Pancreatology最新文献

英文中文

A cross-sectional study of liver dysfunction using transient elastography among patients with chronic pancreatitis 慢性胰腺炎患者肝功能障碍的瞬时弹性成像横断面研究。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.10.004

Anirudh Gupta, Arun S. Sankannavar, Namit Gupta, Kamlesh Kumar Sharma, Sudhir Maharshi, Rupesh Pokharna

引用次数: 0

The impact of opioid use in chronic pancreatitis from 2004–2024: A propensity-matched analysis of 183,214 individuals 2004-2024年阿片类药物使用对慢性胰腺炎的影响：183,214人的倾向匹配分析

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.11.002

Yassine Kilani , Mahmoud Y. Madi , Ayah Obeid , Farah Heis , Park Jiwon , Daniel Alejandro Gonzalez Mosquera , Tarek Nammour , Asbjørn M. Drewes , Søren S. Olesen , Adam D. Farmer

Background

Chronic pancreatitis is a progressive inflammatory disease causing exocrine and endocrine dysfunction, frequently leading to severe, recurrent pain necessitating treatment with opioid analgesics. The impact of opioid use on chronic pancreatitis outcomes is poorly understood.

Objective

This study's objective was to evaluate the effect of opioid use on mortality and healthcare utilization in patients with chronic pancreatitis using real-world data.

Design

We conducted a retrospective cohort study using the TriNetX research network, identifying U.S. adults (≥18 years) with chronic pancreatitis from a 121-million-patient database (2005–2025). Patients were stratified into opioid users and non-users (controls) and propensity score matched (1:1) for demographics, body mass index, comorbidities, laboratory parameters, and treatments. Primary outcomes included acute-on-chronic pancreatitis, all-cause mortality, emergency department (ED) visits and hospitalizations. Outcomes were analyzed using Cox regression and time-stratified methods, reported as adjusted hazard ratios (aHR).

Results

Of 252,130 patients with chronic pancreatitis, 143,758 opioid users and 108,372 non-users were propensity-matched. Opioid users were older, with higher rates of alcohol use, pancreatitis risk factors, psychiatric disorders, substance use disorder, malnutrition, and analgesic use (all p < 0.0001). Opioids were associated with increased risks of acute-on-chronic pancreatitis (aHR = 1.45, 95 % CI: 1.36–1.54), all-cause mortality (aHR = 1.90, 95 % CI: 1.80–2.00), and ED visits (aHR = 1.28, 95 % CI: 1.22–1.36).

Conclusion

Opioid use in chronic pancreatitis is associated with higher morbidity, mortality, and healthcare utilization, likely reflecting underlying disease severity and complications. These patients represent a high-risk group warranting greater attention, and prospective studies are needed to clarify causal relationships and guide optimized pain management strategies.

背景：慢性胰腺炎是一种进行性炎性疾病，引起外分泌和内分泌功能障碍，经常导致严重的复发性疼痛，需要阿片类镇痛药治疗。阿片类药物使用对慢性胰腺炎结局的影响尚不清楚。目的：本研究的目的是利用真实世界数据评估阿片类药物使用对慢性胰腺炎患者死亡率和医疗保健利用的影响。设计：我们使用TriNetX研究网络进行了一项回顾性队列研究，从1.21亿患者数据库（2005-2025）中确定患有慢性胰腺炎的美国成年人（≥18岁）。将患者分为阿片类药物使用者和非使用者（对照组），并在人口统计学、体重指数、合并症、实验室参数和治疗方面进行倾向评分匹配（1:1）。主要结局包括急性慢性胰腺炎、全因死亡率、急诊科（ED）就诊和住院。结果采用Cox回归和时间分层方法进行分析，以校正风险比（aHR）报告。结果：252,130例慢性胰腺炎患者中，143,758例阿片类药物使用者和108,372例非阿片类药物使用者倾向匹配。阿片类药物使用者年龄较大，饮酒、胰腺炎危险因素、精神疾病、物质使用障碍、营养不良和止痛药使用的比例较高（均p < 0.0001）。阿片类药物与急性慢性胰腺炎（aHR = 1.45, 95% CI: 1.36-1.54）、全因死亡率（aHR = 1.90, 95% CI: 1.80-2.00）和急诊科就诊（aHR = 1.28, 95% CI: 1.22-1.36）的风险增加相关。结论：慢性胰腺炎中阿片类药物的使用与较高的发病率、死亡率和医疗保健利用率相关，可能反映了潜在疾病的严重程度和并发症。这些患者代表了一个需要更多关注的高风险群体，需要前瞻性研究来澄清因果关系并指导优化的疼痛管理策略。

