• Title/Summary/Keyword: Cancer, Pancreatic

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DEP Domain Containing 1 is a Novel Diagnostic Marker and Prognostic Predictor for Hepatocellular Carcinoma

  • Yuan, Sheng-Guang;Liao, Wei-Jia;Yang, Jian-Jun;Huang, Guo-Jin;Huang, Zhao-Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10917-10922
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    • 2015
  • Background: This study was conducted to determine DEPDC1 expression in hepatocelluar carcinomas (HCCs) and to reveal its potential role in diagnosis and prognosis of affected patients. Materials and Methods: DEPDC1 expression at the mRNA level was detected by quantitative real-time PCR (qRT-PCR) in 205 cases of HCC and paired adjacent normal liver tissues, and by semi-quantitative RT-PCR in 20 cases. Survival curves were obtained by using Kaplan-Meier method and Log-rank test. Independent predictors associated with regard to disease free survival (DFS) and overall survival (OS) were identified using the Cox proportional hazard model. Results: High DEPDC1 mRNA levels were detected in 144 out of 205 cases (70.24%) of HCC, significantly associated with clinicopathological parameters, including tumor size (${\geq}4cm$), alpha-fetoprotein (${\geq}100ng/ml$), B-C of BCLC stage and recurrence. Kaplan-Meier survival analysis revealed that HCC patients with high DEPDC1 expression had poor OS and DFS. Multivariate analysis demonstrated that high DEPDC1 expression was an independent predictor for OS (HR=1.651; 95% 95%CI, 1.041-2.617; p=0.033) and DFS (HR=1.583; 95%CI, 1.01-2.483; p=0.045). Conclusions: Our results indicate DEPDC1 might be a novel diagnostic marker and an independent prognostic predictor for HCC patients.

Inhibitory Effects of Sophora Flavescens on the Pancreatic & Cardiac Side Effects of Chemotherapy by Cisplatin (고삼이 항암제 cisplatin의 췌$\cdot$심장 부작용 감소에 미치는 영향)

  • Kim, Jin-Cheo;Lim, Seong-Chul;Jung, Tae-Young;Seo, Jung-Chul;Han, Sang-Won
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.4
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    • pp.945-949
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    • 2005
  • The objective of this study is to investigate the inhibitor effects of an traditional oriental herb, Sophora flavescens on the pancreatic & cardiac side effects of chemotherapy were studied by using Bl6-BL6 melanoma-injected C57BL6 mouse tumor model. In this study, the effects of an traditional oriental herb, Sophora flavescens, on the side effects of chemotherapy were studied using B16 melanoma-injected C57BL6 mouse tumor model. Anticancer drugs widely used in clinical situation. Sophora flavescen has significant effect on the reduction of the side effects of chemotherapy. Water extract of Sophora flavescens significantly inhibited cisplatin-induced increase of amylase (AMY) which is a good indicator of pancreatic toxicity. Sophora flavescens extract does not decrease the anti-tumor activity of cisplatin showing that it can selectively inhibit side effects of anticancer drugs preserving beneficial effect. Theses results suggest a possibility that Sophora flavescens extract can be used for cancer patients for the reduction of the side effects and improving the quality of life during chemotherapy of cancer patients.

In vitro Study of the Antagonistic Effect of Low-dose Liquiritigenin on Gemcitabine-induced Capillary Leak Syndrome in Pancreatic Adenocarcinoma via Inhibiting ROS-Mediated Signalling Pathways

