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Chemokine expression profiles predict overall survival and immune infiltration in patients with pancreatic adenocarcinoma 趋化因子表达谱预测胰腺腺癌患者的总生存期和免疫浸润情况
Pub Date : 2023-12-14 DOI: 10.1097/jp9.0000000000000164
Xinyu Peng, Shengnan Lv, Yuxiang Fan, Jian Zhang, Huan Liu, Yan Liu, Feng Wei
Human chemokines are linked to tumour survival and perform a critical role in the pancreatic adenocarcinoma (PAAD) microenvironment. It is not known if abnormal expression of chemokines contributes to the prognostic features of PAAD. Therefore, this study explored gene alteration profiles of chemokines in PAAD and constructed a chemokine family-based prognosis signature (CPS). RNA-Seq and clinical data from 176 PAAD patients were obtained from The Cancer Genome Atlas (TCGA) database. Bioinformatics analysis tools were used to assess the expression and prognostic value of chemokines. A profile affecting patient survival was obtained using unsupervised hierarchical clustering and a prognostic model of chemokine-related genes was constructed to explore the immune landscape. 29 chemokines were highly expressed in PAAD tissues, and 10 were significantly associated with poor prognosis. Hierarchical clustering resulted in the classification of the PAAD cohort into 2 clusters. High levels of chemokines indicated a worse prognosis (for HR=5.4, CI=1.7-17, P=0.004). A CPS containing 7 hub genes was constructed using the least absolute shrinkage and selection operator (LASSO) and stepwise multivariable Cox analysis. This signature separated PAAD patients into high and low risk groups and was confirmed as an independent prognostic factor. An ESTIMATE score and TIMER2.0 analysis further reflected the immune profile of PAAD, which had a higher percentage of localized immune cell infiltration with predominantly suppressive cells. This is the first chemokine family-based model for predicting outcomes in PAAD patients. Our work highlights the need to understand the mechanism of chemokine contributions to PAAD occurrence.
人类趋化因子与肿瘤存活有关,并在胰腺腺癌(PAAD)微环境中发挥关键作用。目前尚不清楚趋化因子的异常表达是否与 PAAD 的预后特征有关。因此,本研究探讨了趋化因子在 PAAD 中的基因改变谱,并构建了基于趋化因子家族的预后特征(CPS)。 研究人员从癌症基因组图谱(TCGA)数据库中获取了176例PAAD患者的RNA-Seq和临床数据。生物信息学分析工具用于评估趋化因子的表达和预后价值。利用无监督分层聚类获得了影响患者生存的概况,并构建了趋化因子相关基因的预后模型,以探索免疫格局。 29种趋化因子在PAAD组织中高表达,其中10种与预后不良显著相关。通过层次聚类,将 PAAD 患者分为两组。高水平的趋化因子表明预后较差(HR=5.4,CI=1.7-17,P=0.004)。使用最小绝对缩小和选择算子(LASSO)和逐步多变量 Cox 分析法构建了包含 7 个枢纽基因的 CPS。该特征将 PAAD 患者分为高危和低危两组,并被证实是一个独立的预后因素。ESTIMATE评分和TIMER2.0分析进一步反映了PAAD的免疫特征,即局部免疫细胞浸润的比例较高,以抑制性细胞为主。 这是首个基于趋化因子家族的 PAAD 患者预后预测模型。我们的工作强调了了解趋化因子对 PAAD 发生的作用机制的必要性。
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引用次数: 0
Non-alcoholic Fatty Pancreas Disease (NAFPD): An updated review 非酒精性脂肪性胰腺疾病(NAFPD):最新综述
Pub Date : 2023-12-12 DOI: 10.1097/jp9.0000000000000157
C. Pang, Peng Dong, Jian Yang, Zhiyao Fan, Zhiqiang Cheng, Hanxiang Zhan
Ectopic accumulation of fat can cause a variety of metabolic diseases, and the emerging non-alcoholic fatty pancreas disease (NAFPD) is increasingly being recognized by clinicians as a cause for concern. NAFPD is a disease caused by abnormal accumulation of adipose tissue in the pancreas, which is related to obesity. The main feature of NAFPD is death of acinar cells, which are then replaced by adipose cells. However, the underlying molecular mechanisms have not been fully explored. Obesity, aging, and metabolic syndrome are independent risk factors for the occurrence and development of NAFPD. Studies have shown that NAFPD leads to insulin resistance and pancreatic dysfunction, increases the risk of diabetes, worsens the severity of pancreatitis, and is significantly correlated with pancreatic cancer and postoperative pancreatic fistula. There is no standard treatment for NAFPD; exercise, a balanced diet, and lifestyle can help reduce pancreatic fat; however, other treatment modalities such as drugs and bariatric surgery are still being explored. The specific pathological mechanism of NAFPD remains unclear, and its potential association with various clinical diseases requires further study. This review summarizes the etiology, diagnosis, clinical consequences, and potential therapeutic strategies of NAFPD.
