ObjectiveTo study the effect of tumor associated neutrophil (TAN) releasing a proliferation-inducing ligand (APRIL) on the proliferation of pancreatic cancer cells in microenvironment.Methods① The expressions of APRIL in neutrophils (differentiated by HL-60 cell) and TAN cells were detected by use ELISA. ② The expressions of APRIL receptors B cell maturation antigen (BCMA) and trans-membrane activator and CAML interactor (TACI) in pancreatic cancer cell line PANC-1 were confirmed by use Western blotting. ③ Pancreatic cancer PANC-1 cells were co-cultured with TAN, and divided into a PANC-1 control group (referred to as the control group), a PANC-1+TAN treatment group (referred to as the PANC-1+TAN group), PANC-1+TAN+APRIL antibody treatment group (referred to as PANC-1+TAN+APRIL group), and PANC-1+rtificial recombinant APRIL protein (rAPRIL) treatment group (referred to as PANC-1+rAPRIL group). The CCK8 method was used to determine TAN release of APRIL on PANC-1 effect of cell proliferation activity.Results① The APRIL content in the culture medium of TAN cell group was higher than that of neutrophil group [(556.20±84.38) pg/mL vs. (377.17±57.07) pg/mL, P=0.038]. ② PANC-1 cells express the receptors BCMA and TACI of APRIL. ③ PANC-1 cell activity of PANC-1+TAN group and PANC-1+rAPRIL group [(126.80±1.42)%, (168.95±12.54)%] were significantly higher than the control group [(100 ± 0.00)%, P<0.05, P<0.001], the activity of PANC-1 cells in the PANC-1+TAN group was significantly higher than that in the PANC-1+TAN+APRIL group [(86.29 ± 12.20)%, P=0.003] and significantly lower than that of PANC-1+rAPRIL group (P=0.002), the activity of PANC-1 cells in PANC-1+rAPRIL group was significantly higher than that in PANC-1+TAN+APRIL antibody group (P<0.001).ConclusionIn the microenvironment of pancreatic cancer, the release of APRIL from TAN increases, which promotes the proliferative activity of PANC-1 in pancreatic cancer cells, which provides a new idea for the mechanism research and treatment of pancreatic cancer progression.
ObjectiveTo evaluate the predictive value of the geriatric nutritional risk index (GNRI) for postoperative overall and severe complications after pancreaticoduodenectomy (PD) in the elderly patients with pancreatic cancer. MethodsThe clinical data of the elderly (65 years old or more) patients with pancreatic cancer underwent PD were retrospectively collected, who were admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from January 2017 to October 2021. The incidences of postoperative overall and severe complications (Clavien-Dindo grade Ⅲ–Ⅴ was defined as severe complications) were summarized. The univariate and multivariate logistic regression models were used to analyze whether GNRI was a risk factor for overall and severe complications after PD. The area under the receiver operating characteristic curve (AUC) was used to evaluate the ability of GNRI to distinguish whether overall or severe complications occurred after PD and to confirm the optimal threshold. Then the patients were assigned into a high nutritional risk group (greater than the optimal threshold) and low nutritional risk group (the optimal threshold or less) based on this. Simultaneously, the clinical outcomes of the two groups were compared. ResultsIn this study, 190 elderly patients with pancreatic cancer were enrolled, 95(50.0%) of whom developed complications, including 28(29.5%) cases of serious complications. The results of multivariate logistic regression model analysis showed that the decreased GNRI was a risk factor for the occurrence of overall and severe complications after PD for the elderly patients [OR(95%CI)=0.361(0.154, 0.848), P=0.019; OR(95%CI)=0.906(0.834, 0.983), P=0.018]. The AUC of GNRI for assessing the occurrence of overall and severe complications was 0.765 and 0.715, respectively, with the optimal critical values of 98 and 96, respectively. Compared with the low nutritional risk group, the high nutritional risk group had higher postoperative total hospitalization costs (Z=–2.37, P=0.019), higher occurrences of overall complications (χ2=44.61, P<0.001) and severe complications (χ2=29.39, P＜0.001). ConclusionsIn elderly patients with pancreatic cancer underwent PD, incidence of serious complications is not lower. GNRI has a good discriminative value in terms of postoperative overall and severe complications. When preoperative GNRI is 98 or less and GNRI is 96 or less, patients should be given early preoperative nutritional support treatment in time.
ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.
ObjectiveTo explore the significance of mesenchymal epithelial transition factor (MET) as a clinical prognostic evaluation index for patients with pancreatic cancer based on bioinformatics analysis.MethodsThe GSE28735 and GSE62452 gene chips from GEO database were downloaded and the difference of MET gene expression between cancer and adjacent cancerous tissues were analyzed by bioinformatics. We downloaded pancreatic cancer gene chip from TCGA database to analyze the correlation between MET gene expression and clinicopathological features of pancreatic cancer patients and prognosis risk. Finally, the possible molecular mechanism of MET involved in pancreatic carcinogenesis was analyzed by GO and KEGG enrichment analysis.ResultsThe expression level of MET gene in pancreatic cancer tissues was significantly higher than that in adjacent cancerous tissues (P<0.001). The overall survival and disease-free survival of pancreatic cancer patients in the high MET gene expression group were lower than those in the low expression group (P<0.001). The expression level of MET gene was related to the age of pancreatic cancer patients, T stage, and histological grading of tumors (P<0.05), and high MET gene expression, age >65 years, and N1 stage were independent risk factors affecting the prognosis of pancreatic cancer patients. KEGG enrichment analysis showed that MET was mainly related to PI3K/AKT signaling pathway, FAK signaling pathway, and cancer transcription dysregulation and so on.ConclusionMET may be a valuable tumor marker for pancreatic cancer and can predict the poor prognosis of patients with pancreatic cancer.
ObjectiveTo summarize the research progress of KRAS mutation in pancreatic tumorigenesis and therapy.MethodThe research progress of KRAS mutation in pancreatic tumorigenesis and therapy were summarized by reading the domestic and international literatures published in recent years.ResultsPancreatic cancer had the title of " king of cancer”. More than 90% of pancreatic cancer patients had KRAS mutation. KRAS had a complex relationship with pancreatic cancer through downstream signaling pathways, including Raf (rapidly accelerated fibrosarcoma)-mitogen-activated protein kinase kinase (MEK)-extracellular signal-regulated kinase (ERK), phosphatidylinositol-4, 5-bisphosphate 3-kinase (PI3K)-protein kinase B (AKT), and RalGDS-Ral. Although basic research on pancreatic cancer was deepening, there was still a lack of effective molecular targeted drugs.ConclusionsKRASgene plays an important role in the occurrence of pancreatic cancer. The treatment associated with KRAS mutation provides a more effective prognostic possibility for pancreatic cancer patients.
ObjectiveTo investigative current status and hotspot issues of pancreatic cancer imaging research.MethodsThe literatures focusing on pancreatic cancer and published from 2001 to 2020 were retrieved from the core database of Web of Science. The quantitative analysis of literatures was then conducted by using the CiteSpace software based on the bibliometric method. The research trend was then summarized systematically and the potential research fronts and focuses were explored.ResultsA total of 2111 articles in the field of pancreatic cancer imaging research were retrieved. The clustering of co-citation of pancreatic cancer included vascular resection, irreversible electroporation, autoimmune pancreatitis, sporadic pancreatic cancer, sarcopenia, pancreas, stereotactic body radiation therapy, metastatic pancreatic cancer, familial pancreatic cancer, abdominal ultrasonography, fibroblast, early diagnosis, time trends in survival, radiomics, pancreatitis, gemcitabine, concurrent chemoradiotherapy, adjuvant chemotherapy, and microbubbles. The burst keywords in the field of pancreatic cancer after 2016 included FOLFIRINOX, skeletal muscle, sarcopenia, and texture analysis. The hot keywords clustering had prognosis, fine needle aspiration, positron emission tomography, vascular invasion, angiogenesis, unresectable, liver transplant, extend pancreatectomy, transplantation, paclitaxel, metastatic colorectal cancer, colorectal cancer, microsatellite stable, radiomics, hospital volume, occult metastasis, risk factor.ConclusionIt might be the trend of imaging research to study the prognosis, risk factors, and quantitative sarcopenia of pancreatic cancer by using radiomics.