  • Wu, Wei;Xia, Qing;Luo, Rui-Jie;Lin, Zi-Qi;Xue, Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4369-4376
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    • 2015
  • Background: To investigate in-vitro antagonistic effect of low-dose liquiritigenin on gemcitabine-induced capillary leak syndrome (CLS) in pancreatic adenocarcinoma via inhibiting reactive oxygen species (ROS)-mediated signalling pathways. Materials and Methods: Human pancreatic adenocarcinoma Panc-1 cells and human umbilical vein endothelial cells (HUVECs) were pre-treated using low-dose liquiritigenin for 24 h, then added into gemcitabine and incubated for 48 h. Cell viability, apoptosis rate and ROS levels of Panc-1 cells and HUVECs were respectively detected through methylthiazolyldiphenyl-tetrazoliumbromide (MTT) and flow cytometry. For HUVECs, transendothelial electrical resistance (TEER) and transcellular and paracellular leak were measured using transwell assays, then poly (ADP-ribose) polymerase 1 (PARP-1) and metal matrix proteinase-9 (MMP9) activity were assayed via kits, mRNA expressions of p53 and Rac-1 were determined through quantitative polymerase chain reaction (qPCR); The expressions of intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and PARP-1 were measured via western blotting. Results: Low-dose liquiritigenin exerted no effect on gemcitabine-induced changes of cell viability, apoptosis rate and ROS levels in Panc-1 cells, but for HUVECs, liquiritigenin ($3{\mu}M$) could remarkably elevate gemcitabine-induced decrease of cell viability, transepithelial electrical resistance (TEER), pro-MMP9 level and expression of ICAM-1 and VCAM-1 (p<0.01). Meanwhile, it could also significantly decrease gemcitabine-induced increase of transcellular and paracellular leak, ROS level, PARP-1 activity, Act-MMP9 level, mRNA expressions of p53 and Rac-1, expression of PARP-1 and apoptosis rate (p<0.01). Conclusions: Low-dose liquiritigenin exerts an antagonistic effect on gemcitabine-induced leak across HUVECs via inhibiting ROS-mediated signalling pathways, but without affecting gemcitabine-induced Panc-1 cell apoptosis. Therefore, low-dose liquiritigenin might be beneficial to prevent the occurrence of gemcitabine-induced CLS in pancreatic adenocarcinoma.

Pancreatic Arteriovenous Malformation as an Unusual Cause of Chronic Gastrointestinal Bleeding in a Patient with Early Gastric Cancer: Multimodality Imaging Spectrum with Pathologic Correlation

  • Lee, Borahm;Lee, Jeong Eun;Cho, June Sik;Shin, Kyung Sook;You, Sun Kyoung;Cheon, Kwang Sik;Song, In Sang;Kim, Kyung Hee
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.241-247
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    • 2015
  • Arteriovenous malformation (AVM) of the pancreas is extremely rare, although it may be increasingly diagnosed due to the widespread use of cross-sectional imaging of the abdomen. Early diagnosis of this disease is important to prevent delay of treatment and resulting fatal complications. We report a rare case of pancreatic AVM in a 48-year-old man who presented with severe chronic anemia and early gastric cancer, which made diagnosis challenging. Imaging findings, including ultrasound, computed tomography, and magnetic resonance imaging, are shown, as well as the pathologic features.

Pancreatoduodenectomy following neoadjuvant chemotherapy in duodenal adenocarcinoma

  • Dongjin Seo;Bo Gyeom Park;Dawn Jung;Ho Kyoung Hwang;Sung Hyun Kim;Seung Soo Hong;Chang Moo Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.1
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    • pp.114-119
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    • 2023
  • A 51-year-old male patient had four times of massive hematochezia episode three days before arrival. Carbohydrate antigen (CA) 19-9 level was extremely elevated. Computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography identified 5.7 cm sized periampullary duodenal cancer with regional metastatic lymph nodes and vascular invasion to aberrant right hepatic artery, main portal vein, and superior mesenteric vein. Diagnosed as duodenal adenocarcinoma through endoscopic biopsy, 16 times of FOLFIRI (5-fluorouracil, leucovorin, irinotecan) was conducted. The regimen changed to XELOX (capecitabine, oxaliplatine), four times of administration was done, and the CA19-9 level dramatically decreased. The tumor decreased to 2.1 cm. After R0 laparoscopic pylorus preserving pancreatoduodenectomy, no adjuvant therapy was given. No sign of recurrence or metastasis was reported, and the patient reached complete remission after five years. We reported a case where neoadjuvant chemotherapy for locally advanced duodenal adenocarcinoma was shown to be effective.

