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2.
J Surg Oncol ; 123(1): 236-244, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33084065

RESUMO

INTRODUCTION: The objective of this study was to characterize time from cancer symptoms to diagnosis and time from diagnosis to surgical treatment among patients undergoing pancreatectomy for cancer. METHODS: Medicare beneficiaries who underwent pancreatectomy for cancer between 2013 and 2017 were identified using the 100% Medicare Inpatient Standard Analytic Files. Mixed effects negative binomial regression models were utilized to determine which factors were associated with the number of weeks to diagnosis and pancreatic resection. RESULTS: Among 7647 Medicare beneficiaries, two-thirds (n = 5127, 67%) had symptoms associated with a pancreatic cancer diagnosis before surgery. Median time from the first symptom to diagnosis was 6 weeks (IQR: 1-25) and the median time from diagnosis to surgery was 4 weeks (IQR: 2-15). In risk-adjusted models, female patients had 13% longer waiting times from identification of a related symptom to pancreatic cancer diagnosis (OR = 1.13, 95% CI: 1.05-1.21) and 12% longer waiting times from diagnosis to surgery (OR = 1.12, 95% CI: 1.07-1.18). Older age was associated with 10% longer waiting times from symptom identification to diagnosis (p < .0001). CONCLUSIONS: Female and older patients had longer wait times between symptom presentation and pancreatic cancer diagnosis. Sex-based disparities in cancer care need to be recognized and addressed by policymakers and health care institutions.


Assuntos
Diagnóstico Tardio/estatística & dados numéricos , Pancreatectomia/mortalidade , Neoplasias Pancreáticas/mortalidade , Tempo para o Tratamento/estatística & dados numéricos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Medicare , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia , Prognóstico , Caracteres Sexuais , Taxa de Sobrevida , Estados Unidos
3.
Medicine (Baltimore) ; 99(49): e23048, 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33285682

RESUMO

Insulinoma is the most common functional neuroendocrine tumor that originates from the islet of beta cells. Insulinoma is usually an isolated benign tumor and small in size (<2 cm). Due to the small size of the lesion, it often leads to difficulty in clinical preoperative localization diagnosis. However, we have unexpectedly discovered that the diffusion-weighted-imaging (DWI) adds great value in the preoperative localization diagnosis of insulinoma in non-invasive examination technique.We verified using operative pathology data and retrospectively analyzed the clinical and imageology findings of 5 cases who reported to have an insulinoma. All the 5 cases underwent DWI examination, among non-contrast enhanced magnetic resonance imaging (MRI) in 1 case, contrast-enhanced MRI in 4 cases.Five cases of DWI showed a nodular high signal <1.3 cm with pancreatic tail in 3 cases, pancreatic neck, and pancreatic head in 1 case each, respectively. Non-contrast enhanced MRI showed suspicious abnormal signals in the tail of the pancreas were detected in 1 case. MRI enhanced scans presented 2 cases with abnormal enhancement in the arterial phase and 2 cases without abnormal enhancement in arterial phase. Also, 3 cases showed mild persistence enhanced in the portal venous phase and delayed phase. However, 1 case remained normal in the portal venous phase and the delay period.DWI examination has high clinical value in the localization diagnosis of insulinoma and thus it can be used as a routine examination for preoperative localization diagnosis.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Insulinoma/diagnóstico , Insulinoma/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Adulto , Feminino , Humanos , Insulinoma/diagnóstico por imagem , Insulinoma/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Período Pré-Operatório , Estudos Retrospectivos
5.
Medicine (Baltimore) ; 99(52): e23863, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350781