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引用次数: 0

Patient-derived organoids from EUS-guided biopsies in pancreatic cancer: moving the needle for precision medicine 胰腺癌eus引导活检中患者来源的类器官：为精准医学移动针头。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.10.007

Kjetil Soreide MD PhD FRCSEdin FACS FEBS(hon)

引用次数: 0

ENDPAC model for defining a high-risk group for pancreatic cancer: Strengths, limitations and the way forward 定义胰腺癌高危人群的ENDPAC模型：优势、局限性和前进方向。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.11.007

Salman Khan , Suresh T. Chari

引用次数: 0

PanSCOPE - Pancreatic cancer signature COllection for prognostic evaluation PanSCOPE -用于预后评估的胰腺癌特征集合。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.11.001

Daisy J.A. Oketch, Matteo Giulietti, Francesco Piva

引用次数: 0

Endoscopic management of pancreaticopleural fistula and dysphagia pancreatica in children 儿童胰胸膜瘘和吞咽困难的内镜治疗。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.10.010

Aditi Kumar , Mansi Varshney , Saswati Kar , Yatheesh K. S , Ranjan Patel , Hemanta Nayak

引用次数: 0

Response to Letter to the Editor: “Bariatric surgery in pancreatic cancer: The double-edged sword of metabolic benefits and diagnostic challenges” 给编辑的信的回复：“胰腺癌减肥手术：代谢益处和诊断挑战的双刃剑”。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.11.010

Ahmed Dirweesh, Stuart K. Amateau

引用次数: 0

Bariatric surgery in pancreatic cancer: The double-edged sword of metabolic benefits and diagnostic challenges 胰腺癌的减肥手术：代谢益处和诊断挑战的双刃剑。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.09.013

Songhe Chen , Ying Zhang , Ye Chen

引用次数: 0

Performance of the EndPAC risk score for pancreatic cancer in new onset diabetes patients with missing data – a database study in the British population 数据缺失的新发糖尿病患者胰腺癌EndPAC风险评分的表现-一项针对英国人群的数据库研究

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.09.017

C. Mellenthin , C.R. Meier , S.S. Jick , L.H. Bühler , M. Adamina , C. Schneider

Introduction

New onset diabetes (NOD) can be a first symptom of pancreatic ductal adenocarcinoma (PDAC), but less than 1 % of NOD are caused by PDAC. The EndPAC score tests for PDAC risk in NOD patients. As necessary information is often missing, the aim of our study was to assess the performance of the score using methods that adjust for missing values so the score can be successfully applied to all patients.

Patients/methods

We retrospectively followed a British cohort with NOD in the Clinical Practice Research Datalink until they developed PDAC or were censored. We calculated the EndPAC score in all patients and assessed its performance with different imputation methods for missing values. We calibrated the score for the British population.

Results

We included 197′092 NOD patients. PDAC occurred in 901 cases within 3 years after the diabetes diagnosis. Complete information to calculate the EndPAC score was available for 9.2 % of the patients. In those, the AUC (Area under the Receiver Operating Curve) of the original EndPAC score was 0.76. Including all patients, using the imputation of the population median for missing values, the AUC was 0.69. It improved to 0.71 after calibration to the UK population.

Conclusions

Use of imputation methods enabled us to use the EndPAC score for all NOD patients. However, use of the EndPAC score alone is still not sufficient to select NOD patients for diagnostic workup, with or without complete information. Its use in combination with a biomarker might lead to a better risk-benefit ratio.

新发糖尿病（NOD）可能是胰腺导管腺癌（PDAC）的首发症状，但只有不到1%的NOD是由PDAC引起的。EndPAC评分检测NOD患者PDAC风险。由于经常缺少必要的信息，我们研究的目的是使用调整缺失值的方法来评估评分的性能，以便评分可以成功地应用于所有患者。患者/方法：我们在临床实践研究数据链中回顾性地跟踪了一组英国NOD患者，直到他们发展为PDAC或被审查。我们计算了所有患者的EndPAC评分，并使用不同的缺失值估算方法评估其表现。我们为英国人校准了分数。结果：我们纳入了197092例NOD患者。901例患者在糖尿病诊断后3年内发生PDAC。9.2%的患者可获得计算EndPAC评分的完整信息。其中，原始EndPAC评分的AUC （Receiver Operating Curve Area under Area）为0.76。包括所有患者，使用缺失值的人口中位数代入，AUC为0.69。对英国人口进行校正后，它提高到0.71。结论：使用归算方法使我们能够对所有NOD患者使用EndPAC评分。然而，单独使用EndPAC评分仍然不足以选择NOD患者进行诊断检查，无论是否有完整的信息。它与生物标志物结合使用可能会带来更好的风险收益比。

