Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Pancreatic Neoplasms: HELP
Articles from Fudan University
Based on 443 articles published since 2008
||||

These are the 443 published articles about Pancreatic Neoplasms that originated from Fudan University during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18
1 Editorial Time to think: Selecting patients who may benefit from synchronous resection of primary pancreatic cancer and liver metastases. 2018

Shi, Si / Yu, Xian-Jun. ·Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China. ·World J Gastroenterol · Pubmed #30197474.

ABSTRACT: Pancreatic cancer remains a lethal disease and is associated with poor prognosis, particularly for patients with distant metastasis at diagnosis. Recently, Oweira reported a retrospective study that included 13233 metastatic pancreatic cancer patients from the Surveillance, Epidemiology and End Results database. They demonstrated that pancreatic cancer patients with isolated liver metastases had worse outcomes than patients with isolated lung metastases or distant nodal metastases. At present, the standard treatment for metastatic pancreatic cancer is chemotherapy. However, improvement in the safety of pancreatic surgery has led to the consideration of more aggressive surgical approaches. Schneitler reported two cases of hepatic metastatic pancreatic cancer in which negative margin (R0) resection and long survival were achieved after effective preoperative chemotherapy. In general, these two studies indicate that although pancreatic cancer patients with liver metastasis have a poor prognosis, surgical approaches may prolong survival for a few of these patients. A strategy to select hepatic metastatic pancreatic cancer patients who may benefit from surgical intervention is urgently needed.

2 Editorial Current status and progress of pancreatic cancer in China. 2015

Lin, Quan-Jun / Yang, Feng / Jin, Chen / Fu, De-Liang. ·Quan-Jun Lin, Feng Yang, Chen Jin, De-Liang Fu, Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China. ·World J Gastroenterol · Pubmed #26185370.

ABSTRACT: Cancer is currently one of the most important public health problems in the world. Pancreatic cancer is a fatal disease with poor prognosis. As in most other countries, the health burden of pancreatic cancer in China is increasing, with annual mortality rates almost equal to incidence rates. The increasing trend of pancreatic cancer incidence is more significant in the rural areas than in the urban areas. Annual diagnoses and deaths of pancreatic cancer in China are now beyond the number of cases in the United States. GLOBOCAN 2012 estimates that cases in China account for 19.45% (65727/337872) of all newly diagnosed pancreatic cancer and 19.27% (63662/330391) of all deaths from pancreatic cancer worldwide. The population's growing socioeconomic status contributes to the rapid increase of China's proportional contribution to global rates. Here, we present an overview of control programs for pancreatic cancer in China focusing on prevention, early diagnosis and treatment. In addition, we describe key epidemiological, demographic, and socioeconomic differences between China and developed countries. Facts including no nationwide screening program for pancreatic cancer, delay in early detection resulting in a late stage at presentation, lack of awareness of pancreatic cancer in the Chinese population, and low investment compared with other cancer types by government have led to backwardness in China's pancreatic cancer diagnosis and treatment. Finally, we suggest measures to improve health outcomes of pancreatic cancer patients in China.

3 Review Role of angiogenesis in pancreatic cancer biology and therapy. 2018

Zhang, Zheng / Ji, Shunrong / Zhang, Bo / Liu, Jiang / Qin, Yi / Xu, Jin / Yu, Xianjun. ·Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Pancreatic Cancer Institute, Fudan University, Shanghai, China. · Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Pancreatic Cancer Institute, Fudan University, Shanghai, China. Electronic address: xujin@fudanpci.org. · Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Pancreatic Cancer Institute, Fudan University, Shanghai, China. Electronic address: yuxianjun@fudanpci.org. ·Biomed Pharmacother · Pubmed #30372814.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, and there is a close parallel between disease mortality and incidence. Malignancy is often diagnosed at an advanced stage due to the lack of early symptoms. For the majority of advanced or metastatic pancreatic cancer patients, therapeutic options are limited. Although several new chemotherapeutic regimens have been developed, the overall response rate remains low. Invasive tumour growth and distant metastasis require angiogenesis, a hallmark of cancer, and angiogenic inhibition is a valuable option for cancer therapy. Some anti-angiogenic drugs have been developed for cancer treatment. This review will focus on the role of angiogenesis and anti-angiogenic treatment strategies as well as combination therapy in pancreatic cancer. Translational information from recent molecular biology and animal studies is also summarized. Finally, the dosing schedule for bevacizumab with other chemotherapeutic protocols for pancreatic cancer treatment is discussed.

4 Review The clinicopathological and prognostic significance of PD-L1 expression in pancreatic cancer: A meta-analysis. 2018

Gao, He-Li / Liu, Liang / Qi, Zi-Hao / Xu, Hua-Xiang / Wang, Wen-Quan / Wu, Chun-Tao / Zhang, Shi-Rong / Xu, Jin-Zhi / Ni, Quan-Xing / Yu, Xian-Jun. ·Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Pancreatic Cancer Institute, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. ·Hepatobiliary Pancreat Dis Int · Pubmed #29576277.