RESUMO

ABSTRACT: To identify serum microRNA-25 (miR-25) as a diagnostic biomarker for pancreatic cancer (PCa) and to evaluate its supplementary role with serum carbohydrate antigen 19-9 (CA19-9) in early identification of cancers.Eighty patients with pancreatic cancer and 91 non-cancer controls were enrolled in this study. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression level of miR-25. Levels of CA19-9, carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) were measured by chemiluminescent immunoassay. The logistic model was established to evaluate the correlation of miR-25 with clinical characteristics. A risk model for PCa was conducted by R statistical software. Diagnostic utility for PCa and correlation with clinical characteristics were analyzed.The expression level of miR-25, in the PCa group was significantly higher (P < .05). Risk Model illustrated the relation between miR-25 and pancreatic cancer. With the combination of CA19-9, the performance of miR-25 in early stages (I+II) in the diagnosis of PCa was profoundly better than CA19-9 and miR-25 alone. This combination was more effective for discriminating PCa from non-cancer controls (AUC-ROC, 0.985; sensitivity, 97.50%; specificity, 90.11%) compared with CA19-9 alone or the combination of CA19-9 and CA125.The expression level of miR-25 among pancreatic cancer patients was significantly higher than that in the control group. miR-25 existed as one of the most relevant factors of PCa. miR-25 can serve as a novel noninvasive approach for PCa diagnosis, and with the supplementary of CA19-9, the combination was more effective, especially in early tumor screening.


Assuntos
Antígeno CA-19-9/sangue , MicroRNAs/sangue , Neoplasias Pancreáticas , Medição de Risco/métodos , Biomarcadores Tumorais/sangue , Diagnóstico Diferencial , Detecção Precoce de Câncer , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Reprodutibilidade dos Testes
6.
Vnitr Lek ; 66(7): 447-448, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33380125

RESUMO

Hypoglycemia is a rather frequent complication of diabetes treatment, however it can occur also in non-diabetic patients. The article presents a brief differential diagnosis of hypoglycemia in non-diabetic patients.


Assuntos
Diabetes Mellitus Tipo 2 , Hipoglicemia , Insulinoma , Neoplasias Pancreáticas , Diagnóstico Diferencial , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/diagnóstico , Insulinoma/diagnóstico , Neoplasias Pancreáticas/diagnóstico
7.
Medicine (Baltimore) ; 99(46): e22291, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181635

RESUMO

Histologically, the World Health Organization has classified pancreatic neuroendocrine neoplasms (p-NENs) into well-differentiated pancreatic neuroendocrine tumors (G1/G2 p-NETs) and poorly-differentiated pancreatic neuroendocrine carcinoma (G3 p-NECs) based on tumor mitotic counts and Ki-67 index. Recently, the 8th edition of American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging manual has incorporated some major changes in 2017 that the TNM staging system for p-NENs should only be applied to well-differentiated G1/G2 p-NETs, while poorly-differentiated G3 p-NECs be classified according to the new system for pancreatic exocrine adenocarcinomas. However, this new manual for p-NENs has seldom been evaluated.Data of patients with both G1/G2 and G3 non-functional p-NENs (NF-p-NENs) from our institution was retrospectively collected and analyzed using 2 new AJCC 8th staging systems. We also made survival comparisons between the 8th and 7th edition system separately for different subgroups.For G1/G2 NF-p-NETs, there were 52 patients classified in AJCC 8th edition stage I, 40 in stage II, 41 in stage III and 19 in stage IV. As for G3 NF-p-NECs, 17, 19, 24, and 18 patients were respectively defined from AJCC 8th edition stage I to stage IV. In terms of the AJCC 7th staging system, the 230 patients with NF-p-NENs were totally distributed from stage I to stage IV (94, 63, 36, 37, respectively). For the survival analysis of both G1/G2 NF-p-NETs and G3 NF-p-NECs, the AJCC 7th edition system failed to discriminate the survival differences when compared stage III with stage II or stage IV (P > .05), while the 8th edition ones could perfectly allocate patients into 4 statistically different groups (P < .05). The HCIs of AJCC 8th stage for G1/G2 NF-p-NETs [HCI=0.658, 95% confidence interval (CI)=0.602-0.741] and stage for G3 NF-p-NECs (HCI=0.704, 95% CI=0.595-0.813) was both statistically larger than those of AJCC 7th stage for different grading NF-p-NENs [(HCI=0.578, 95% CI=0.557-0.649; P=.031), (HCI=0.546, 95% CI=0.531-0.636; P = .019); respectively], indicating a more accurate predictive ability for the survivals of NF-p-NENs.Our data suggested the 2 new AJCC 8th staging systems were superior to its 7th edition for patients with both G1/G2 NF-p-NETs and G3 NF-p-NECs.


