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1.
Medicine (Baltimore) ; 99(24): e20345, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541456

RESUMO

BACKGROUND: Single nucleotide polymorphisms (SNPs) have been inconsistently associated with pancreatic cancer (PC) risk. This meta-analysis aimed to synthesize relevant data on SNPs associated with PC. METHODS: Databases were searched to identify association studies of SNPs and PC published through January 2020 from the databases of PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database (VIP) and Wanfang databases. Network meta-analysis and Thakkinstian algorithm were used to select the most appropriate genetic model, along with false positive report probability (FPRP) for noteworthy associations. The methodological quality of data was assessed based on the STREGA statement Stata 14.0 will be used for systematic review and meta-analysis. RESULTS: This study will provide a high-quality evidence to find the SNP most associated with pancreatic cancer susceptibility and the best genetic model. CONCLUSIONS: This study will explore which SNP is most associated with pancreatic cancer susceptibility.Registration: INPLASY202040023.


Assuntos
Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/genética , Polimorfismo de Nucleotídeo Único/genética , Algoritmos , Estudos de Casos e Controles , China/epidemiologia , Reações Falso-Positivas , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Metanálise em Rede , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/mortalidade , Risco , Sensibilidade e Especificidade
2.
Lancet ; 395(10242): 2008-2020, 2020 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-32593337

RESUMO

Pancreatic cancer is a highly fatal disease with a 5-year survival rate of approximately 10% in the USA, and it is becoming an increasingly common cause of cancer mortality. Risk factors for developing pancreatic cancer include family history, obesity, type 2 diabetes, and tobacco use. Patients typically present with advanced disease due to lack of or vague symptoms when the cancer is still localised. High quality computed tomography with intravenous contrast using a dual phase pancreatic protocol is typically the best method to detect a pancreatic tumour and to determine surgical resectability. Endoscopic ultrasound is an increasingly used complementary staging modality which also allows for diagnostic confirmation when combined with fine needle aspiration. Patients with pancreatic cancer are often divided into one of four categories based on extent of disease: resectable, borderline resectable, locally advanced, and metastatic; patient condition is also an important consideration. Surgical resection represents the only chance for cure, and advancements in adjuvant chemotherapy have improved long-term outcomes in these patients. Systemic chemotherapy combinations including FOLFIRINOX (5-fluorouracil, folinic acid [leucovorin], irinotecan, and oxaliplatin) and gemcitabine plus nab-paclitaxel remain the mainstay of treatment for patients with advanced disease. Data on the benefit of PARP inhibition as maintenance therapy in patients with germline BRCA1 or BRACA2 mutations might prove to be a harbinger of advancement in targeted therapy. Additional research efforts are focusing on modulating the pancreatic tumour microenvironment to enhance the efficacy of the immunotherapeutic strategies.


Assuntos
Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/terapia , Administração Intravenosa , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Proteína BRCA1/efeitos dos fármacos , Proteína BRCA1/genética , Proteína BRCA2/efeitos dos fármacos , Proteína BRCA2/genética , Quimioterapia Adjuvante/métodos , Meios de Contraste/administração & dosagem , Dano ao DNA/efeitos dos fármacos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Humanos , Imunoterapia/métodos , Pessoa de Meia-Idade , Mutação , Estadiamento de Neoplasias , Neoplasias Pancreáticas/patologia , Fatores de Risco , Taxa de Sobrevida , Tomografia Computadorizada por Raios X/métodos , Microambiente Tumoral/efeitos dos fármacos
5.
Ann Endocrinol (Paris) ; 81(2-3): 110-117, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32409005

RESUMO

Hypoglycemia is defined by a low blood glucose level associated to clinical symptoms. Hypoglycemia may be related to treatment of diabetes, but also to drugs, alcohol, critical illness, cortisol insufficiency including hypopituitarism, insulinoma, bariatric or gastric surgery, pancreas transplantation or glucagon deficiency, or may be surreptitious. Some hypoglycemic episodes remain unexplained, and genetic, paraneoplastic and immune causes should be considered. Genetic causes may be related to endogenous hyperinsulinism and to inborn errors of metabolism (IEM). Endogenous hyperinsulinism is related to monogenic congenital hyperinsulinism, and especially to mutations of the glucokinase-activating gene or of insulin receptors, both characterised by postprandial hypoglycemia with major hyperinsulinism. In adulthood, IEM-related hypoglycemia can persist in a previously diagnosed childhood disease or may be a presenting sign. It is suggested by systemic involvement (rhabdomyolysis after fasting or exercising, heart disease, hepatomegaly), sometimes associated to a family history of hypoglycemia. The timing of hypoglycemic episodes with respect to the last meal also helps to orientate diagnosis. Fasting hypoglycemia may be related to type 0, I or III glycogen synthesis disorder, fatty acid oxidation or gluconeogenesis disorder. Postprandial hypoglycemia may be related to inherited fructose intolerance. Exercise-induced hyperinsulinism is mainly related to activating mutation of the SLC16A1 gene. Besides exceptional ectopic insulin secretion, paraneoplastic causes involve NICTH (Non-Islet-Cell Tumour Hypoglycemia), caused by Big-IGF2 secretion by a large tumour, with low blood levels of insulin, C-peptide and IGF1. Autoimmune causes involve antibodies against insulin (HIRATA syndrome), especially in case of Graves' disease, or against the insulin receptor. Medical history, timing, and insulin level orientate the diagnosis.