ABSTRACT: BACKGROUND: Immunotherapy has shown promise against solid tumors. However, the clinical significance of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) in pancreatic ductal adenocarcinoma (PDAC) remains unclear. This meta-analysis aimed to analyze the prognostic effect of PD-L1 in PDAC. DATA SOURCES: Electronic search of the PubMed, Cochrane Library and Web of Science was performed until December 2016. Through database searches, we identified articles describing the relationship between PD-L1 status and PDAC patient prognosis. Meta-analysis was performed to investigate the relationship between PD-1 and overall survival (OS). RESULTS: Nine studies with 989 PDAC patients were included for PD-L1 expression analysis. And 5 studies with 688 PDAC patients were included in the prognostic analysis. The PD-L1 positive rate measured by immunohistochemistry (IHC) was higher than that measured by polymerase chain reaction (PCR) (P < 0.001). PDAC patients with high expression levels of PD-L1 had significantly reduced OS (HR = 2.34; 95% CI: 1.78-3.08). Subgroup analysis showed that the prognostic effect of PD-L1 levels was similar between the IHC and PCR methods. The PD-L1 positive rate was associated with PDAC T stages; the PD-L1 positive rate in the T3-4 group was higher than that in the T1-2 group (OR = 0.37; P = 0.001). CONCLUSIONS: High PD-L1 expression levels predicted a poor prognosis in PDAC patients. Thus, PD-L1 status helps determine treatment in PDAC patients.

5 Review Do anti-stroma therapies improve extrinsic resistance to increase the efficacy of gemcitabine in pancreatic cancer? 2018

Liang, Chen / Shi, Si / Meng, Qingcai / Liang, Dingkong / Ji, Shunrong / Zhang, Bo / Qin, Yi / Xu, Jin / Ni, Quanxing / Yu, Xianjun. ·Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, People's Republic of China. · Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. · Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China. · Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, People's Republic of China. yuxianjun@fudanpci.org. · Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. yuxianjun@fudanpci.org. · Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, People's Republic of China. yuxianjun@fudanpci.org. ·Cell Mol Life Sci · Pubmed #28993833.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is among the most devastating human malignancies, with approximately 20-30% of PDAC patients receiving the surgical resection with curative intent. Although many studies have focused on finding ideal "drug chaperones" that facilitate and/or potentiate the effects of gemcitabine (GEM) in pancreatic cancer, a significant benefit in overall survival could not be demonstrated for any of these combination therapies in PDAC. Given that pancreatic cancer is characterized by desmoplasia and the dual biological roles of stroma in pancreatic cancer, we reassess the importance of stroma in GEM-based therapeutic approaches in light of current findings. This review is focused on understanding the role of stromal components in the extrinsic resistance to GEM and whether anti-stroma therapies have a positive effect on the GEM delivery. This work contributes to the development of novel and promising combination GEM-based regimens that have achieved significant survival benefits for the patients with pancreatic cancer.

6 Review Complex roles of the stroma in the intrinsic resistance to gemcitabine in pancreatic cancer: where we are and where we are going. 2017

Liang, Chen / Shi, Si / Meng, Qingcai / Liang, Dingkong / Ji, Shunrong / Zhang, Bo / Qin, Yi / Xu, Jin / Ni, Quanxing / Yu, Xianjun. ·Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. · Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. · Pancreatic Cancer Institute, Fudan University, Shanghai, China. ·Exp Mol Med · Pubmed #29611542.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is among the most devastating human malignancies. The poor clinical outcome in PDAC is partly attributed to a growth-permissive tumor microenvironment. In the PDAC microenvironment, the stroma is characterized by the development of extensive fibrosis, with stromal components outnumbering pancreatic cancer cells. Each of the components within the stroma has a distinct role in conferring chemoresistance to PDAC, and intrinsic chemoresistance has further worsened this pessimistic prognosis. The nucleoside analog gemcitabine (GEM) is usually the recommended first-line chemotherapeutic agent for PDAC patients and is given alone or in combination with other agents. The mechanisms of intrinsic resistance to GEM are an active area of ongoing research. This review highlights the important role the complex structure of stroma in PDAC plays in the intrinsic resistance to GEM and discusses whether antistroma therapy improves the efficacy of GEM. The addition of antistroma therapy combined with GEM is expected to be a novel therapeutic strategy with significant survival benefits for PDAC patients.

7 Review Role of immune cells in pancreatic cancer from bench to clinical application: An updated review. 2016

Chang, Jae Hyuck / Jiang, Yongjian / Pillarisetty, Venu G. ·aDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea bDepartment of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai, China cDepartment of Surgery, University of Washington Medical Center, Seattle, University of Washington, Seattle, WA. ·Medicine (Baltimore) · Pubmed #27930550.

