• Title/Summary/Keyword: Pancreatic Cancer

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Pancreatic Compression during Lymph Node Dissection in Laparoscopic Gastrectomy: Possible Cause of Pancreatic Leakage

  • Ida, Satoshi;Hiki, Naoki;Ishizawa, Takeaki;Kuriki, Yugo;Kamiya, Mako;Urano, Yasuteru;Nakamura, Takuro;Tsuda, Yasuo;Kano, Yosuke;Kumagai, Koshi;Nunobe, Souya;Ohashi, Manabu;Sano, Takeshi
    • Journal of Gastric Cancer
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    • v.18 no.2
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    • pp.134-141
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    • 2018
  • Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. Materials and Methods: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. Results: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. Conclusions: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.

SELDI-TOF MS Combined with Magnetic Beads for Detecting Serum Protein Biomarkers and Establishment of a Boosting Decision Tree Model for Diagnosis of Pancreatic Cancer

  • Qian, Jing-Yi;Mou, Si-Hua;Liu, Chi-Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1911-1915
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    • 2012
  • Aim: New technologies for the early detection of pancreatic cancer (PC) are urgently needed. The aim of the present study was to screen for the potential protein biomarkers in serum using proteomic fingerprint technology. Methods: Magnetic beads combined with surface-enhanced laser desorption/ionization (SELDI) TOF MS were used to profile and compare the protein spectra of serum samples from 85 patients with pancreatic cancer, 50 patients with acute-on-chronic pancreatitis and 98 healthy blood donors. Proteomic patterns associated with pancreatic cancer were identified with Biomarker Patterns Software. Results: A total of 37 differential m/z peaks were identified that were related to PC (P < 0.01). A tree model of biomarkers was constructed with the software based on the three biomarkers (7762 Da, 8560 Da, 11654 Da), this showing excellent separation between pancreatic cancer and non-cancer., with a sensitivity of 93.3% and a specificity of 95.6%. Blind test data showed a sensitivity of 88% and a specificity of 91.4%. Conclusions: The results suggested that serum biomarkers for pancreatic cancer can be detected using SELDI-TOF-MS combined with magnetic beads. Application of combined biomarkers may provide a powerful and reliable diagnostic method for pancreatic cancer with a high sensitivity and specificity.

Establishment of a Pancreatic Cancer Stem Cell Model Using the SW1990 Human Pancreatic Cancer Cell Line in Nude Mice

  • Pan, Yan;Gao, Song;Hua, Yong-Qiang;Liu, Lu-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.437-442
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    • 2015
  • Aim: To establish a pancreatic cancer stem cell model using human pancreatic cancer cells in nude mice to provide a platform for pancreatic cancer stem cell research. Materials and Methods: To establish pancreatic cancer xenografts using human pancreatic cancer cell line SW1990, nude mice were randomly divided into control and gemcitabine groups. When the tumor grew to a volume of $125mm^3$, they treated with gemcitabine at a dose of 50mg/kg by intraperitoneal injection of 0.2ml in the gemcitabine group, while the mice in control group were treated with the same volume of normal saline. Gemcitabine was given 2 times a week for 3 times. When the model was established, the proliferation of pancreatic cancer stem cells was observed by clone formation assay, and the protein and/or mRNA expression of pancreatic stem cell surface markers including CD24, CD44, CD133, ALDH, transcription factors containing Oct-4, Sox-2, Nanog and Gli, the key nuclear transcription factor in Sonic Hedgehog signaling pathway was detected by Western blot and/or RT-PCR to verify the reliability of this model. Results: This model is feasible and safe. During the establishment, no mice died and the weight of nude mice maintained above 16.5g. The clone forming ability in gemcitabine group was stronger than that of the control group (p<0.01). In gemcitabine group, the protein expression of pancreatic cancer stem cell surface markers including CD44, and ALDH was up-regulated, the protein and mRNA expression of nuclear transcription factor including Oct-4, Sox-2 and Nanog was also significantly increased (P<0.01). In addition, the protein expression of key nuclear transcription factor in Sonic Hedgehog signaling pathway, Gli-1, was significantly enhanced (p<0.01). Conclusions: The pancreatic cancer stem cell model was successfully established using human pancreatic cancer cell line SW1990 in nude mice. Gemcitabine could enrich pancreatic cancer stem cells, simultaneously accompanied by the activation of Sonic Hedgehog signaling pathway.