异位脂肪堆积可导致多种代谢性疾病,而新出现的非酒精性脂肪性胰腺疾病(NAFPD)正日益被临床医生视为一个值得关注的问题。非酒精性脂肪性胰腺疾病是一种由胰腺脂肪组织异常堆积引起的疾病,与肥胖有关。NAFPD 的主要特征是胰腺尖细胞死亡,然后由脂肪细胞取代。然而,其潜在的分子机制尚未得到充分探究。肥胖、衰老和代谢综合征是发生和发展 NAFPD 的独立风险因素。研究表明,NAFPD 会导致胰岛素抵抗和胰腺功能障碍,增加患糖尿病的风险,加重胰腺炎的严重程度,并与胰腺癌和术后胰瘘密切相关。目前尚无治疗 NAFPD 的标准疗法;运动、均衡饮食和生活方式有助于减少胰腺脂肪;然而,药物和减肥手术等其他治疗方式仍在探索之中。NAFPD的具体病理机制尚不清楚,其与各种临床疾病的潜在关联也有待进一步研究。本综述总结了 NAFPD 的病因、诊断、临床后果和潜在治疗策略。
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引用次数: 0
Synergistic effects of resveratrol with gemcitabine in pancreatic cancer chemotherapy by inhibiting the c-Met/PARP1 axis 白藜芦醇与吉西他滨通过抑制 c-Met/PARP1 轴在胰腺癌化疗中产生协同效应
Pub Date : 2023-12-12 DOI: 10.1097/jp9.0000000000000160
Shuai Wu, Jiaqiang Ren, Weikun Qian, M. Gong, Jie Li, Tao Qin, Simei Zhang, Wunai Zhang, Hao Sun, Zheng Wu, Zheng Wang, Qingyong Ma, Wanxing Duan
Pancreatic cancer is a highly malignant tumor of the digestive tract with a dismal prognosis. A key challenge of pancreatic cancer is its resistance to chemotherapy. The c-Met/PARP1 axis plays an important role in the therapeutic resistance of breast cancer and hepatocellular carcinoma. Therefore, this study aims to explore potential therapeutic targets for improving chemotherapy for pancreatic cancer and the underlying mechanisms. Gemcitabine-resistant pancreatic cancer cell lines were constructed by our laboratory using a continuous low-concentration gemcitabine induction method. The proliferation and apoptosis of combination therapy were examined using flow cytometry and comet assay. Synergistic effects of two drugs were determined by Chou-Talalay's combination index (CI). The interactions between proteins were predicted using the AutoDock model and detected through Coimmunoprecipitation assays. The combination of resveratrol and gemcitabine inhibited proliferation and promoted apoptosis of pancreatic cancer cells. We found that c-Met and PARP1 were highly expressed in gemcitabine-resistant pancreatic cancer cells. However, resveratrol inhibited their expression and improved the effectiveness of gemcitabine-induced DNA damage. In addition, our data demonstrated that resveratrol and gemcitabine had synergistic effects (CI < 1). Furthermore, the protein interactions between c-Met and PARP1 were attenuated after the early stage of resveratrol intervention. Using AutoDock models, we predicted the potential binding sites where resveratrol could impact the protein interaction between c-Met (tyrosine kinase domain) and PARP1 (CAT domain). Our results suggested that the synergistic effects of resveratrol with gemcitabine depend on the c-Met/PAPR1 axis. Using resveratrol as a combined chemotherapy agent may have clinical benefits for patients with refractory pancreatic cancer.