ABSTRACT: BACKGROUND: Pancreatic cancer (PC) remains difficult to treat, despite the recent advances in various anticancer therapies. Immuno-inflammatory response is considered to be a major risk factor for the development of PC in addition to a combination of genetic background and environmental factors. Although patients with PC exhibit evidence of systemic immune dysfunction, the PC microenvironment is replete with immune cells. METHODS: We searched PubMed for all relevant English language articles published up to March 2016. They included clinical trials, experimental studies, observational studies, and reviews. Trials enrolled at Clinical trial.gov were also searched. RESULTS: PC induces an immunosuppressive microenvironment, and intratumoral activation of immunity in PC is attenuated by inhibitory signals that limit immune effector function. Multiple types of immune responses can promote an immunosuppressive microenvironment; key regulators of the host tumor immune response are dendritic cells, natural killer cells, macrophages, myeloid derived suppressor cells, and T cells. The function of these immune cells in PC is also influenced by chemotherapeutic agents and the components in tumor microenvironment such as pancreatic stellate cells. Immunotherapy of PC employs monoclonal antibodies/effector cells generated in vitro or vaccination to stimulate antitumor response. Immune therapy in PC has failed to improve overall survival; however, combination therapies comprising immune checkpoint inhibitors and vaccines have been attempted to increase the response. CONCLUSION: A number of studies have begun to elucidate the roles of immune cell subtypes and their capacity to function or dysfunction in the tumor microenvironment of PC. It will not be long before immune therapy for PC becomes a clinical reality.

8 Review Circulating tumor cells in pancreatic cancer patients: efficacy in diagnosis and value in prognosis. 2016

Xie, Zhi-Bo / Yao, Lie / Jin, Chen / Fu, De-Liang. ·Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China. · These authors contributed equally to this article. ·Discov Med · Pubmed #27755967.

ABSTRACT: Detection of circulating tumor cells (CTCs) has become widely used as a liquid biopsy for many patients. In pancreatic cancer patients, there have been a number of published reports on the efficacy of CTCs in the diagnosis and prognosis of pancreatic cancer, and in the evaluation of response to treatment. We systematically reviewed the diagnosis efficiency and prognostic value of CTCs reported in the literature. We found that the frequency of CTCs is rare, limited to a certain degree by the current enrichment and detection methodologies. The sensitivity of CTCs for diagnosis is variable likely due to the different stages of the disease at the time of diagnosis (varied from 25.0% to 100.0%) but specificity remained relatively high (varied from 99.7% to 100.0%). However, pooled results from meta-analyses (patients with CTC positivity had worse overall survival than patients with CTC negativity) demonstrated that CTCs could be used as an effective tool in the prognosis prediction in pancreatic cancer patients.

9 Review Energy sources identify metabolic phenotypes in pancreatic cancer. 2016

Liang, Chen / Qin, Yi / Zhang, Bo / Ji, Shunrong / Shi, Si / Xu, Wenyan / Liu, Jiang / Xiang, Jinfeng / Liang, Dingkong / Hu, Qiangsheng / Liu, Liang / Liu, Chen / Luo, Guopei / Ni, Quanxing / Xu, Jin / Yu, Xianjun. ·Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China. · Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China. · Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. · Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China yuxianjun@fudanpci.org xujin@fudanpci.org. ·Acta Biochim Biophys Sin (Shanghai) · Pubmed #27649892.

ABSTRACT: Metabolic reprogramming is one of the emerging hallmarks of cancers. As a highly malignant tumor, pancreatic ductal adenocarcinoma (PDA) is not only a metabolic disease but also a heterogeneous disease. Heterogeneity induces PDA dependence on distinct nutritive substrates, thereby inducing different metabolic phenotypes. We stratified PDA into four phenotypes with distinct types of energy metabolism, including a Warburg phenotype, a reverse Warburg phenotype, a glutaminolysis phenotype, and a lipid-dependent phenotype. The four phenotypes possess distinct metabolic features and reprogram their metabolic pathways to adapt to stress. The metabolic type present in PDA should prompt differential imaging and serologic metabolite detection for diagnosis and prognosis. The targeting of an individual metabolic phenotype with corresponding metabolic inhibitors is considered a promising therapeutic approach and, in combination with chemotherapy, is expected to be a novel strategy for PDA treatment.

10 Review Metabolic plasticity in heterogeneous pancreatic ductal adenocarcinoma. 2016

Liang, Chen / Qin, Yi / Zhang, Bo / Ji, Shunrong / Shi, Si / Xu, Wenyan / Liu, Jiang / Xiang, Jinfeng / Liang, Dingkong / Hu, Qiangsheng / Ni, Quanxing / Xu, Jin / Yu, Xianjun. ·Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. ·Biochim Biophys Acta · Pubmed #27600832.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDA) is one of the most lethal malignant neoplasms. The recognized hallmarks of PDA are regarded to be downstream events of metabolic reprogramming. Because PDA is a heterogeneous disease that is influenced by genetic polymorphisms and changes in the microenvironment, metabolic plasticity is a novel feature of PDA. As intrinsic factors for metabolic plasticity, K-ras activation and mutations in other tumor suppressor genes induce abnormal mitochondrial metabolism and enhance glycolysis, with alterations in glutamine and lipid metabolism. As extrinsic factors, the acidic and oxygen/nutrient-deprived microenvironment also induces cancer cells to reprogram their metabolic pathway and hijack stromal cells (mainly cancer-associated fibroblasts and immunocytes) to communicate, thereby adapting to metabolic stress. Therefore, a better understanding of the metabolic features of PDA will contribute to the development of novel diagnostic and therapeutic strategies.