A Study on Quality of Life of Advanced Hepatobiliary and Pancreatic Cancer patients Administered with Traditional Korean Cancer Treatment (간, 담도, 췌장의 진행암으로 한방병원에 내원한 환자의 삶의 질(FACT-G)에 대한 분석)

  • Choi, Chul-Min;Koh, Byung-Hee;Kim, Se-Hyun;Choi, Won-Cheol;Lee, Soo-Kyung
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.30-38
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    • 2008
  • Objectives: The main goals of cancer treatment are improvement of quality of life and survival prolongation. There is a limitation to prolonging the survival time in hepatobiliary and pancreatic cancer. The purpose of this study was to evaluate the quality of life of hepatobiliary and pancreatic cancer patients who visited for traditional Korean cancer treatment. Methods: We evaluated the quality of life of 23 hepatobiliary and pancreatic cancer patients who visited for oriental medicine treatment at East-West Neo Medical Center from June to October of 2007. FACT-G (Functional Assessment Cancer Therapy-General), used in this study, is a scale for evaluation of QOL confirmed validity and reliability, popularly used in many countries to evaluate QOL of cancer patients. Results: The average age of enrolled patients was 57. There were 10 hepatocellular carcinoma patients, 7 pancreatic cancer patients, 6 biliary tract cancer patients. Twenty one patients were in stage IV and 20 patients had distant metastases. By Sasang constitution, Taeumin were 7, Soyangin were 8, and Soeumuin were 8. The baselines of FACT-G score in the first visit were from 34.33 to 85, and the mean score was 67.3. The mean score of FACT-G in hepatocellular carcinoma patients was 67.5, that of pancreatic cancer patients was 62.5, and that of biliary tract cancer patients was 71. Conclusions: This study is valuable as an initial QOL study of hepatobiliary and pancreatic cancer patients who visited an oriental medical clinic. We believe that consistent studies will be necessary to demonstrate oriental treatment-related quality of life with hepatobiliary and pancreatic cancer.

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Prophylaxis of Venous Thromboembolism in Patients with Pancreatic Cancer (췌장암 환자에서 정맥 혈전증 예방)

  • Lee, Kang Won;Lee, Jae Min;Lee, Hong Sik
    • Journal of Digestive Cancer Reports
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    • v.8 no.1
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    • pp.51-55
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    • 2020
  • Prognosis of patients with pancreatic cancer is poor due to difficulty in early diagnosis and low resectability rate at the time of diagnosis. Apart from the progression of cancer, venous thromboembolism - a complication that can increase patient mortality - is known to occur frequently in pancreatic cancer. This review was aimed at identifying whether venous thromboembolism is more common in pancreatic cancer than in other cancer types. In addition, we reviewed several studies to determine whether thromboprophylaxis increases the survival rates of patients with pancreatic cancer.

A Patient with Locally Advanced Pancreatic Cancer Who Refused Additional Chemotherapy (추가 항암 치료를 거부하는 국소 진행형 췌장암 환자 1례)

  • Hee Seung Lee;Moon Jae Chung;Jeong Youp Park;Seungmin Bang;Seung Woo Park;Si Young Song
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.127-129
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    • 2016
  • The prognosis for pancreatic cancer patient is very poor. Patients with locally advanced disease have a median survival time of 8 to 12 months, and patients with distant metastases have significantly worse outcomes, with a median survival time of only 3 to 6 months. Approximately 30% of patients with pancreatic cancer present with locally advanced disease defined as unresectable pancreatic cancer without evidence of distant metastatic disease. Primary treatment options in locally advanced pancreatic cancer include chemotherapy and radiotherapy. Here, we reported a patient with locally advanced pancreatic cancer who does not want further chemotherapy because of chemotherapy induced nausea and vomiting. Irreversible electroporation was performed. Irreversible electroporation was well tolerated in this case, and may be a therapeutic modality for selected patients with locally advanced pancreatic cancer.

