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Pancreatic Neoplasms: HELP
Articles from Shanghai
Based on 1,118 articles published since 2008
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These are the 1118 published articles about Pancreatic Neoplasms that originated from Shanghai during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Editorial Pancreatic cancer: challenges and opportunities. 2018

Zhu, Huiyun / Li, Tuo / Du, Yiqi / Li, Min. ·Department of Gastroenterology, Changhai Hospital, Shanghai, 200433, China. · Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA. · Department of Endocrinology, Changzheng Hospital, Shanghai, 200003, China. · Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA. Min-Li@ouhsc.edu. ·BMC Med · Pubmed #30463539.

ABSTRACT: Pancreatic cancer is the fourth leading cause of cancer-related death in the United States, with increasing incidence. The mortality rate of pancreatic cancer is rising rapidly, and is projected to be the second most common of all malignant tumors by 2030. However, the diagnosis and therapy of pancreatic cancer remain a formidable challenge. Recently, enormous efforts have been made to develop several new methods for the early diagnosis and treatment of pancreatic cancer. We briefly introduce the most groundbreaking advances in pancreatic cancer diagnosis and clinical treatment strategies over the past 15 years, including surgery, chemotherapy, endoscopic therapy, immunotherapy and personalized medicine. The signaling pathways that are altered in the progression of pancreatic cancer, which may be used as therapeutic targets, are also discussed.

2 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.

3 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.

4 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.

5 Review Solid pseudopapillary neoplasm of pancreas in pregnancy treated with tumor enucleation: Case report and review of the literature. 2018

Huang, T T / Zhu, J / Zhou, H / Zhao, A M. ·Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. · Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. ·Niger J Clin Pract · Pubmed #30156213.

ABSTRACT: Solid pseudopapillary neoplasm of pancreas (SPN) during pregnancy is rare and presents a threat both to the mother and the fetus. We report a case of SPN in a 26-year-old woman diagnosed at 21 weeks of gestation. Tumor enucleation was successfully performed by a general surgeon. A healthy female infant was delivered at 39 weeks and 5 days of gestation vaginally without complications. Our report provides an example that tumor enucleation of SPN during the second trimester could be successfully performed during pregnancy. A multidisciplinary approach with respect to the pregnant patient's diagnosis, indications, and timing of surgery is necessary in ensuring the best possible outcomes for both the mother and the child.

6 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.

7 Review Prognostic role of the neutrophil-to-lymphocyte ratio in pancreatic cancer: A meta-analysis containing 8252 patients. 2018

Zhou, Yongping / Wei, Qian / Fan, Junsheng / Cheng, Sijin / Ding, Wenzhou / Hua, Zhiyuan. ·Department of Hepatobiliary, Wuxi Second Hospital, Nanjing Medical University, Wuxi, China. · Tongji University School of Medicine, Shanghai, China. · Department of Hepatobiliary, Wuxi Second Hospital, Nanjing Medical University, Wuxi, China. Electronic address: 1339218645@qq.com. ·Clin Chim Acta · Pubmed #29407690.

ABSTRACT: Several studies were carried out to explore the prognostic role of neutrophil-to-lymphocyte ratio (NLR) in pancreatic cancer, however, with contradictory results. The objectives of this study were to summarize the prognostic value of NLR in pancreatic cancer. Embase, PubMed and Cochrane Library were comprehensively retrieved. All the cohort studies focusing on the prognostic value of NLR in pancreatic cancer were eligible. 37 papers containing 43 cohort studies with pancreatic cancer were finally included into this study. The results presented that patients with low NLR might have longer OS when compared to the patients with high NLR (HR = 1.81, 95%CI = 1.59-2.05, P < 0.00001; I

8 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.

9 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.

10 Review Metformin is associated with survival benefit in pancreatic cancer patients with diabetes: a systematic review and meta-analysis. 2017

Zhou, Ping-Ting / Li, Bo / Liu, Fu-Rao / Zhang, Mei-Chao / Wang, Qian / Li, Yan-Yan / Xu, Ci / Liu, Yuan-Hua / Yao, Yuan / Li, Dong. ·Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. · Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. · Department of Chemotherapy, Nanjing Medical University Affiliated Cancer Hospital, Cancer Institute of Jiangsu Province, Nanjing, Jiangsu, China. · Department of Radiation Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. ·Oncotarget · Pubmed #28445955.