11 Review K-Ras mutation detection in liquid biopsy and tumor tissue as prognostic biomarker in patients with pancreatic cancer: a systematic review with meta-analysis. 2016

Li, Tao / Zheng, Yuanting / Sun, Hong / Zhuang, Rongyuan / Liu, Jing / Liu, Tianshu / Cai, Weimin. ·Department of Clinical Pharmacy, School of Pharmacy, Fudan University, Shanghai, China. · Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China. · Department of Clinical Pharmacy, School of Pharmacy, Fudan University, Shanghai, China. weimincai@fudan.edu.cn. ·Med Oncol · Pubmed #27225938.

ABSTRACT: K-Ras gene mutations have been found in most pancreatic cancers; however, conflicting data on the prognostic value of K-Ras mutations in pancreatic cancer have been published. We conducted a meta-analysis to assess its prognostic significance. Literature searches of PubMed, EMBASE, Cochrane Library, Web of Science and Google Scholar were performed through December 2015 to identify publications exploring the association of K-Ras mutation with overall survival. Forty eligible studies involving 3427 patients with pancreatic cancer were included in the present meta-analysis. Our analysis showed a hazard ratio (HR) of negative association with survival of 1.61 [95 % confidence interval (CI) 1.36-1.90; p < 0.01] in K-Ras mutant pancreatic cancer patients. In subgroup analyses, K-Ras mutations detected in tumor tissues and in liquid biopsies had HRs of 1.37 (95 % CI 1.20-1.57; p < 0.01) and 3.16 (95 % CI 2.1-4.71; p < 0.01), respectively. In addition, the HR was higher when K-Ras mutations were detected in fresh frozen samples (HR = 2.01, 95 % CI 1.28-3.16, p = 0.002) than in formalin-fixed, paraffin-embedded (FFPE) samples (HR = 1.29, 95 % CI 1.12-1.49, p < 0.01). Though K-Ras alterations are more frequent among non-East Asian individuals than East Asian individuals, there were no significant differences in HRs of survival between the two ethnic subgroups. In conclusion, this meta-analysis suggests that K-Ras mutations are associated with a worse overall survival in pancreatic cancer patients, especially when mutations are detected in liquid biopsies or fresh frozen tumor tissue samples.

12 Review Targeting tumor-associated macrophages to combat pancreatic cancer. 2016

Cui, Ran / Yue, Wen / Lattime, Edmund C / Stein, Mark N / Xu, Qing / Tan, Xiang-Lin. ·Department of Oncology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, P. R. China. · Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P. R. China. · Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA. · Department of Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA. ·Oncotarget · Pubmed #27191744.

ABSTRACT: The tumor microenvironment is replete with cells that evolve with and provide support to tumor cells during the transition to malignancy. The hijacking of the immune system in the pancreatic tumor microenvironment is suggested to contribute to the failure to date to produce significant improvements in pancreatic cancer survival by various chemotherapeutics. Regulatory T cells, myeloid derived suppressor cells, and fibroblasts, all of which constitute a complex ecology microenvironment, can suppress CD8+ T cells and NK cells, thus inhibiting effector immune responses. Tumor-associated macrophages (TAM) are versatile immune cells that can express different functional programs in response to stimuli in tumor microenvironment at different stages of pancreatic cancer development. TAM have been implicated in suppression of anti-tumorigenic immune responses, promotion of cancer cell proliferation, stimulation of tumor angiogenesis and extracellular matrix breakdown, and subsequent enhancement of tumor invasion and metastasis. Many emerging agents that have demonstrated efficacy in combating other types of tumors via modulation of macrophages in tumor microenvironments are, however, only marginally studied for pancreatic cancer prevention and treatment. A better understanding of the paradoxical roles of TAM in pancreatic cancer may pave the way to novel preventive and therapeutic approaches. Here we give an overview of the recruitment and differentiation of macrophages, TAM and pancreatic cancer progression and prognosis, as well as the potential preventive and therapeutic targets that interact with TAM for pancreatic cancer prevention and treatment.

13 Review Critical role of oncogenic KRAS in pancreatic cancer (Review). 2016

Liu, Jiang / Ji, Shunrong / Liang, Chen / Qin, Yi / Jin, Kaizhou / Liang, Dingkon / Xu, Wenyan / Shi, Si / Zhang, Bo / Liu, Liang / Liu, Chen / Xu, Jin / Ni, Quanxing / Yu, Xianjun. ·Department of Pancreatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai 200032, P.R. China. ·Mol Med Rep · Pubmed #27121414.