ObjectiveTo explore the application value of high intensity focused ultrasound (HIFU) in the treatment of advanced pancreatic cancer.MethodThe domestic and foreign literatures about studies of HIFU treating advanced pancreatic cancer in recent years were retrieved and summarized.ResultsHIFU could prolong the survival time, control pain, and enhance the body’s immune function in patients with advanced pancreatic cancer. There were no obvious serious complications during the treatment process. The combined treatment with radiotherapy, chemotherapy, and traditional Chinese medicine could obviously prolong the survival time and improve the quality of life for the patients with advanced pancreatic cancer.ConclusionsHIFU is an important component in the comprehensive treatment of advanced pancreatic cancer. However, because there is no uniform standard for the dosage of HIFU treatment, the sample size of many related studies is small, so the research results have certain limitations, so more studies are needed to improve their understanding of advanced pancreatic cancer in order to better serve clinical workin future.
ObjectivesTo evaluate the economic efficacy of nab-paclitaxel (NAB-P) combined with gemcitabine (GEM) versus GEM alone in the treatment of metastatic pancreatic cancer in China.MethodsA Markov model simulating the costs and health outcomes was developed to estimate quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). The impact of parameter uncertainty on the model was assessed by deterministic one-way sensitivity analysis.ResultsNAB-P combined with GEM was shown superior efficacy compared to gemcitabine monotherapy, however with higher costs. The ICER between the two groups was 964 780.79￥/QALY.ConclusionsCompared with gemcitabine monotherapy, NAB-P combined with GEM is not cost-effective. The conclusion is confirmed by deterministic one-way sensitivity analysis.
Objective To summarize the progress in related basic research of molecular targeted therapy in pancreatic cancer. Method The relevant literatures on oncogenes, epigenome, tumour microenvironment and immunotherapy in recent years at home and abroad were reviewed. ResultsIn basic research, molecularly targeted drugs had shown some efficacy in the treatment of progression of pancreatic cancer, however, in clinical trials, more satisfactory results were not achieved. Conclusion Molecularly targeted therapies for pancreatic cancer are still at a preliminary stage of exploration, and basic research has not yet been effectively translated clinically, which requires further exploration efforts in subsequent studies to provide a more solid and reliable basis for precise treatment of pancreatic cancer and achieve better clinical benefits.
ObjectiveThis review aimed to summarize the current epidemiological status and risk factors of pancreatic cancer at home and abroad.MethodThe literatures on epidemiology and risk factors of pancreatic cancer in recent years were collected and summarized.ResultsCurrently the overall incidence of pancreatic cancer was lower in all malignant tumors, but the mortality rate was the opposite. Incidence varies from region to region, the incidence rate in economically developed areas was higher than that of underdeveloped areas. Although the disease had made some progress in the fields of surgery, chemotherapy, an so on, the long-term survival of patients with pancreatic cancer was still not ideal. The onset of pancreatic cancer was associated with smoking, alcohol, obesity, dietary imbalance, age, gender, blood type, ethnicity, family history and genetic history, chronic pancreatitis, infection, and intestinal flora imbalance.ConclusionsPancreatic cancer is a high malignancy with a poor prognosis. It is influenced by a variety of risk factors. Therefore, it is especially necessary to pay attention to the primary prevention of pancreatic cancer and screen high-risk individuals regularly, to diagnose pancreatic cancer at an early stage.