ABSTRACT: BACKGROUND: Pancreatic cancer is a highly lethal disease with a poor prognosis while metformin has been associated with a decreased risk of pancreatic cancer. Although the benefit of metformin was observed for pancreatic cancer prevention, it is not clear whether it can also affect the survival of pancreatic cancer patients with type 2 diabetes mellitus. A systematic review and meta-analysis was conducted to assess the effect of metformin on the survival of pancreatic cancer patients with type 2 diabetes mellitus. METHODS: Two independent authors searched PubMed and Web of science up to 08/07/2016. We assessed studies for eligibility, extracted data, and examined their quality, with the primary outcome as overall survival. We used published hazard ratio (HR) available or estimated based on other survival data. We pooled the data and used a random-effect model to combine direct comparisons from included articles. We also investigated treatment effects by different countries, quality and the time of metformin initiation. RESULTS: We found that there was a relative survival benefit associated with metformin treatment compared with non-metformin treatment in both overall survival (OS) ([HR] 0.84; 95% confidence interval [CI]: 0.73 - 0.96). These associations were also observed in subgroups of Asian countries and high quality articles. CONCLUSIONS: Our results support the notion that metformin maybe the best anti-diabetic medicine of choice in patients with pancreatic cancer and concurrent type 2 diabetes mellitus. The perspectives of enhancing survival of pancreatic cancer patients with diabetes mellitus by the use of metformin deserve more attention in future research and clinical practice.

11 Review Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review. 2017

Lu, Yi / Chen, Lu / Li, Chujun / Chen, Honglei / Chen, Jinhua. ·Digestive Endoscopy Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou. · Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China. · Digestive Endoscopy Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou. lichujun@mail.sysu.edu.cn. ·Med Ultrason · Pubmed #28440348.

ABSTRACT: AIM: The accuracy for endoscopic ultrasonography-elastography (EUS-EG) in the evaluation of solid pancreatic masses varies greatly and the pooled results have not been updated since 2013. Also, there still lack a comprehensive comparison among EUS-EG, contrast-enhanced EUS (CE-EUS), and EUS-guided fine needle aspiration (EUS-FNA).Material and methods: A thorough search was made for diagnostic trials investigating the role of EUS-EG in solid pancreatic masses. Meta-Disc was used to calculate the pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operator characteristics. Results: Finally, 17 studies (1537 patients, 1544 lesions) were selected. The pooled sensitivity and specificity for qualitative methods were 0.97 (95%CI, 0.95-0.99) and 0.67 (95%CI, 0.59-0.74), respectively; the pooled sensitivity and specificity for strain histograms were 0.97 (95%CI, 0.95-0.98) and 0.67(95%CI, 0.61-0.73), respectively; the pooled sensitivity and specificity for strain ratio were 0.98 (95%CI, 0.96-0.99) and 0.62 (95%CI, 0.56-0.68), respectively; the pooled sensitivity and specificity for CE-EUS were 0.90 (95%CI, 0.83-0.95) and 0.76 (95%CI, 0.67-0.84), respectively; the pooled sensitivity and specificity for EUS-FNA were 0.84 (95%CI, 0.77-0.90) and 0.96(95%CI, 0.88-1.00), respectively. CONCLUSION: EUS-EG is reliable for distinguishing solid pancreatic masses; the sensitivity and specificity for different diagnostic methods were very close. Both EUS-EG and CE-EUS can be valuable complementary supplements for EUS-FNA.

12 Review The critical role and potential target of the autotaxin/lysophosphatidate axis in pancreatic cancer. 2017

Quan, Ming / Cui, Jiu-Jie / Feng, Xiao / Huang, Qian. ·Cancer Center, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China. ·Tumour Biol · Pubmed #28347252.