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引用次数: 0

A comprehensive population-based study and predictive survival model for undifferentiated carcinoma of the pancreas 一项全面的基于人群的研究和未分化胰腺癌的预测生存模型。

IF 2.7 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology

Pub Date : 2025-12-01 DOI: 10.1016/j.pan.2025.10.005

Wenhao Luo, Hao Chen, Yifan Fu, Jun Wang, Taiping Zhang

Background

Undifferentiated carcinoma of the pancreas (UCP) is a lesser-known type of pancreatic cancer with poor knowledge of epidemiology, clinical features, survival and prognosis outcomes. This article aims to investigate several prognostic factors influencing survival in patients with UCP, with the goal of constructing a nomogram predictive model, aiding clinicians in risk stratification and personalized treatment decision-making.

Methods

UCP patient data between 2000 and 2019 was extracted from the Surveillance Epidemiology and End Results (SEER) database. Univariate and multivariable Cox regression analysis were conducted to present prognostic factors for overall survival (OS) and cancer-specific survival (CSS) of UCP patients. We applied Kaplan-Meier curves to evaluate the OS and CSS for each feature or therapeutic method. Moreover, a nomogram predictive model was completed to demonstrate the prognosis of UCP patients.

Results

The study comprised 177 participants specifically selected as UCP patients. Kaplan-Meier curves illustrated that UCP patients who were female, underwent primary tumor resection (PTR), received chemotherapy, had tumor sizes equal to or less than 5 cm, and lacked liver metastasis or exhibited histology of osteoclast-like giant cells experienced significantly improved OS and cancer-specific survival CSS compared to their male counterparts, those who did not undergo PTR or did not receive chemotherapy, had tumor sizes larger than 5 cm, with liver metastasis, or histology lacking osteoclast-like giant cells. Multivariable Cox regression analysis revealed that histological type, PTR, chemotherapy, tumor size, and the presence of liver metastasis independently influenced both OS and CSS. The predictive nomogram model demonstrated acceptable predictive performance.

Conclusion

The nomogram model, which incorporates histological type, PTR, chemotherapy, tumor size, and liver metastasis, provides valuable guidance and insights for both clinicians and UCP patients.

背景：胰腺未分化癌（Undifferentiated carcinoma of the pancreatic， UCP）是一种鲜为人知的胰腺癌类型，对其流行病学、临床特征、生存和预后结果的了解较少。本文旨在探讨影响UCP患者生存的几个预后因素，构建nomogram预测模型，帮助临床医生进行风险分层和个性化治疗决策。方法：从监测流行病学和最终结果（SEER）数据库中提取2000年至2019年的UCP患者数据。采用单因素和多因素Cox回归分析，探讨影响UCP患者总生存期（OS）和肿瘤特异性生存期（CSS）的预后因素。我们应用Kaplan-Meier曲线来评估每个特征或治疗方法的OS和CSS。此外，我们还建立了一个nomogram预测模型来预测UCP患者的预后。结果：该研究包括177名被特别选择为UCP患者的参与者。Kaplan-Meier曲线显示，接受过原发肿瘤切除术（PTR）、化疗、肿瘤大小等于或小于5cm、无肝转移或具有破骨细胞样巨细胞组织学特征的女性UCP患者的OS和癌症特异性生存CSS明显优于男性患者，未接受PTR或化疗、肿瘤大小大于5cm且有肝转移的女性UCP患者。或者组织学上缺乏破骨细胞样巨细胞。多变量Cox回归分析显示，组织学类型、PTR、化疗、肿瘤大小和是否存在肝转移是影响OS和CSS的独立因素。预测模态图模型显示出可接受的预测性能。结论：结合组织类型、PTR、化疗、肿瘤大小和肝转移情况的nomogram模型，对临床医生和UCP患者具有重要的指导意义。

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