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Pancreatic Cancer Incidence and Mortality Patterns in China, 2009

  • Chen, Wan-Qing;Liang, Di;Zhang, Si-Wei;Zheng, Rou-Shou;He, Yu-Tong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7321-7324
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    • 2013
  • Objective: To estimate the incidence and mortality rates for pancreatic cancer in China. Methods: After checking and reviewing the cancer registry data in 2009 from 72 cancer registry centers, we divided cancer registry areas into urban and rural areas. Incidence/mortality rates, age-specific incidence/mortality rates, age-standardized incidence/mortality rates, proportions, and cumulative incidence/mortality rates for pancreatic cancer were calculated. Results: The total number of newly diagnosed pancreatic cancer cases and deaths in 2009 were 6,220 and 5,650, respectively. The crude incidence rate in all cancer registry areas was 7.28/100,000 (males 8.24, females 6.29). The age-standardized incidence rate by Chinese standard population (ASR) was 3.35/100,000, with ranking at 7th among all cancers. Pancreatic cancer incidence rate was 8.19/100,000 in urban areas whereas it was 5.41/100 000 in rural areas. Cancer mortality rate in all cancer registry areas was 6.61/100,000 (males 7.45; females 5.75), with ranking at 6th among all cancers, and 7.42/100 000 in urban but 4.94/100000 in rural areas. Conclusions: Pancreatic cancer incidence and mortality rates have shown a gradual increase in China. Owing to the difficulty of early diagnosis, identification of high-risk population and modification of risk factors are important to reduce the burden of pancreatic cancer.

Clinical Efficacy of Endoscopic Pancreatic Drainage for Pain Relief with Malignant Pancreatic Duct Obstruction

  • Gao, Fei;Ma, Shuren;Zhang, Ning;Zhang, Yingchun;Ai, Meina;Wang, Bing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6823-6827
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    • 2014
  • Objective: This study was conducted to investigate the efficacy of pancreatic drainage for pain relief in advanced pancreatic cancer. Method: Seventy-one patients with pancreatic carcinoma were divided into two groups: dilated and non-dilated pancreatic ducts. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic biliary stenting and pancreatic stenting. Visual Analog Scale (VAS) scores, pain remission rates and survival time were evaluated during follow-up. Results: The post-ERCP VAS score of the dilated group was lower than that of the non-dilated group at 1 and 3 months post-ERCP. There was no difference at 6 months. The pain remission rate in the dilated duct group was significantly higher than that in non-dilated duct group in 1 and 3 months post-ERCP. The median survival times were 8.17 and 8.22 months respectively. Conclusion: Endoscopic pancreatic drainage can relieve pain of advanced pancreatic cancer accompanied by safe dilation of the pancreatic duct.

Resection for Pancreatic Cancer Lung Metastases

  • Okui, Masayuki;Yamamichi, Takashi;Asakawa, Ayaka;Harada, Masahiko;Horio, Hirotoshi
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.326-328
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    • 2017
  • Background: Pancreatic cancer is a highly aggressive solid tumor. Patients with metastases from pancreatic cancer have poor survival rates. Here, we report the outcomes of 6 patients for whom resection of lung metastases was performed after a pancreatectomy to treat pancreatic cancer. Methods: We retrospectively reviewed the perioperative clinical data of patients with lung metastases resulting from primary pancreatic cancer who were treated with lung resection between 2008 and 2015. We report 6 cases where lung resection was performed to treat lung metastases after a pancreatectomy. Results: The number of lung metastases was 1 in 5 cases and 2 in 1 case. The surgical procedures performed to treat the lung metastases included 4 wedge resections and 2 lobectomies. The cell type of the primary tumor and metastases was tubular adenocarcinoma in 5 cases and intraductal papillary-mucinous carcinoma in 1 case. All 6 patients survived with a mean follow-up period of 65.6 months, although the disease recurred in 2 patients. Conclusion: Resection of lung metastases resulting from primary pancreatic cancer may lengthen survival, provided the patient can tolerate surgery.

Metformin May Improve the Prognosis of Patients with Pancreatic Cancer

  • Zhang, Jia-Wei;Sun, Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3937-3940
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    • 2015
  • Background: Pancreatic cancer risk is increased in patients with type 2 diabetes, while being reduced by metformin treatment. However, it is unclear whether metformin could be associated with clinical outcomes of patients with pancreatic cancer and concurrent type 2 diabetes. Materials and Methods: A pooled analysis of 4 publications including 1,429 patients was performed to investigate the association of metformin and overall survival(OS) in patients with pancreatic cancer and concurrent type 2 diabetes. Results: A borderline significant relative survival benefit was found in metformin treated patients compared with non-metformin treated patients (hazard ratio 0.80; 95% CI: 0.62-1.03). Conclusions: These results suggest that further investigation is warranted of whether metformin may benefit the survival of patients with pancreatic cancer and concurrent type 2 diabetes.