ABSTRACT: Autotaxin, an ecto-lysophospholipase D encoded by the human ENNP2 gene, is expressed in multiple tissues, and participates in numerous critical physiologic and pathologic processes including inflammation, pain, obesity, embryo development, and cancer via the generation of the bioactive lipid lysophosphatidate. Overwhelming evidences indicate that the autotaxin/lysophosphatidate signaling axis serves key roles in the numerous processes central to tumorigenesis and progression, including proliferation, survival, migration, invasion, metastasis, cancer stem cell, tumor microenvironment, and treatment resistance by interacting with a series of at least six G-protein-coupled receptors (LPAR1-6). This review provides an overview of the autotaxin/lysophosphatidate axis and collates current knowledge regarding its specific role in pancreatic cancer. With a deeper understanding of the critical role of the autotaxin/lysophosphatidate axis in pancreatic cancer, targeting autotaxin or lysophosphatidate receptor may be a potential and promising strategy for cancer therapy.

13 Review The epithelial to mesenchymal transition (EMT) and cancer stem cells: implication for treatment resistance in pancreatic cancer. 2017

Zhou, Pingting / Li, Bo / Liu, Furao / Zhang, Meichao / Wang, Qian / Liu, Yuanhua / Yao, Yuan / Li, Dong. ·Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. · Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. · Department of Chemotherapy, Nanjing Medical University Affiliated Cancer Hospital, Cancer Institute of Jiangsu Province, Nanjing, Jiangsu, China. · Department of Radiation Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. · Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. lidong@shsmu.edu.cn. ·Mol Cancer · Pubmed #28245823.

ABSTRACT: The mechanical properties of epithelial to mesenchymal transition (EMT) and a pancreatic cancer subpopulation with stem cell properties have been increasingly recognized as potent modulators of the effective of therapy. In particular, pancreatic cancer stem cells (PCSCs) are functionally important during tumor relapse and therapy resistance. In this review we have surveyed recent advances in the role of EMT and PCSCs in tumor progression, metastasis and treatment resistance, and the mechanisms of integrated with biochemical signals and the underlying pathways involved in treatment resistance of pancreatic cancer. These findings highlight the importance of confirming stem-cells markers and complex molecular signaling pathways controlling EMT and cancer stem cells in pancreatic cancer during tumor formation, progression, and response to therapy.

14 Review Natural Products as Adjunctive Treatment for Pancreatic Cancer: Recent Trends and Advancements. 2017

Yue, Qingxi / Gao, Guogang / Zou, Gangyong / Yu, Haiqing / Zheng, Xi. ·Department of Oncology, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA. · Department of Cardiothoracic Surgery, Weihai Municipal Hospital, Weihai, Shandong, China. · Department of Pathology, Weihai Municipal Hospital, Weihai, Shandong, China. · Department of Internal Medicine, University of Missouri Hospital and Clinics, Columbia, MO, USA. · Department of Chemical Biology, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA; Allan H. Conney Laboratory for Anticancer Research, School of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, China. ·Biomed Res Int · Pubmed #28232946.

ABSTRACT: Pancreatic cancer is a type of common malignant tumors with high occurrence in the world. Most patients presented in clinic had pancreatic cancer at advanced stages. Furthermore, chemotherapy or radiotherapy had very limited success in treating pancreatic cancer. Complementary and alternative medicines, such as natural products/herbal medicines, represent exciting adjunctive therapies. In this review, we summarize the recent advances of using natural products/herbal medicines, such as Chinese herbal medicine, in combination with conventional chemotherapeutic agents to treat pancreatic cancer in preclinical and clinical trials.

15 Review A systematic review of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas. 2017

Zhou, Yanming / Shi, Bin / Wu, Lupeng / Si, Xiaoying. ·Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China. Electronic address: zhouymsxy@sina.cn. · General Intensive Care Unit, Songjiang Central Hospital, First People's Hospital of Shanghai Jiaotong University, Shanghai, China. · Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China. ·HPB (Oxford) · Pubmed #27553838.