Retrospective analysis of 8th edition American Joint Cancer Classification: Distal cholangiocarcinoma

  • Atish Darshan Bajracharya;Suniti Shrestha;Hyung Sun Kim;Ji Hae Nahm;Kwanhoon Park;Joon Seong Park
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.251-257
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    • 2023
  • Backgrounds/Aims: This is a retrospective analysis of whether the 8th edition American Joint Committee on Cancer (AJCC) was a significant improvement over the 7th AJCC distal extrahepatic cholangiocarcinoma classification. Methods: In total, 111 patients who underwent curative resection of mid-distal bile duct cancer from 2002 to 2019 were included. Cases were re-classified into 7th and 8th AJCC as well as clinicopathological univariate and multivariate, and Kaplan-Meier survival curve and log rank were calculated using R software. Results: In patient characteristics, pancreaticoduodenectomy/pylorus preserving pancreaticoduodenectomy had better survival than segmental resection. Only lymphovascular invasion was found to be significant (hazard ratio 2.01, p = 0.039) among all clinicopathological variables. The 8th edition AJCC Kaplan Meier survival curve showed an inability to properly segregate stage I and IIA, while there was a large difference in survival probability between IIA and IIB. Conclusions: The 8th distal AJCC classification did resolve the anatomical issue with the T stage, as T1 and T3 showed improvement over the 7th AJCC, and the N stage division of the N1 and N2 category was found to be justified, with poorer survival in N2 than N1. Meanwhile, in TMN staging, the 8th AJCC was able differentiate between early stage (I and IIA) and late stage (IIB and III) to better explain the patient prognosis.

Evaluation of the mechanical properties of current biliary selfexpandable metallic stents: axial and radial force, and axial force zero border

  • Wataru Yamagata;Toshio Fujisawa;Takashi Sasaki;Rei Ishibashi;Tomotaka Saito;Shuntaro Yoshida;Shizuka No;Kouta Inoue;Yousuke Nakai;Naoki Sasahira;Hiroyuki Isayama
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.633-649
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    • 2023
  • Background/Aims: Mechanical properties (MPs) and axial and radial force (AF and RF) may influence the efficacy and complications of self-expandable metallic stent (SEMS) placement. We measured the MPs of various SEMSs and examined their influence on the SEMS clinical ability. Methods: We evaluated the MPs of 29 types of 10-mm SEMSs. RF was measured using a conventional measurement device. AF was measured using the conventional and new methods, and the correlation between the methods was evaluated. Results: A high correlation in AFs was observed, as measured by the new and conventional manual methods. AF and RF scatterplots divided the SEMSs into three subgroups according to structure: hook-and-cross-type (low AF and RF), cross-type (high AF and low RF), and laser-cut-type (intermediate AF and high RF). The hook-and-cross-type had the largest axial force zero border (>20°), followed by the laser-cut and cross types. Conclusions: MPs were related to stent structure. Hook-and-cross-type SEMSs had a low AF and high axial force zero border and were considered safest because they caused minimal stress on the biliary wall. However, the increase in RF must be overcome.

Scoring systems for the management of oncological hepato-pancreato-biliary patients

  • Alexander W. Coombs;Chloe Jordan;Sabba A. Hussain;Omar Ghandour
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.17-30
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    • 2022
  • Oncological scoring systems in surgery are used as evidence-based decision aids to best support management through assessing prognosis, effectiveness and recurrence. Currently, the use of scoring systems in the hepato-pancreato-biliary (HPB) field is limited as concerns over precision and applicability prevent their widespread clinical implementation. The aim of this review was to discuss clinically useful oncological scoring systems for surgical management of HPB patients. A narrative review was conducted to appraise oncological HPB scoring systems. Original research articles of established and novel scoring systems were searched using Google Scholar, PubMed, Cochrane, and Ovid Medline. Selected models were determined by authors. This review discusses nine scoring systems in cancers of the liver (CLIP, BCLC, ALBI Grade, RETREAT, Fong's score), pancreas (Genç's score, mGPS), and biliary tract (TMHSS, MEGNA). Eight models used exclusively objective measurements to compute their scores while one used a mixture of both subjective and objective inputs. Seven models evaluated their scoring performance in external populations, with reported discriminatory c-statistic ranging from 0.58 to 0.82. Selection of model variables was most frequently determined using a combination of univariate and multivariate analysis. Calibration, another determinant of model accuracy, was poorly reported amongst nine scoring systems. A diverse range of HPB surgical scoring systems may facilitate evidence-based decisions on patient management and treatment. Future scoring systems need to be developed using heterogenous patient cohorts with improved stratification, with future trends integrating machine learning and genetics to improve outcome prediction.