Assuntos
Oncologia/métodos , Estadiamento de Neoplasias/métodos , Neoplasias Pancreáticas/classificação , Livros de Texto como Assunto/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Oncologia/instrumentação , Oncologia/organização & administração , Pessoa de Meia-Idade , Células Neuroendócrinas/patologia , Neoplasias Pancreáticas/diagnóstico , Estudos Retrospectivos , Estados Unidos
8.
Medicine (Baltimore) ; 99(47): e23267, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217853

RESUMO

INTRODUCTION: Mature cystic teratoma originating in the pancreas is very unusual, often observed as an incidental finding during routine examinations or recognized perioperatively as the patients present with very unspecific clinical symptoms. The confirmatory diagnosis of a pancreatic cystic teratoma is generally made by histopathology after surgical excision. So, the preoperative diagnosis is very challenging, especially differentiation from the other pancreatic pathologies. PATIENT CONCERNS: A 23-year-old woman was admitted to our hospital with a complaint of mild grade periumbilical abdominal pain. A pancreatic mass was revealed on a preliminary abdominal ultrasound examination. Her medical history was unremarkable with no long-standing illness or malignancy. DIAGNOSIS: Mature cystic teratoma in the head of the pancreas. INTERVENTIONS: Roux-enY choledochojejunostomy with gastrojejunostomy was performed, excising the tumor from the pancreatic head. OUTCOMES: The postoperative course was uneventful; the patient was asymptomatic and has no evidence of recurrence on a 2-year follow up. CONCLUSIONS: Pancreatic cystic teratoma is a benign, well-differentiated, and extremely rare congenital tumor. MRI is the choice of imaging modality and phase-GRE or fat suppression is the best technique for pre-operative diagnosis.


Assuntos
Neoplasias Pancreáticas/diagnóstico , Teratoma/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Adulto Jovem
9.
JAMA Netw Open ; 3(11): e2022933, 2020 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-33252689

RESUMO

Importance: Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) are common pancreatic preneoplastic lesions, but their surveillance is not personalized. Objective: To investigate patient- and cyst-related factors associated with progression into worrisome features (WFs) or high-risk stigmata (HRS) categories of BD-IPMNs. Design, Setting, and Participants: Cyst- and patient-related factors of consecutive BD-IPMNs without WFs or HRS in 540 patients diagnosed from 2009 to 2018 with at least 12 months' surveillance until February 28, 2020, were registered in a 2-center ambispective cohort study in Italy. In a subgroup, the ABO blood group was studied for the first time in this setting. Exposure: Cyst-related and patients-related factors and ABO blood group. Main Outcomes and Measures: The study outcome was the appearance of WFs or HRS according to the 2017 International Association of Pancreatology guidelines. Survival probability was calculated using Kaplan-Meier curve and risk factors identified by Cox proportional hazards regression. ABO blood group was inferred through genotypes with DNA extraction. Results: Of 540 patients with BD-IPMNs (median age, 66 years [interquartile range, 58.5-72.0 years]; 337 women [62.4%]) undergoing surveillance for a median of 51.5 months (interquartile range, 28-84 months) for 2758 person-years, 130 patients (24.1%) experienced progression. Probability of progression was 3.7% at 1 year, 23.4% at 5 years, and 43.3% at 10 years; 15 patients (2.8%) underwent surgery, 7 patients (1.3%) had malignant histologic findings, and 3 patients (0.56%) died of pancreatic-associated disease. Initial cyst size greater than 15 mm (hazard ratio [HR], 2.05; 95% CI, 1.44-2.91), body mass index greater than 26.4 (HR, 1.72; 95% CI, 1.19-2.50), and heavy smoking (HR, 1.81; 95% CI, 1.14-2.86) were significant independent factors associated with progression risk. The AA blood genotype was also associated with progression risk (HR, 3.49; 95% CI, 1.04-11.71) compared with the OO genotype in the investigated subgroup. Conclusions and Relevance: This analysis of factors associated with progression of BD-IPMNs according to recent guidelines suggests that cyst size alone is not a reliable factor for estimation of progression risk; however, along with other readily available data, size is helpful for planning personalized surveillance of BD-IPMNs.