ABSTRACT: BACKGROUND: To assess the published evidence on clinical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS) for adenocarcinoma in the body or tail of the pancreas. METHOD: PubMed and Chinese Biomedical Literature databases were searched. The results of comparisons between RAMPS and standard retrograde pancreatosplenectomy (SRPS) were analyzed by meta-analytical techniques. RESULTS: The literature search identified 13 observational studies involving 354 patients undergoing RAMPS. The overall morbidity and 30-day mortality was 40% and 0% respectively. The R0 resection rate was 88%; the median number of retrieved lymph nodes was 21; and the median 5-year overall survival rate was 37%. The result of meta-analysis showed that RAMPS was associated with a significantly less intraoperative bleeding [weighted mean difference -195.2 (95% confidence interval (CI) -223.27 to -167.13); P < 0.001], a greater number of retrieved lymph nodes [odds ratio (OR) 6.19 (95% CI 3.72 to 8.67); P < 0.001] and a higher percentage of R0 resection [OR 2.46 (95% CI 1.13 to 5.35); P = 0.02] as compared with SRPS. CONCLUSION: The current literature provides supportive evidence that RAMPS is a safe and effective procedure for adenocarcinoma in the body or tail of the pancreas, and is oncologically superior to SRPS.

16 Review Circulating Tumor Cells and Circulating Tumor DNA Provide New Insights into Pancreatic Cancer. 2016

Gao, Yang / Zhu, Yayun / Yuan, Zhou. ·Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China. ·Int J Med Sci · Pubmed #27994495.

ABSTRACT: Pancreatic cancer has a rather dismal prognosis mainly due to high malignance of tumor biology. Up to now, the relevant researches on pancreatic cancer lag behind seriously partly due to the obstacles for tissue biopsy, which handicaps the understanding of molecular and genetic features of pancreatic cancer. In the last two decades, liquid biopsy, including circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), is promising to provide new insights into the biological and clinical characteristics of malignant tumors. Both CTCs and ctDNA provide an opportunity for studying tumor heterogeneity, drug resistance, and metastatic mechanism for pancreatic cancer. Furthermore, they can also play important roles in detecting early-stage tumors, providing prognostic information, monitoring tumor progression and guiding treatment regimens. In this review, we will introduce the latest findings on biological features and clinical applications of both CTCs and ctDNA in pancreatic cancer. In a word, CTCs and ctDNA are promising to promote precision medicine in pancreatic cancer.

17 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.

18 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.

19 Review Long Non-Coding RNA: An Emerging Paradigm of Pancreatic Cancer. 2016

Han, T / Hu, H / Zhuo, M / Wang, L / Cui, J-J / Jiao, F / Wang, L-W. ·Department of Medical Oncology and Pancreatic Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Pancreatic Diseases, 650 New Songjiang Road, Shanghai 201620, China. jiao_f@outlook.com. · . yzwlw@hotmail.com. ·Curr Mol Med · Pubmed #27686798.

ABSTRACT: Pancreatic cancer remains a worldwide issue and burden that is hard to resolve given its low resection rate and chemo-resistance. Early diagnosis and early treatment are critical for conquering pancreatic cancer. Therefore, new biomarkers for diagnosis and prognosis are urgently needed. Previously, researchers mainly focused on protein-coding genetic and epigenetic changes in many types of cancers, and regarded the noncoding part as waste. Recently, however, long non-coding RNA (lncRNA) has emerged as a major participant in carcinogenesis, as it regulates cell proliferation, migration, invasion, metastasis, chemo-resistance, etc. The underlying mechanisms are summarized as signaling, decoy, guide and scaffold, yet the specific regulation networks remain to be uncovered. Several studies have revealed that some lncRNAs are dysregulated in pancreatic cancer, participating in biological functions. In this review, we will briefly outline the functional lncRNAs in pancreatic cancer, decipher possible mechanisms of lncRNAs, and further explore their significance in pancreatic cancer.

20 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.

21 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.

22 Review Aspirin in pancreatic cancer: chemopreventive effects and therapeutic potentials. 2016

Jiang, Ming-Jie / Dai, Juan-Juan / Gu, Dian-Na / Huang, Qian / Tian, Ling. ·Institute of Translational Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China; Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China. · Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China; Comprehensive Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China. · Institute of Translational Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China; Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China. Electronic address: TL09168@hotmail.com. ·Biochim Biophys Acta · Pubmed #27567928.