Epidemiological trends of gallbladder cancer in Australia between 1982 to 2018: A population-based study utilizing the Australian Cancer Database

  • Taha Mollah;Marc Chia;Luke C. Wang;Prasenjit Modak;Kirby R. Qin
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.263-269
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    • 2022
  • Backgrounds/Aims: Gallbladder cancer (GBC) is a rare neoplasm. The epidemiology of GBC has not been updated in Australia for over five decades. Methods: Data of all Australian patients diagnosed with GBC at any age from 1982 to 2018 were identified from the Australian Cancer Database. Age-standardized rates were calculated and joinpoint analysis was performed to ascertain the trends of incidence and mortality of GBC. Results: Between 1982 and 2018, there were 22,745 cases of GBC and 11,054 GBC-related deaths in Australia. There were three distinct periods showing changed incidence. Period 1 (1982-1995) was stable. Period 2 (1996-2006) showed reduced incidence in females (3.6 to 2.8/100,000; p < 0.01) and all Australians (3.7 to 2.8/100,000, p < 0.01). Period 3 (2006-2017) demonstrated significantly increased incidence in all groups (males: 2.7 to 4.0/100,000, p < 0.01; females: 2.8 to 3.5/100,000, p < 0.01; all Australians: 2.8 to 3.7/100,000, p < 0.01). Incidence between females and males had declined from 1.10 : 1 in 1982 to 0.87 : 1 in 2017. There was a 71% reduction in mortality (3.1 to 0.9/100,000; p < 0.01). Median age at diagnosis increased from 69.7 to 74.3 years for females and from 67.2 to 73.3 years for males. Increasing incidence in the 6th to 8th decade of life in males, compared to previous years, was noted. Conclusions: Incidence, mortality, sex, and age of GBC have significantly changed in Australia since 1982. Rising incidence of GBC in Australia warrants further investigation.

Ginsenoside Rg1 Epigenetically Modulates Smad7 Expression in Liver Fibrosis via MicroRNA-152

  • Rongrong Zhang ;Xinmiao Li ;Yuxiang Gao ;Qiqi Tao;Zhichao Lang;Yating Zhan;Chunxue Li;Jianjian Zheng
    • Journal of Ginseng Research
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    • v.47 no.4
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    • pp.534-542
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    • 2023
  • Background: Ginsenoside Rg1, a bioactive component of Ginseng, has demonstrated anti-inflammatory, anti-cancer, and hepatoprotective effects. It is known that the epithelial-mesenchymal transition (EMT) plays a key role in the activation of hepatic stellate cells (HSCs). Recently, Rg1 has been shown to reverse liver fibrosis by suppressing EMT, although the mechanism of Rg1-mediated anti-fibrosis effects is still largely unclear. Interestingly, Smad7, a negative regulator of the transforming growth factor β (TGF-β) pathway, is often methylated during liver fibrosis. Whether Smad7 methylation plays a vital role in the effects of Rg1 on liver fibrosis remains unclear. Methods: Anti-fibrosis effects were examined after Rg1 processing in vivo and in vitro. Smad7 expression, Smad7 methylation, and microRNA-152 (miR-152) levels were also analyzed. Results: Rg1 significantly reduced the liver fibrosis caused by carbon tetrachloride, and reduced collagen deposition was also observed. Rg1 also contributed to the suppression of collagenation and HSC reproduction in vitro. Rg1 caused EMT inactivation, reducing Desmin and increasing E-cadherin levels. Notably, the effect of Rg1 on HSC activation was mediated by the TGF-β pathway. Rg1 induced Smad7 expression and demethylation. The over-expression of DNA methyltransferase 1 (DNMT1) blocked the Rg1-mediated inhibition of Smad7 methylation, and miR-152 targeted DNMT1. Further experiments suggested that Rg1 repressed Smad7 methylation via miR-152-mediated DNMT1 inhibition. MiR-152 inhibition reversed the Rg1-induced promotion of Smad7 expression and demethylation. In addition, miR-152 silencing led to the inhibition of the Rg1-induced EMT inactivation. Conclusion: Rg1 inhibits HSC activation by epigenetically modulating Smad7 expression and at least by partly inhibiting EMT.