胰腺癌是一种预后不良的高度恶性消化道肿瘤。胰腺癌的一个主要挑战是对化疗的耐药性。c-Met/PARP1 轴在乳腺癌和肝细胞癌的耐药性中起着重要作用。因此,本研究旨在探索改善胰腺癌化疗的潜在治疗靶点及其内在机制。 本实验室采用连续低浓度吉西他滨诱导方法构建了吉西他滨耐药胰腺癌细胞系。采用流式细胞术和彗星试验检测了联合疗法的增殖和凋亡情况。通过 Chou-Talalay 联合指数(CI)确定两种药物的协同效应。使用 AutoDock 模型预测了蛋白质之间的相互作用,并通过免疫共沉淀试验进行了检测。 白藜芦醇和吉西他滨的联合用药抑制了胰腺癌细胞的增殖并促进了其凋亡。我们发现,c-Met和PARP1在吉西他滨耐药的胰腺癌细胞中高表达。然而,白藜芦醇抑制了它们的表达,并改善了吉西他滨诱导的DNA损伤的有效性。此外,我们的数据表明,白藜芦醇和吉西他滨具有协同作用(CI < 1)。此外,在白藜芦醇干预的早期阶段,c-Met 和 PARP1 之间的蛋白质相互作用有所减弱。我们利用AutoDock模型预测了白藜芦醇可能影响c-Met(酪氨酸激酶结构域)和PARP1(CAT结构域)之间蛋白质相互作用的潜在结合位点。 我们的结果表明,白藜芦醇与吉西他滨的协同作用取决于 c-Met/PAPR1 轴。使用白藜芦醇作为联合化疗药物可能会对难治性胰腺癌患者产生临床疗效。
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引用次数: 0
Prognostic value of para-aortic lymph node metastasis and dissection for pancreatic head ductal adenocarcinoma: a retrospective cohort study 胰头导管腺癌主动脉旁淋巴结转移和切除的预后价值:一项回顾性队列研究
Pub Date : 2023-12-12 DOI: 10.1097/jp9.0000000000000159
Yecheng Xu, Feng Yang, Deliang Fu
Para-aortic lymph node (PALN) metastasis affects approximately 20% of patients with pancreatic ductal adenocarcinoma (PDAC). However, the prognostic significance of PALN metastases and dissection remain unclear. This retrospective cohort study included patients with PDAC of the pancreatic head who had undergone pancreaticoduodenectomy (PD) at our center between January 2017 and December 2020. A total of 234 patients were included in the study. PALN dissection improved the median overall survival (OS) without statistical significance (24.1 vs. 18.1 months, p = 0.156). The median recurrence-free survival was significantly longer in the PALN-dissection group than the group without PALN-dissection (18.2 vs. 11.6 months, p = 0.040). Conversely, there were no significant differences in the long-term prognosis between the PALN-positive and -negative subgroups in the PALN-dissection group. Multivariate analysis showed that PALN metastasis was not an independent risk factor for OS (hazard ratio: 0.831, 95% confidence interval: 0.538-1.285, p = 0.406). For patients with pancreatic head ductal adenocarcinoma, PD with PALN-dissection may achieve survival prolongation and bridge the survival gap between patients with and without PALN metastasis without significantly increasing the perioperative risks.