ABSTRACT: Pancreatic cancer is one of the most aggressive malignancies with dismal prognosis. Recently, aspirin has been found to be an effective chemopreventive agent for many solid tumors. However, the function of aspirin use in pancreatic cancer largely remains unknown. We herein argued that aspirin could also lower the risk of pancreatic cancer. Importantly, aspirin assumes pleiotropic effects by targeting multiple molecules. It could further target the unique tumor biology of pancreatic cancer and modify the cancer microenvironment, thus showing remarkable therapeutic potentials. Besides, aspirin could reverse the chemoradiation resistance by repressing tumor repopulation and exert synergistic potentials with metformin on pancreatic cancer chemoprevention. Moreover, aspirin secondarily benefits pancreatic cancer patients through modestly reducing cancer pain and the risk of venous thromboembolism. Furthermore, new aspirin derivatives and delivery systems might help to improve risk-to-benefit ratio. In brief, aspirin is a promising chemopreventive agent and exerts significant therapeutic potentials in pancreatic cancer.

23 Review LncRNAs in pancreatic cancer. 2016

Huang, Xiaoyi / Zhi, Xiaosong / Gao, Yisha / Ta, Na / Jiang, Hui / Zheng, Jianming. ·Department of Pathology, Changhai Hospital, Second Military Medical University, Shanghai, China. · Department of Cell Biology, Second Military Medical University, Shanghai, China. ·Oncotarget · Pubmed #27429196.

ABSTRACT: Pancreatic cancer (PC) is one of the most common causes of cancer-related death. The underlying mechanism of PC is not completely understood at present. Studies in recent years have demonstrated that long non-coding RNAs (lncRNAs) have multiple biological functions in cell growth, differentiation and proliferation. Notably, expressions of some lncRNAs undergo significant changes in the initiation and progression of cancers. In addition, lncRNAs are reported to be involved in various steps of PC development and have a potential value in the diagnosis, treatment and prognostic prediction of PC. In this review, we highlight recent evidence related to the molecular mechanism of lncRNAs in growth, survival, invasion, metastasis, angiogenesis and apoptosis of PC cells, and discuss the potential clinical application of lncRNAs to the diagnosis, treatment and prognostic prediction of PC.

24 Review A meta-analysis of the diagnostic value of detecting K-ras mutation in pancreatic juice as a molecular marker for pancreatic cancer. 2016

Yang, Jing / Li, Sainan / Li, Jingjing / Wang, Fan / Chen, Kan / Zheng, Yuanyuan / Wang, Jianrong / Lu, Wenxia / Zhou, Yuqing / Yin, Qin / Zhang, Huawei / Guo, Chuanyong. ·Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China. · Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China; The First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China. · Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China; The First Affiliated Hospital of Soochow University, Suzhou 215006, China. · Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China. Electronic address: guochuanyong@hotmail.com. ·Pancreatology · Pubmed #27237100.

ABSTRACT: BACKGROUND: K-ras codon 12 mutation is one of the earliest genetic changes in the development of pancreatic cancer (PC) and accurate detection of K-ras mutations is gaining increasing attention in the field of molecular diagnosis. METHODS: Original research articles which evaluated the diagnostic accuracy of K-ras mutation detection in PC were selected. Data were presented as forest plots and summary receiver operating characteristic curve analysis was used to summarize the overall test performance. RESULTS: We assessed 16 studies from 15 published articles. The pooled sensitivity and specificity were 59% (95%CI: 54%-64%) and 87% (95%CI: 84%-89%), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 4.13 (95%CI: 2.73-6.25) and 0.42 (95%CI: 0.32-0.56), respectively, and the pooled diagnostic odds ratio was 13.66 (95% CI: 7.25-25.74). CONCLUSIONS: Our results indicate that the analysis of K-ras mutations in pancreatic juice has a considerable diagnostic value in PC. Further studies with rigorous design, large sample size, and multi-regional co-operation are needed.

25 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.

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