ABSTRACT: Pancreatic cancer is a human malignancy with one of the highest mortality rates and little progress has been achieved in its treatment in recent decades. Further improvement to the understanding of the biological and molecular mechanisms underlying the initiation and development of pancreatic ductal adenocarcinoma (PDAC) is required. Previous studies using genetically engineered mouse models have demonstrated that oncogenic GTPase KRas (KRAS) mutation is involved in the formation of pancreatic intraepithelial neoplasia and promotes the progression of PDAC. However, attempts to target KRAS directly by pharmacological inhibition have been unsuccessful. This has resulted in increased efforts to identify pharmacological targets and nodes associated with the mutated KRAS. The present review discusses the recent progress and prospects of KRAS signaling in pancreatic cancer.

14 Review New insights into perineural invasion of pancreatic cancer: More than pain. 2016

Liang, Dingkong / Shi, Si / Xu, Jin / Zhang, Bo / Qin, Yi / Ji, Shunrong / Xu, Wenyan / Liu, Jiang / Liu, Liang / Liu, Chen / Long, Jiang / Ni, Quanxing / Yu, Xianjun. ·Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Pancreatic Cancer Institute, Fudan University, Shanghai, China. ·Biochim Biophys Acta · Pubmed #26794395.

ABSTRACT: Pancreatic cancer is one of the most malignant human tumors. Perineural invasion, whereby a cancer cell invades the perineural spaces surrounding nerves, is acknowledged as a gradual contributor to cancer aggressiveness. Furthermore, perineural invasion is considered one of the root causes of the recurrence and metastasis observed after pancreatic resection, and it is also an independent predictor of prognosis. Advanced research has demonstrated that the neural microenvironment is closely associated with perineural invasion in pancreatic cancer. Therapy targeting the molecular mechanism of perineural invasion may enable the durable clinical treatment of this formidable disease. This review provides an overview of the present status of perineural invasion, the relevant molecular mechanisms of perineural invasion, pain and hyperglycemia associated with perineural invasion in pancreatic cancer, and the targeted therapeutics based on these studies.

15 Review Superparamagnetic iron oxide nanoparticles for MR imaging of pancreatic cancer: Potential for early diagnosis through targeted strategies. 2016

Zhang, Chongjie / Yan, Yuzhong / Zou, Qi / Chen, Jie / Li, Chunsheng. ·Departments of Hepatobiliary Surgery and. · Clinical Laboratory, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Pudong, Shanghai, China. · Department of Transfusion Medicine, Huashan Hospital, Fudan University, Shanghai, China. ·Asia Pac J Clin Oncol · Pubmed #26663873.

ABSTRACT: Superparamagnetic iron oxide nanoparticles (SPION)-based magnetic resonance imaging is a powerful, noninvasive tool in biomedical imaging. The recent embedding of SPIO in nanoencapsulations that had different controllable surface properties has now made it possible to use SPIO in the imaging of metabolic processes. The two major issues to realize maximized and selective SPIO cancer targeting are the minimization of macrophage uptake and the preferential binding to cancerous cells over healthy neighbor cells. The utility of SPIO has been shown in clinical applications using a series of marketed SPION-based contrast agents. Applications have ranged from detecting inflammatory diseases to the specific identification of cell surface markers expressed on tumors. This review focuses on iron-oxide-based nanoparticles, to include the physiochemical properties of SPION surface engineering and its synthetic methods as well as SPIO imaging applications and specifically targeted SPIO conjugates (e.g. targeted probes) for labeling cancerous, cell-surface molecules. As a specific application of this technology, we discuss its use in the imaging of pancreatic duct adenocarcinoma in addition to its potential for use in early diagnosis through targeted strategies.

16 Review Prognostic value of Ki-67 in solid pseudopapillary tumor of the pancreas: Huashan experience and systematic review of the literature. 2016

Yang, Feng / Yu, Xinzhe / Bao, Yun / Du, Zunguo / Jin, Chen / Fu, Deliang. ·Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital affiliated to Fudan University, Shanghai, China. · Department of Pathology, Huashan Hospital affiliated to Fudan University, Shanghai, China. · Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital affiliated to Fudan University, Shanghai, China. Electronic address: surgeonfu@163.com. ·Surgery · Pubmed #26619927.

ABSTRACT: BACKGROUND: Solid pseudopapillary tumor of the pancreas (SPTP) is considered to have a low Ki-67 proliferation index, which may explain the generally good clinical outcome. The aim of our study was to evaluate whether Ki-67 has prognostic value in SPTP. METHODS: A case series study of patients with SPTP treated in our institution from June 2002 to April 2014 was conducted. Prognostic factors for clinical outcomes were analyzed by the use of clinical decision and survival analysis. In addition, we performed a systematic review and pooled analysis to evaluate our results. RESULTS: The institutional data included 71 patients (13 male and 58 female) ranging in age from 12 to 64 years (median, 31 years). Three patients developed local recurrence and/or liver metastasis after initial surgery. The 5-year recurrence-free survival rate was 93.6%. One patient died of disease, with the 5-year disease-specific survival rate of 98.5%. Ki-67 index ≥ 4% was found significantly associated with the survival of SPTP. Twenty-six studies comprising 163 patients were included in the pooled analysis based on our inclusion criteria. A total of 15 cases showed a Ki-67 index ≥ 4%. Kaplan-Meier survival analysis confirmed that Ki-67 index ≥ 4% was significantly associated with poorer recurrence-free survival and disease-specific survival (both P < .001). CONCLUSION: This study highlighted a potential role of Ki-67 in predicting adverse outcome of patients with SPTP and should be considered as part of routine histological reporting of SPTP.