约 20% 的胰腺导管腺癌(PDAC)患者会出现主动脉旁淋巴结(PALN)转移。然而,PALN转移和切除的预后意义仍不明确。 这项回顾性队列研究纳入了2017年1月至2020年12月期间在本中心接受胰十二指肠切除术(PD)的胰头PDAC患者。 研究共纳入 234 例患者。PALN切除术提高了中位总生存期(OS),但无统计学意义(24.1个月 vs. 18.1个月,P = 0.156)。PALN切除组的中位无复发生存期明显长于未进行PALN切除组(18.2个月对11.6个月,p = 0.040)。相反,在PALN切除组中,PALN阳性亚组和阴性亚组的长期预后无明显差异。多变量分析显示,PALN转移不是OS的独立危险因素(危险比:0.831,95%置信区间:0.538-1.285,P = 0.406)。 对于胰头导管腺癌患者,PD联合PALN切除术可延长生存期,缩小有PALN转移和无PALN转移患者之间的生存差距,且不会显著增加围手术期风险。
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引用次数: 0
Recent Advances in the Understanding and Management of Chronic Pancreatitis Pain 了解和处理慢性胰腺炎疼痛的最新进展
Pub Date : 2023-12-12 DOI: 10.1097/jp9.0000000000000163
Jessica Walker, Olivia L. Babyok, Jami L. Saloman, Anna Evans Phillips
Abdominal pain is the most common symptom of chronic pancreatitis (CP), and is often debilitating for patients and very difficult to treat. To date, there exists no cure for the disease. Treatment strategies focus on symptom management and on mitigation of disease progression by reducing toxin exposure and avoiding recurrent inflammatory events. Traditional treatment protocols start with medical management followed by consideration of procedural or surgical intervention on selected patients with severe and persistent pain. The incorporation of adjuvant therapies to treat comorbidities including psychiatric disorders, exocrine pancreatic insufficiency, mineral bone disease, frailty, and malnutrition, are in their early stages. Recent clinical studies and animal models have been designed to improve investigation into the pathophysiology of CP pain, as well as to improve pain management. Despite the array of tools available, many therapeutic options for the management of CP pain provide incomplete relief. There still remains much to discover about the neural regulation of pancreas-related pain. In this review we will discuss research from the last five years that has provided new insights into novel methods of pain phenotyping and the pathophysiology of CP pain. These discoveries have led to improvements in patient selection for optimization of outcomes for both medical and procedural management, and identification of potential future therapies.
腹痛是慢性胰腺炎(CP)最常见的症状,通常会让患者感到虚弱无力,而且非常难以治疗。迄今为止,这种疾病还没有治愈的方法。治疗策略侧重于症状控制,以及通过减少毒素暴露和避免炎症复发来缓解疾病进展。传统的治疗方案首先是药物治疗,然后再考虑对部分有严重和持续性疼痛的患者进行手术或外科干预。为治疗合并症(包括精神障碍、胰腺外分泌功能不全、矿物质骨病、虚弱和营养不良)而采用的辅助疗法尚处于早期阶段。近期的临床研究和动物模型旨在改进对 CP 疼痛病理生理学的研究,并改善疼痛管理。尽管有一系列可用的工具,但许多治疗 CP 疼痛的方案并不能完全缓解疼痛。关于胰腺相关疼痛的神经调控,仍有许多研究有待发现。在本综述中,我们将讨论过去五年的研究,这些研究为疼痛表型的新方法和 CP 疼痛的病理生理学提供了新的见解。这些发现改进了患者的选择,优化了医疗和程序管理的结果,并确定了未来潜在的疗法。
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引用次数: 0
Advances in Hydrogel Materials Applied to Pancreatic-Related Diseases 应用于胰腺相关疾病的水凝胶材料研究进展
Pub Date : 2023-12-12 DOI: 10.1097/jp9.0000000000000158
Yuan Zhou, M. Pan, R. Lin, Heguang Huang
The pancreas is a glandular organ that maintains internal homeostasis through its endocrine and exocrine functions. These functions are vital for overall well-being. However, environmental and lifestyle changes have led to an increasing incidence of pancreatic diseases, including pancreatic cancer, pancreatitis, and pancreatic neuroendocrine tumors. These conditions profoundly impact the health and quality of life of affected individuals. The existing diagnostic and treatment approaches for pancreatic diseases exhibit limitations and shortcomings, necessitating exploring novel strategies. In recent years, advancements in medicine and bioengineering have fostered multidisciplinary and interdisciplinary innovations, introducing fresh avenues for diagnosing and treating pancreatic diseases. Hydrogels, emerging as a biomaterial, represent highly hydrated cross-linked hydrophilic polymer networks. Their exceptional biodegradability and biocompatibility have rendered them instrumental in various medical applications. Hydrogels, with their macromolecular porous structures, are efficient carriers for drug delivery and controlled release. Hydrogel materials have garnered substantial attention for their unique properties and diverse applications in the context of pancreatic diseases. This article aims to provide an overview of the current limitations in diagnosing and treating pancreatic diseases while highlighting the latest trends and advancements in developing hydrogel carrier materials tailored for these conditions, primarily focusing on strategies for pancreatitis, pancreatic cancer, and pancreatic neuroendocrine tumors. The manuscript endeavors to give researchers and clinicians a comprehensive grasp of this field, offering valuable insights into prospective research directions and emerging trends.
