE study, n = 1544) from 141 centers worldwide were collated. Demographic data and analgesic use (within 72 h of presentation) were used for latent class analysis of binary analgesic data. The number of clusters was determined by minimisation of Bayesian information criterion. Cluster assignment and AP outcomes were interrogated with multivariable mixed-effects logistic regression.

Results

Overall, 3469 patients (median age 52; 47 % female) were analysed. There were 1015 (29.2 %) patients that had moderately severe to severe AP. Within the first 72 h, 494 (14.2 %) patients received non-steroidal anti-inflammatory drugs (NSAIDs), 1410 (40.6 %) weak opioids, 1347 (14.2 %) strong opioids, and 48 (1.4 %) epidural analgesia. There were significant variations in analgesic prescribing patterns across centers (p < 0.001, interclass correlation coefficient 43.8 %). Latent class analysis identified 5 unique patient clusters: early NSAIDs use, minimal analgesic use, strong opioid use, early multimodal analgesia use, and early weak opioid use. The cluster characterized by early NSAIDs was associated with non-severe AP (adjusted odds ratio 0.64, 95 % confidence interval 0.44–0.93, p = 0.02), which could suggest that the use of NSAIDs was perhaps driven by milder pain severity.

Conclusion

Unique clusters in the management of pain in AP were identified, with associations to severity of AP. Substantial centre-level variations exist in the patterns of analgesic prescribing globally, contributing to variations in outcomes.

急性胰腺炎（AP）的疼痛管理具有重要的治疗和预后意义。我们旨在根据疼痛管理策略确定AP患者的表型，并评估其对预后的影响。方法：对来自全球141个中心的两项主要的AP患者国际前瞻性队列研究（PAINAP研究，n = 2119和APPRENTICE研究，n = 1544）的数据进行整理。人口统计学数据和镇痛药使用情况（就诊后72小时内）用于二元镇痛药数据的潜在分类分析。通过贝叶斯信息准则的最小化来确定聚类的数量。聚类分配和AP结果通过多变量混合效应逻辑回归进行询问。结果：总共分析了3469例患者（中位年龄52岁，47%为女性）。1015例（29.2%）患者有中重度到重度AP。在最初72小时内，494例（14.2%）患者使用非甾体类抗炎药（NSAIDs）， 1410例（40.6%）使用弱阿片类药物，1347例（14.2%）使用强阿片类药物，48例（1.4%）使用硬膜外镇痛。各中心镇痛药处方模式差异显著（p < 0.001，类间相关系数43.8%）。潜在分类分析确定了5个独特的患者群：早期使用非甾体抗炎药、少量使用镇痛药、强烈使用阿片类药物、早期使用多模式镇痛药和早期使用弱阿片类药物。以早期非甾体抗炎药为特征的组群与非严重AP相关（调整优势比0.64,95%可信区间0.44-0.93,p = 0.02），这可能表明非甾体抗炎药的使用可能是由较轻的疼痛严重程度驱动的。结论：确定了AP疼痛管理的独特集群，与AP的严重程度有关。全球镇痛处方模式存在实质性的中心水平差异，导致了结果的变化。

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引用次数: 0

Elevated circulating glycine levels are associated with reduced pancreatic cancer risk: A prospective cohort study based on the UK biobank 循环甘氨酸水平升高与胰腺癌风险降低相关：一项基于英国生物银行的前瞻性队列研究。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2026-02-01 DOI: 10.1016/j.pan.2025.12.015

Shuai Xiang , Yunlong Li , Yuxin Wang , Hongxu Nie , Chengfeng Wang , Xu Che , Yongxing Du

Background

Identifying biomarkers associated with pancreatic cancer (PC) development could facilitate early intervention and improve outcomes.

Methods

This study enrolled 206,363 participants, with 854 incident cases of PC were identified during follow-up. 168 metabolic biomarkers were measured by nuclear magnetic resonance spectroscopy, and the polygenic risk score (PRS) for PC constructed by 44 single nucleotide polymorphisms was calculated. Multivariate Cox regression analysis and multiple hypothesis testing were employed to evaluate the association between metabolites and PC risk. Stratified analyses and interaction tests were conducted to explore the effects of metabolites under different genetic backgrounds and lifestyle factors.

Results

After correction for multiple hypothesis testing, only plasma glycine levels showed a significant inverse correlation with PC risk (FDR-corrected P-value <0.05). High glycine levels were associated with a 21.4 % reduction in PC risk compared to low levels (HR: 0.786, 95 % CI: 0.657–0.940). PRS was positively associated with PC risk, with high PRS participants showing a 2.871-fold increased risk (95 % CI: 2.382–3.460). Glycine's protective effects were more pronounced in low PRS participants and never smokers. High glycine and low PRS participants demonstrated a 72.3 % reduction in PC risk compared to low glycine and high PRS participants (HR: 0.277, 95 % CI: 0.197–0.389). Notably, even among participants with the highest PRS, baseline plasma glycine levels were still significantly inversely associated with future PC risk.

Conclusion

Higher circulating glycine levels are associated with a reduced risk of PC, even in individuals with the highest genetic susceptibility. These findings suggest that higher circulating glycine levels may hold potential for PC prevention strategies, warranting further experimental validation of glycine supplementation in prospective trials.

背景：识别与胰腺癌（PC）发展相关的生物标志物可以促进早期干预和改善预后。方法：本研究纳入206,363名参与者，在随访期间发现854例PC事件。采用核磁共振波谱法测定168个代谢生物标志物，计算44个单核苷酸多态性构建的PC多基因风险评分（PRS）。采用多变量Cox回归分析和多假设检验来评估代谢物与PC风险的关系。通过分层分析和相互作用试验探讨不同遗传背景和生活方式因素对代谢物的影响。结果：经过多重假设检验校正后，只有血浆甘氨酸水平与PC风险呈显著负相关（fdr校正的p值）。结论：较高的循环甘氨酸水平与PC风险降低相关，即使在遗传易感性最高的个体中也是如此。这些发现表明，较高的循环甘氨酸水平可能具有预防PC策略的潜力，需要在前瞻性试验中进一步实验验证补充甘氨酸。

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引用次数: 0

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