Assuntos
Carcinoma Ductal Pancreático/patologia , Neoplasias Císticas, Mucinosas e Serosas/patologia , Neoplasias Pancreáticas/patologia , Lesões Pré-Cancerosas/patologia , Idoso , Carcinoma Ductal Pancreático/diagnóstico , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Císticas, Mucinosas e Serosas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Lesões Pré-Cancerosas/diagnóstico , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
10.
Ann Intern Med ; 173(11): 914-921, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33253616

RESUMO

Because pancreatic cancer is typically advanced at the time of diagnosis, it has a very low 5-year survival rate and may become the second leading cause of cancer death in the United States. A screening program to find early-stage pancreatic cancer is needed but has been challenging to develop because of the lack of an effective screening test. In 2019, the U.S. Preventive Services Task Force performed an evidence review and updated its guidance, confirming its 2004 "D" recommendation against routine screening for average-risk patients. Here, 2 experts review the updated guideline and recent evidence and discuss whether a patient with a family history of pancreatic cancer should undergo screening.


Assuntos
Neoplasias Pancreáticas/diagnóstico , Detecção Precoce de Câncer/efeitos adversos , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Fatores de Risco , Visitas com Preceptor
11.
Nat Commun ; 11(1): 5584, 2020 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-33149131

RESUMO

Homologous recombination deficiency (HRD) results in impaired double strand break repair and is a frequent driver of tumorigenesis. Here, we develop a genome-wide mutational scar-based pan-cancer Classifier of HOmologous Recombination Deficiency (CHORD) that can discriminate BRCA1- and BRCA2-subtypes. Analysis of a metastatic (n = 3,504) and primary (n = 1,854) pan-cancer cohort reveals that HRD is most frequent in ovarian and breast cancer, followed by pancreatic and prostate cancer. We identify biallelic inactivation of BRCA1, BRCA2, RAD51C or PALB2 as the most common genetic cause of HRD, with RAD51C and PALB2 inactivation resulting in BRCA2-type HRD. We find that while the specific genetic cause of HRD is cancer type specific, biallelic inactivation is predominantly associated with loss-of-heterozygosity (LOH), with increased contribution of deep deletions in prostate cancer. Our results demonstrate the value of pan-cancer genomics-based HRD testing and its potential diagnostic value for patient stratification towards treatment with e.g. poly ADP-ribose polymerase inhibitors (PARPi).


Assuntos
Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Genômica/métodos , Recombinação Homóloga , Neoplasias Ovarianas/genética , Alelos , Neoplasias da Mama/diagnóstico , Proteínas de Ligação a DNA/genética , Bases de Dados Genéticas , Proteína do Grupo de Complementação N da Anemia de Fanconi/genética , Feminino , Humanos , Incidência , Perda de Heterozigosidade , Masculino , Família Multigênica , Mutação , Neoplasias Ovarianas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética
13.
Ther Umsch ; 77(9): 449-455, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33146094

RESUMO

Neuroendocrine Neoplasia of the digestive tract Abstract. Neuroendocrine neoplasia are a rare and heterogenous tumor entity with long median survival even in metastatic situation. Surgery is the key therapeutic option although a wide range of other therapies are available in metastatic situation. Milestones in classification and grading were achieved by the European Neuroendocrine Tumor Society (ENETS) leading to practical guidelines and WHO- and TNM-classification comparable to the colorectal carcinoma. These new guidelines enable the handling of a rare and complex tumor entity.