胰腺是一个腺体器官,通过其内分泌和外分泌功能维持体内平衡。这些功能对整体健康至关重要。然而,环境和生活方式的改变导致胰腺疾病的发病率不断上升,包括胰腺癌、胰腺炎和胰腺神经内分泌肿瘤。这些疾病严重影响了患者的健康和生活质量。现有的胰腺疾病诊断和治疗方法存在局限性和不足,因此有必要探索新的策略。近年来,医学和生物工程的发展促进了多学科和跨学科创新,为诊断和治疗胰腺疾病提供了新途径。水凝胶作为一种新兴的生物材料,代表了高度水合交联的亲水性聚合物网络。水凝胶具有优异的生物可降解性和生物相容性,因此在各种医疗应用中发挥着重要作用。水凝胶具有大分子多孔结构,是药物输送和控制释放的高效载体。水凝胶材料因其独特的性能和在胰腺疾病方面的多种应用而备受关注。本文旨在概述目前诊断和治疗胰腺疾病的局限性,同时重点介绍针对这些疾病开发水凝胶载体材料的最新趋势和进展,主要侧重于胰腺炎、胰腺癌和胰腺神经内分泌肿瘤的治疗策略。该手稿力求让研究人员和临床医生全面掌握这一领域,为前瞻性研究方向和新兴趋势提供有价值的见解。
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引用次数: 0
Modern radiological assessment after neoadjuvant therapy in Pancreatic cancer. An overview. 胰腺癌新辅助治疗后的现代放射学评估。综述。
Pub Date : 2023-12-11 DOI: 10.1097/jp9.0000000000000156
Marcus Steingrüber, Yousef Moulla, Timm Denecke, Hans-Jonas Meyer
This narrative review provides an overview about the current radiological assessment of pancreatic cancer after neoadjuvant treatment. The current literature was searched for evidence of the different radiological quantitative imaging modalities to stage pancreatic cancer. An overview is given in a narrative method. The quantitative imaging modalities comprise CT perfusion, dual energy CT, MRI and FDG-PET/CT. Radiomics analysis can be used to further characterize the tumors and to reflect the complex tumor microstructure before and after neoadjuvant treatment. Exact extension of the tumor and infiltration of the surrounding tissue is of utter importance to decide, whether the neoadjuvant treatment leads to a resectability or not. There is increasing evidence of the importance of quantitative imaging modalities to assess treatment response in patients with pancreatic cancer after neoadjuvant treatment. Prospective studies employing these modalities are needed to further investigate the benefit for the patients.
