Establishment and validation of a nomogram based on coagulation parameters to predict the prognosis of pancreatic cancer.

BACKGROUND: In recent years, multiple coagulation and fibrinolysis (CF) indexes have been reported to be significantly related to the progression and prognosis of some cancers. OBJECTIVE: The purpose of this study was to comprehensively analyze the value of CF parameters in prognosis prediction of pancreatic cancer (PC). METHODS: The preoperative coagulation related data, clinicopathological information, and survival data of patients with pancreatic tumor were collected retrospectively. Mann Whitney U test, Kaplan-Meier analysis, and Cox proportional hazards regression model were applied to analyze the differences of coagulation indexes between benign and malignant tumors, as well as the roles of these indexes in PC prognosis prediction. RESULTS: Compared with benign tumors, the preoperative levels of some traditional coagulation and fibrinolysis (TCF) indexes (such as TT, Fibrinogen, APTT, and D-dimer) were abnormally increased or decreased in patients with pancreatic cancer, as well as Thromboelastography (TEG) parameters (such as R, K, α Angle, MA, and CI). Kaplan Meier survival analysis based on resectable PC patients showed that the overall survival (OS) of patients with elevated α angle, MA, CI, PT, D-dimer, or decreased PDW was markedly shorter than other patients; moreover, patients with lower CI or PT have longer disease-free survival. Further univariate and multivariate analysis revealed that PT, D-dimer, PDW, vascular invasion (VI), and tumor size (TS) were independent risk factors for poor prognosis of PC. According to the results of modeling group and validation group, the nomogram model based on independent risk factors could effectively predict the postoperative survival of PC patients. CONCLUSION: Many abnormal CF parameters were remarkably correlated with PC prognosis, including α Angle, MA, CI, PT, D-dimer, and PDW. Furthermore, only PT, D-dimer, and PDW were independent prognostic indicators for poor prognosis of PC, and the prognosis prediction model based on these indicators was an effective tool to predict the postoperative survival of PC.

RNA sequence analysis reveals pathways and candidate genes associated with pancreatic acinar cells injury in a mouse pancreatitis model.

Compared with acute pancreatitis caused by other reasons, hyperlipidemia pancreatitis has a higher severity, complication and organ failure rate. Our previous studies have found that hyperglycemia may promote the occurrence and development of hyperlipidemia pancreatitis, but the mechanism is still unclear. Pancreatic acinar cell injury is the initial link of acute pancreatitis and plays a vital role in the course of the disease. The aim of the present study was to analyze the differentially expressed genes (DEGs) between hyperlipidemia acute pancreatitis (HLAP) mouse and hyperglycemia and hyperlipidemia acute pancreatitis (HLGAP) mouse by RNA-sequence. The GO and KEGG analysis of these DEGs did not indicate a direct pathway related to acinar cell injury. However, in further targeted analysis, we found that there are different genes related to cell injury between the HLAP and HLGAP groups, such as necroptosis, autophagy, mitophagy and ferroptosis. In the later immunofluorescence experiments, it was also confirmed that the genes related to cell injury were significantly differentially expressed between the two groups. In conclusion, there are multiple cell injury modes in the course of hyperglycemia and hyperlipidemia pancreatitis. More importantly, the correlation and transition between multiple cell injury modes may be the key mechanism for the occurrence and development of pancreatitis.