Assuntos
Tumores Neuroendócrinos , Neoplasias Pancreáticas , Trato Gastrointestinal/patologia , Humanos , Estadiamento de Neoplasias , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Prognóstico
14.
Sci Rep ; 10(1): 16275, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004987

RESUMO

We analyzed 1196 proteins in longitudinal plasma samples from participants in a commercial wellness program, including samples collected pre-diagnosis from ten cancer patients and 69 controls. For three individuals ultimately diagnosed with metastatic breast, lung, or pancreatic cancer, CEACAM5 was a persistent longitudinal outlier as early as 26.5 months pre-diagnosis. CALCA, a biomarker for medullary thyroid cancer, was hypersecreted in metastatic pancreatic cancer at least 16.5 months pre-diagnosis. ERBB2 levels spiked in metastatic breast cancer between 10.0 and 4.0 months pre-diagnosis. Our results support the value of deep phenotyping seemingly healthy individuals in prospectively inferring disease transitions.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias/sangue , Idoso , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Antígeno Carcinoembrionário/sangue , Carcinoma Neuroendócrino/sangue , Carcinoma Neuroendócrino/diagnóstico , Estudos de Casos e Controles , Proteínas Ligadas por GPI/sangue , Promoção da Saúde/estatística & dados numéricos , Humanos , Estudos Longitudinais , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/sangue , Neoplasias/diagnóstico , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico , Estudos Prospectivos , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/diagnóstico , Fatores de Tempo
15.
Am J Gastroenterol ; 115(12): 2103-2108, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33105193

RESUMO

INTRODUCTION: Imaging-based surveillance programs fail to detect pancreatic ductal adenocarcinoma at a curable stage, creating an urgent need for diagnostic biomarkers. METHODS: Secretin-stimulated pancreatic juice (PJ) was collected from the duodenal lumen during endoscopic ultrasound. The yield of biomarkers and organoids was compared for 2 collection techniques (endoscope suction channel vs catheter-based) and 3 periods (0-4 vs 4-8 vs 8-15 minutes). RESULTS: Collection through the endoscope suction channel was superior to collection with a catheter. Collection beyond 8 minutes reduced biomarker yield. PJ-derived organoid culture was feasible. DISCUSSION: The optimal protocol for secretin-stimulated PJ collection is through the endoscope suction channel for 8 minutes allowing biomarker detection and organoid culture.


Assuntos
Biomarcadores/metabolismo , Carcinoma Ductal Pancreático/diagnóstico , Suco Pancreático/metabolismo , Neoplasias Pancreáticas/diagnóstico , Carcinoma Ductal Pancreático/metabolismo , Detecção Precoce de Câncer/métodos , Endossonografia , Humanos , Neoplasias Pancreáticas/metabolismo , Estudos Prospectivos
17.
Intern Med ; 59(19): 2383-2389, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32999265

RESUMO

Follow-up computed tomography revealed a 40-mm pancreatic tail cyst in a 59-year-old man with type 1 diabetes mellitus. An intraductal papillary mucinous neoplasm was suspected; mucinous cystic neoplasm (MCN) was not considered because the patient was a man. During follow-up, cyst infection occurred but was improved by conservative treatment. At the 24-month follow up examination, cyst nodules had developed, corresponding to an increase in the carbohydrate antigen 19-9 level. Mucinous cystadenocarcinoma (MCC) was diagnosed pathologically based on distal pancreatectomy. A diagnosis of male MCN/MCC is often delayed, which may lead to a poor prognosis. MCN infection is also rare and poorly recognized. We observed an atypical male case of MCN/MCC.


Assuntos
Cistadenocarcinoma Mucinoso/patologia , Cisto Pancreático/patologia , Neoplasias Pancreáticas/patologia , Antígeno CA-19-9/sangue , Cistadenocarcinoma Mucinoso/diagnóstico , Cistadenocarcinoma Mucinoso/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico , Tomografia Computadorizada por Raios X
18.
Medicine (Baltimore) ; 99(35): e22045, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871962