17 Review Process of hepatic metastasis from pancreatic cancer: biology with clinical significance. 2016

Shi, Haojun / Li, Ji / Fu, Deliang. ·Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China. · Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China. surgeonf@126.com. ·J Cancer Res Clin Oncol · Pubmed #26250876.

ABSTRACT: PURPOSE: Pancreatic cancer shows a remarkable preference for the liver to establish secondary tumors. Selective metastasis to the liver is attributed to the development of potential microenvironment for the survival of pancreatic cancer cells. This review aims to provide a full understanding of the hepatic metastatic process from circulating pancreatic cancer cells to their settlement in the liver, serving as a basic theory for efficient prediction and treatment of metastatic diseases. METHODS: A systematic search of relevant original articles and reviews was performed on PubMed, EMBASE and Cochrane Library for the purpose of this review. RESULTS: Three interrelated phases are delineated as the contributions of the interaction between pancreatic cancer cells and the liver to hepatic metastasis process. Chemotaxis of disseminated pancreatic cancer cells and simultaneous defensive formation of platelets or neutrophils facilitate specific metastasis toward the liver. Remodeling of extracellular matrix and stromal cells in hepatic lobules and angiogenesis induced by proangiogenic factors support the survival and growth of clinical micrometastasis colonizing the liver. The bimodal role of the immune system or prevalence of cancer cells over the immune system makes metastatic progression successfully proceed from micrometastasis to macrometastasis. CONCLUSIONS: Pancreatic cancer is an appropriate research object of cancer metastasis representing more than a straight cascade. If any of the successive or simultaneous phases, especially tumor-induced immunosuppression, is totally disrupted, hepatic metastasis will be temporarily under control or even cancelled forever. To shrink cancers on multiple fronts and prolong survival for patients, novel oral or intravenous anti-cancer agents covering one or different phases of metastatic pancreatic cancer are expected to be integrated into innovative strategies on the premise of safety and efficacious biostability.

18 Review Effect of Diabetes Mellitus on Survival in Patients with Pancreatic Cancer: A Systematic Review and Meta-analysis. 2015

Mao, Yixiang / Tao, Min / Jia, Xiaoyan / Xu, Hong / Chen, Kai / Tang, Hongwei / Li, Donghui. ·Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China. · Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. · Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. · Jiangsu Institute of Clinical Immunology, Suzhou, China. ·Sci Rep · Pubmed #26598798.

ABSTRACT: Concurrent diabetes has been linked with an increased risk of death in many cancers, but findings in pancreatic cancer have been inconsistent. We performed a systematic review and meta-analysis to assess the effect of diabetes on survival in patients with pancreatic cancer. Of 4, 463 original articles, 41 were included in the review; 29 studies with 33 risk estimates were included in the meta-analysis. In the overall comparison of patients with pancreatic cancer and diabetes with their nondiabetic counterparts, the former had significantly higher all-cause mortality (pooled HR: 1.13; 95% CI: 1.04-1.22). Subgroup analyses showed that diabetes was associated with poor survival in patients with resectable disease (HR: 1.37; 95% CI: 1.15-1.63) but not in those with unresectable disease (HR: 1.07; 95% CI: 0.89-1.29). The HR (95% CI) was 1.52 (1.20-1.93) for patients with new-onset diabetes (≤ 2 years of diabetes duration) and 1.22 (0.83-1.80) for those with longstanding diabetes (> 2 years). Diabetes was associated with higher mortality overall in patients with pancreatic cancer. The effect of diabetes on overall survival was associated with the stages of tumor and the duration of diabetes.

19 Review Clear cell sarcoma of the pancreas: a case report and review of literature. 2015

Huang, Jie / Luo, Rong-Kui / Du, Min / Zeng, Hai-Ying / Chen, Ling-Li / Ji, Yuan. ·Department of Pathology, Zhongshan Hospital, Fudan University Shanghai 200032, China. ·Int J Clin Exp Pathol · Pubmed #25973121.