本文综述了胰腺癌新辅助治疗后的影像学评价。目前的文献检索了不同的放射定量成像方式分期胰腺癌的证据。以叙述的方式给出概述。定量成像方式包括CT灌注、双能CT、MRI和FDG-PET/CT。放射组学分析可以进一步表征肿瘤,反映新辅助治疗前后复杂的肿瘤微观结构。肿瘤的确切扩展和周围组织的浸润是决定新辅助治疗是否可切除的重要因素。越来越多的证据表明,定量影像学对评估胰腺癌患者新辅助治疗后治疗反应的重要性。需要采用这些模式的前瞻性研究来进一步调查患者的获益。
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引用次数: 0
Hypertriglyceridemia and acute pancreatitis: clinical and basic research-a narrative review 高甘油三酯血症与急性胰腺炎:临床和基础研究综述
Pub Date : 2023-11-15 DOI: 10.1097/jp9.0000000000000153
Lin Gao, Weiqin Li
Hypertriglyceridemia (HTG) is the third most common cause for acute pancreatitis (AP), and the incidence of hypertriglyceridemia induced acute pancreatitis (HTG-AP) is rising worldwide as a result of changes in lifestyle and dietary habits. In China, HTG accounts for 10-20% the causes of AP, even becoming the second leading cause of AP. The presentation and diagnosis of HTG-AP is similar to that of AP from other causes, however, the complication rates and severe AP are significantly higher in patients with HTG-AP than in patients with other etiologies. Regarding the management for HTG-AP, the initial management is similar to that of AP from other causes and mainly includes fluid resuscitation, pain control and nutritional support. In addition to supportive care, it is necessary to take appropriate measures to decrease serum TG levels, in order to alleviate the progression of AP and prevent recurrence. This review aims to summarize existing clinical and basic research evidence of HTG-AP, and seeks to highlight the epidemiology, definition, pathogenesis, clinical course, diagnosis, management, prevention of recurrence and specific clinical scenarios, such as HTG-AP during pregnancy, HTG-AP with diabetic ketoacidosis.
高甘油三酯血症(HTG)是急性胰腺炎(AP)的第三大常见原因,由于生活方式和饮食习惯的改变,高甘油三酯血症诱发的急性胰腺炎(HTG-AP)的发病率在全球范围内呈上升趋势。在中国,HTG占AP病因的10-20%,甚至成为AP的第二大病因。HTG-AP的表现和诊断与其他病因的AP相似,但HTG-AP患者的并发症发生率和严重程度明显高于其他病因的患者。HTG-AP的初始处理与其他原因AP类似,主要包括液体复苏、疼痛控制和营养支持。在支持治疗的基础上,采取适当措施降低血清TG水平,以缓解AP的进展,防止复发。本文旨在总结HTG-AP的现有临床和基础研究证据,重点介绍HTG-AP的流行病学、定义、发病机制、临床病程、诊断、管理、复发预防及具体临床情况,如妊娠期HTG-AP、HTG-AP合并糖尿病酮症酸中毒等。
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引用次数: 0
Mass Spectrometry-based Proteomics Technology in Pancreatic Cancer Research 基于质谱的蛋白质组学技术在胰腺癌研究中的应用
Pub Date : 2023-11-14 DOI: 10.1097/jp9.0000000000000152
Xue Sun, Siyuan Wang, Catherine C.L. Wong
Pancreatic ductal adenocarcinoma (PDAC) has become a significant health concern with increasing incidence and mortality rates over the past few decades. Researchers have turned their attention to cutting-edge mass spectrometry (MS) technology due to its high-throughput and accurate detection capacity, which plays a vital role in understanding the mechanisms and discovering biomarkers for pancreatic diseases. In this review, we comprehensively investigate various methodologies of quantitative and qualitative proteomics MS technologies, alongside bioinformatical platforms employed in pancreatic cancer research. The integration of these optimized approaches provides novel insights into the molecular mechanisms underlying tumorigenesis and disease progression, ultimately facilitating the discovery of potential diagnostic, prognostic biomarkers, and therapeutic targets. The robust MS-based strategy shows promise in paving the way for early diagnosis and personalized medicine for pancreatic cancer patients.