RESUMO

BACKGROUND: Previous studies have reported that microRNA-21 (mRNA-21) has an effect on the prognosis of pancreatic cancer. However, the conclusion is still unclear. Therefore, this study will try to explore the effect of high expression of mRNA-21 on the prognosis of pancreatic cancer. METHODS: Retrieved the database, including the China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature Database (CBM), Chinese Scientific and Journal Database (VIP), Wan Fang database, PubMed, and EMBASE. Hazard ratios (HRs) and its 95% confidence intervals (CIs) to assess the prognostic effect of miRNA-21 on overall survival (OS) and disease-free survival (DFS). RevMan 5.3 and STATA 16.0 software were used to perform the meta-analysis. RESULTS: This study will comprehensively review and evaluate the available evidence of high expression of miRNA-21 on the prognosis of patients with pancreatic cancer. CONCLUSION: Our findings will show the effect of high expression of miRNA-21 on the prognosis of patients with pancreatic cancer. Such studies may find a new prognostic marker for patients with pancreatic cancer and help clinicians and health professionals make clinical decisions. ETHICS AND DISSEMINATION: The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not available. The results may be published in a peer- reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/2A6KJ.


Assuntos
MicroRNAs/metabolismo , Neoplasias Pancreáticas/metabolismo , Humanos , Metanálise como Assunto , Neoplasias Pancreáticas/diagnóstico , Prognóstico , Revisões Sistemáticas como Assunto
19.
Medicine (Baltimore) ; 99(38): e22261, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957376

RESUMO

Pancreatic cancer (PC) is one of the major causes of cancer mortality in developed countries. Therefore, there is an urgent need to derive biomarkers for early diagnosis of PC patients at high risk.This study was designed to identify a panel of miRNAs that might serve as biomarkers for the early diagnosis of PC.The data containing both PC and control samples were extracted from the Gene Expression Omnibus (GEO) database. EdgeR was applied to identify the differentially expressed miRNAs and genes between PC patients and healthy controls. Then a miRNA-mRNA network was constructed based on the differentially expressed miRNAs and genes. The miRNAs-based biomarker for PC was finally constructed by random forest. Finally, AUC was used to evaluate the performance of miRNAs to classify PC and control samples.A total of 33 differentially expressed miRNAs, 753 differentially expressed genes, and 8 miRNAs (hsa-mir-139, hsa-mir-31, hsa-mir-196b, hsa-mir-221, hsa-mir-203b, hsa-mir-215, hsa-mir-144, and hsa-mir-4433b) that play important roles in PC were identified. The target genes of these miRNAs were found to be mainly enriched in negative regulation of acute inflammatory response cell-substrate responses, and o-glycan processing pathways. The constructed biomarkers based on these 8 miRNAs could distinguish samples coming from PC and healthy controls.We identified a panel of eight-miRNAs that would serve as early diagnostic biomarkers for PC patients.


Assuntos
Biomarcadores Tumorais/genética , Detecção Precoce de Câncer , MicroRNAs/genética , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Perfilação da Expressão Gênica , Humanos , Prognóstico , RNA Mensageiro/genética
20.
Biochim Biophys Acta Rev Cancer ; 1874(2): 188414, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32866530

RESUMO

Pancreatic cancer (PaCa) is considered an aggressive but still asymptomatic malignancy. Due to the lack of effective diagnostic markers, PaCa is often diagnosed during late metastatic stages. Besides surgical resection, no other treatment appears to be effective during earlier stages of the disease. Exosomes are related to a class of nanovesicles coated by a bilayer lipid membrane and enriched in protein, nucleic acid, and lipid contents. They are widely present in human body fluids, including blood, saliva, and pancreatic duct fluid, with functions in signal transduction and material transport. A large number of studies have suggested for a crucial role for exosomes in PaCa, which may be utilized to improve its future diagnosis and treatment, but the underlying molecular mechanisms as well as their potential clinical applications are largely unknown. By collecting and analyzing the most up-to-date literature, here we summarize the current progress of the clinical applications related to exosomes in PaCa. Therefore, we presently provide some rationale for the potential value of exosomes in PaCa, thereby promoting putative applications in targeted PaCa treatment.


Assuntos
Biomarcadores Tumorais/metabolismo , Exossomos/metabolismo , Neoplasias Pancreáticas/metabolismo , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Detecção Precoce de Câncer , Exossomos/efeitos dos fármacos , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos , Microambiente Tumoral/efeitos dos fármacos
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