ABSTRACT: Clear cell sarcoma (CCS), is an uncommon malignant soft tissue neoplasm that displays melanocytic differentiation with a distinct molecular profile. It is very rarely localized in gastrointestinal tract. We reported the first case of a primary CCS arising in pancreas. A 36-year-old man presented with jaundice for one month. A preoperative abdominal computer tomography showed a low-density mass in the head of pancreas. Whipple procedure was performed and the tumor was resected. Pathological examination showed polygonal or fusiform cells arranged in a uniform nested to fascicular growth pattern with thin fibrous septa. Immunohistochemical studies revealed positivity for HMB-45, Melan A, S-100, MiTF and vimentin protein. Fluorescence in situ hybridization on paraffin section showed a translocation involving the EWSR1 gene region. No BRAF and NRAS mutation was detected. The patient underwent transcatheter arterial chemoembolization (TACE) six times and eventually died of diffuse liver metastasis 10 months later. This case illustrates that the pancreas is a potential site for primary clear cell sarcoma and molecular studies play an important role in making a conclusive diagnosis.

20 Review Noncoding RNAs as potential biomarkers to predict the outcome in pancreatic cancer. 2015

Jin, Kaizhou / Luo, Guopei / Xiao, Zhiwen / Liu, Zuqiang / Liu, Chen / Ji, Shunrong / Xu, Jin / Liu, Liang / Long, Jiang / Ni, Quanxing / Yu, Xianjun. ·Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China ; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China ; Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China. ·Drug Des Devel Ther · Pubmed #25750521.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC), a common digestive system cancer, is highly malignant and has a poor disease outcome. Currently, all available examination and detection methods cannot accurately predict the clinical outcome. Therefore, it is extremely important to identify novel molecular biomarkers for personalized medication and to significantly improve the overall outcome. The "noncoding RNAs" (ncRNAs) are a group of RNAs that do not code for proteins, and they are categorized as structural RNAs and regulatory RNAs. It has been shown that microRNAs and long ncRNAs function as regulatory RNAs to affect the progression of various diseases. Many studies have confirmed a role for ncRNAs in the progression of PDAC during the last few years. Because of the significant role of ncRNAs in PDAC, ncRNA profiling may be used to predict PDAC outcome with high accuracy. This review comprehensively analyzes the value of ncRNAs as potential biomarkers to predict the outcome in PDAC and the possible mechanisms thereof.

21 Review Metabolic tumor burden: a new promising way to reach precise personalized therapy in PDAC. 2015

Xiang, Jinfeng / Liu, Liang / Wang, Wenquan / Xu, Huaxiang / Wu, Chuntao / Xu, Jin / Liu, Chen / Long, Jiang / Ni, Quanxing / Yu, Xianjun. ·Department of Pancreatic and Hepatobiliary Surgery, Shanghai Cancer Center, Fudan University, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. ·Cancer Lett · Pubmed #25617800.

ABSTRACT: Pancreatic cancer is currently one of the deadliest solid malignancies and pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer. In the past decade, diagnostics and surgical techniques for PDAC have been evolving steadily; however, clinical outcomes of patients with PDAC have shown little, if any, improvement. Subgroup classification based on accurate prediction of prognosis in patients with pancreatic cancer is important for treatment selection and clinical decision-making. The traditional method to evaluate prognosis relies on the TNM staging system, but it may not reflect the true status of every patient due to individual biological differences. Metabolomics is a field of study that involves the identification and quantification of metabolites present in a biological system. Analysis of metabolic differences between cancerous and noncancerous tissues can provide novel insights into tumor biology that are closely associated with disease prognosis and diagnosis. Therefore, evaluation of metabolic tumor burden may improve the accuracy of the clinical decision-making process, thereby facilitating optimization of the treatment strategies for pancreatic cancer.

22 Review Splenic vessel preservation versus Warshaw's technique during spleen-preserving distal pancreatectomy: a meta-analysis and systematic review. 2015

Yu, Xinzhe / Li, Hengchao / Jin, Chen / Fu, Deliang / Di, Yang / Hao, Sijie / Li, Ji. ·Pancreatic Surgery Department of Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China. ·Langenbecks Arch Surg · Pubmed #25613494.

ABSTRACT: BACKGROUND: Splenic preservation can be achieved through splenic vessel resection by Warshaw's technique (WT) or by preserving the splenic vessels. This meta-analysis aims to provide evidence-based comparison regarding the perioperative outcome and long-term benefits between patients with and without splenic vessel preservation (SVP) during spleen-preserving distal pancreatectomy. METHOD: A meta-analysis was performed to evaluate studies comparing splenic vessel preservation versus resection groups. Ten retrospective studies including 699 patients were eligible for an analysis of general, perioperative, and long-term outcomes. A further analysis composed of five subgroups was also conducted in terms of laparoscopic approach. RESULTS: Warshaw's technique related to significant shorter operation time (P < 0.0001). There was no difference in blood loss (P = 0.45) as well as median tumor size (p = 0.1) between the two groups. The overall rate of complications indicated no difference between SVP and WT (P = 0.1), including pancreatic fistula rates, which were not statistically different among the treatment groups (P = 0.27). However, the occurrence of gastric varices and splenic infarction was significant higher in the WT group (P < 0.01). In laparoscopic subgroups, patients treated by WT had much lower blood loss (P = 0.002). CONCLUSION: In spleen-preserving distal pancreatectomy, comparing with SVP, there is no evidence of significant benefit of WT. Nonetheless, surgeons should master both techniques and choose an appropriate one based on personal experience and a "case by case" situation. However, the current available evidence is weak, and further randomized controlled data are warranted.