在过去的几十年里,胰腺导管腺癌(PDAC)的发病率和死亡率不断上升,已成为一个重要的健康问题。由于质谱技术的高通量和准确的检测能力,研究人员将注意力转向了尖端的质谱技术,这在了解胰腺疾病的机制和发现生物标志物方面起着至关重要的作用。在这篇综述中,我们全面研究了定量和定性蛋白质组学质谱技术的各种方法,以及用于胰腺癌研究的生物信息平台。这些优化方法的整合为肿瘤发生和疾病进展的分子机制提供了新的见解,最终促进了潜在诊断、预后生物标志物和治疗靶点的发现。强有力的基于ms的策略为胰腺癌患者的早期诊断和个性化治疗铺平了道路。
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引用次数: 0
Retrospective review paper identification racial disparities in patients with pancreatic cancer 回顾性研究论文确定胰腺癌患者的种族差异
Pub Date : 2023-11-02 DOI: 10.1097/jp9.0000000000000151
Chibueze Onyemkpa, Danielle Dougherty, Sajjaad Samat, Tolutope Oyasiji, Michael McLeod
Background: Pancreatic cancer is the fourth leading cause of cancer death in the US. There has been postulates of racial disparities. Based on this, we primarily examined the presence of race, for the diagnosis and treatment of pancreatic cancer. Methods: A retrospective review was conducted on patients with pancreatic cancers using the Surveillance Epidemiology, and End Results - Medicare registry. Univariate and multivariate analyses were performed. Overall Survival analysis was done using the Kaplan-Meier curve. Comparison of survival curves was done using the log rank test. Cox proportional hazards regression model was used to determine independent predictors of survival. Other areas focused on were Time interval from diagnosis to treatment”, “Predictors of Surgery of the primary site”, “Predictors for recommending surgery of the primary site”, “Predictors for oncologic resection”, “Predictors of performance and refusal of surgery of primary site if recommended”, and “Predictors for any other therapy (all therapies excluding surgery). Results: A total of 52,951 patients were identified from the database. 24, 523 were males and 26, 715 were females. 81.9% were Caucasian, 10.9% were black and 7.2% were other races. There was approximately equal distribution of the different stages between both genders. 10.2% of the females were diagnosed at stage I, 28.9%, 9.3% and 51.6% at stages I, Ill and IV respectively compared to males with 8.4% 28.3%, 9.2% and 54.1% for stages I, II, Ill and IV respectively. 9.5% of the black patients were diagnosed at stage I, 24.2% at stage II, 10.1% at stage III and 56.2% at stage IV. A similar distribution was noted in the other races. Black patients had worse overall survival when compared to Caucasians (p=0.004) and other races (p = 0.001). Conclusion: Compared to Caucasian patients, black patients with pancreatic cancer had worse overall survival.
背景:胰腺癌是美国癌症死亡的第四大原因。一直存在种族不平等的假设。在此基础上,我们主要研究了种族的存在,用于胰腺癌的诊断和治疗。方法:使用监测流行病学和最终结果-医疗保险登记对胰腺癌患者进行回顾性评价。进行单因素和多因素分析。总体生存分析采用Kaplan-Meier曲线。生存曲线比较采用对数秩检验。采用Cox比例风险回归模型确定独立的生存预测因子。其他领域的重点是“从诊断到治疗的时间间隔”,“原发部位手术的预测因素”,“推荐原发部位手术的预测因素”,“肿瘤切除的预测因素”,“推荐原发部位手术的表现和拒绝手术的预测因素”,以及“任何其他治疗(除手术外的所有治疗)的预测因素”。结果:从数据库中共识别出52,951例患者。男性24,523人,女性26,715人。81.9%为白种人,10.9%为黑人,7.2%为其他种族。不同阶段在两性之间的分布大致相等。女性诊断为ⅰ期的比例为10.2%,ⅰ期、ⅱ期和ⅳ期分别为28.9%、9.3%和51.6%,男性诊断为ⅰ期、ⅱ期、ⅰ期和ⅳ期的比例分别为8.4%、28.3%、9.2%和54.1%。9.5%的黑人患者被诊断为I期,24.2%为II期,10.1%为III期,56.2%为IV期。在其他种族中也有类似的分布。与白种人(p=0.004)和其他种族(p= 0.001)相比,黑人患者的总生存率更差。结论:与白种人患者相比,黑人胰腺癌患者的总生存期较差。
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引用次数: 0
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Journal of pancreatology
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