23 Review Epithelial-mesenchymal transition in pancreatic cancer: Is it a clinically significant factor? 2015

Jiang, Jia-Hao / Liu, Chen / Cheng, He / Lu, Yu / Qin, Yi / Xu, Yong-Feng / Xu, Jin / Long, Jiang / Liu, Liang / Ni, Quan-Xing / Yu, Xian-Jun. ·Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, PR China. · Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, PR China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, PR China. · Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, PR China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, PR China. Electronic address: yuxianjun88@hotmail.com. ·Biochim Biophys Acta · Pubmed #25432020.

ABSTRACT: Pancreatic cancer is one of the most aggressive solid malignancies. This aggressiveness is partly attributable to extensive local tumor invasion and early systemic dissemination as well as resistance to chemotherapy. Epithelial-mesenchymal transition (EMT) plays fundamental roles in embryonic development and in the differentiation of normal tissues and organs. EMT also plays critical roles in tumor formation, dissemination and drug resistance in pancreatic cancer. Emerging data suggest that inhibiting EMT may reverse the EMT phenotype and enhance the efficacy of chemotherapeutic agents against pancreatic cancer cells. Thus, an understanding of the molecular biology of EMT in pancreatic cancer may provide insights into the mechanisms of tumor invasion and metastatic progression and facilitate the development of alternative therapeutic approaches to improve the treatment outcomes for patients suffering from pancreatic cancer.

24 Review Utility of PET/CT in diagnosis, staging, assessment of resectability and metabolic response of pancreatic cancer. 2014

Wang, Xiao-Yi / Yang, Feng / Jin, Chen / Fu, De-Liang. ·Xiao-Yi Wang, Feng Yang, Chen Jin, De-Liang Fu, Pancreatic Disease Institute, Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China. ·World J Gastroenterol · Pubmed #25400441.

ABSTRACT: Pancreatic cancer is one of the most common gastrointestinal tumors, with its incidence staying at a high level in both the United States and China. However, the overall 5-year survival rate of pancreatic cancer is still extremely low. Surgery remains the only potential chance for long-term survival. Early diagnosis and precise staging are crucial to make proper clinical decision for surgery candidates. Despite advances in diagnostic technology such as computed tomography (CT) and endoscopic ultrasound, diagnosis, staging and monitoring of the metabolic response remain a challenge for this devastating disease. Positron emission tomography/CT (PET/CT), a relatively novel modality, combines metabolic detection with anatomic information. It has been widely used in oncology and achieves good results in breast cancer, lung cancer and lymphoma. Its utilization in pancreatic cancer has also been widely accepted. However, the value of PET/CT in pancreatic disease is still controversial. Will PET/CT change the treatment strategy for potential surgery candidates? What kind of patients benefits most from this exam? In this review, we focus on the utility of PET/CT in diagnosis, staging, and assessment of resectability of pancreatic cancer. In addition, its ability to monitor metabolic response and recurrence after treatment will be emphasis of discussion. We hope to provide answers to the questions above, which clinicians care most about.

25 Review Pathophysiological roles of Pim-3 kinase in pancreatic cancer development and progression. 2014

Li, Ying-Yi / Mukaida, Naofumi. ·Ying-Yi Li, Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai 200433, China. ·World J Gastroenterol · Pubmed #25071334.

ABSTRACT: Pim-3 is a member of the provirus integration site for Moloney murine leukemia virus (Pim) family proteins that exhibit serine/threonine kinase activity. Similar to the other Pim kinases (Pim-1 and Pim-2), Pim-3 is involved in many cellular processes, including cell proliferation, survival, and protein synthesis. Although Pim-3 is expressed in normal vital organs, it is overexpressed particularly in tumor tissues of endoderm-derived organs, including the liver, pancreas, and colon. Silencing of Pim-3 expression can retard in vitro cell proliferation of hepatocellular, pancreatic, and colon carcinoma cell lines by promoting cell apoptosis. Pim-3 lacks the regulatory domains similarly as Pim-1 and Pim-2 lack, and therefore, Pim-3 can exhibit its kinase activity once it is expressed. Pim-3 expression is regulated at transcriptional and post-transcriptional levels by transcription factors (e.g., Ets-1) and post-translational modifiers (e.g., translationally-controlled tumor protein), respectively. Pim-3 could promote growth and angiogenesis of human pancreatic cancer cells in vivo in an orthotopic nude mouse model. Furthermore, a Pim-3 kinase inhibitor inhibited cell proliferation when human pancreatic cancer cells were injected into nude mice, without inducing any major adverse effects. Thus, Pim-3 kinase may serve as a novel molecular target for developing targeting drugs against pancreatic and other types of cancer.

Next