Assuntos
Hipoglicemia/epidemiologia , Hipoglicemia/etiologia , Adulto , Idade de Início , Antígenos CD/genética , Criança , Complicações do Diabetes/sangue , Complicações do Diabetes/epidemiologia , Jejum/sangue , Humanos , Hiperinsulinismo/sangue , Hiperinsulinismo/complicações , Hiperinsulinismo/epidemiologia , Insulinoma/sangue , Insulinoma/complicações , Insulinoma/epidemiologia , Erros Inatos do Metabolismo/sangue , Erros Inatos do Metabolismo/complicações , Erros Inatos do Metabolismo/epidemiologia , Erros Inatos do Metabolismo/genética , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/epidemiologia , Receptor de Insulina/genética , Fatores de Risco
6.
Rev Fac Cien Med Univ Nac Cordoba ; 77(1): 33-38, 2020 03 16.
Artigo em Espanhol | MEDLINE | ID: mdl-32238256

RESUMO

Introduction: Solid-pseudopapillary neoplasms (SPN), or Frantz tumor, is a rare, low-grade neoplasm that occurs mainly in young women. It was described in 1959 by Virginia Frantz and constitutes 0.2-2.7 % of all pancreatic tumors. Computed tomography (CT) plays an important role in the diagnosis of this pathology of scarce reporting. The objective of the present study is to describe the epidemiological and tomographic characteristics of the SPN in the Instituto Nacional de Enfermedades Neoplásicas (INEN) of Peru. Methods: Descriptive cross-sectional study performed with medical records of all patients diagnosed with SPN between 2004 and 2014. The variables described were tumor size, location, shape, borders, thickness of the capsule, composition, calcifications and uptake of contrast. The categorical variables were expressed in absolute and relative frequencies; while the numerical variables were described with median and interquartile deviation (ID). Statistical support STATA Version 12.0 was used. Results: Of all pancreatic cystic tumors (PCT), 51.9% corresponded to confirmed cases of TSP. The median age was 23.5 years. The isolated location in the head predominated (33.3%); the most frequent mixed location was body and tail (16.7%); diameter was more frequent between 5.1-10 cm and the content of the majority was predominantly solid. 30.0% of the NSP presented calcifications. Conclusion: Most cases of INP SPN (2004-2014) have similar characteristics to those reported in the international literature.


Assuntos
Neoplasias Pancreáticas/diagnóstico por imagem , Estudos Transversais , Humanos , Neoplasias Pancreáticas/epidemiologia , Peru/epidemiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
7.
Medicine (Baltimore) ; 99(14): e19413, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243360

RESUMO

The aim of this observational study was to test whether ABO blood type was a prognostic factor for pancreatic ductal adenocarcinoma (PDAC) patients and whether other risk factors could influence pancreatic cancer patients' survival. This study included 610 patients who were diagnosed as pancreatic cancer and had undergone radical surgery. Patients' characteristics included age, gender, tumor stage, tumor grade, adenosquamous carcinoma (ASC) status, preoperative serum carbohydrate antigen 19-9 (CA19-9) levels, preoperative serum carcinoembryonic antigen (CEA) levels, ABO blood type, smoking status, and drinking status were analyzed in this study. Cox proportional hazards regression model and Kaplan-Meier method were used to evaluate the role of prognostic factors. For pancreatic cancer patients undergoing radical surgery, the overall survival was worse for ASC patients than PDAC patients (Log-rank = 11.315, P < .001). Compared with ASC patients (Log-rank < 0.001, P = .996), PDAC patients can benefit from chemotherapy (Log-rank = 17.665, P < .001). For PDAC patients, O blood type had better overall survival than non-O blood type (Log-rank = 4.153, P = .042). Moreover, the group with higher serum levels of CA19-9 had poor prognosis compared to another group with low serum CA19-9 (Log-rank = 4.122, P = .042). Higher CEA levels indicated poor prognosis (Log-rank = 13.618, P < .001). In conclusion, ASC status was associated with overall survival of pancreatic cancer patients and cannot benefit from postoperative chemotherapy. Non-O blood type was a prognostic factor for PDAC patients.


Assuntos
Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/patologia , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Sistema ABO de Grupos Sanguíneos/sangue , Adulto , Fatores Etários , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Carcinoma Adenoescamoso/patologia , Carcinoma Ductal Pancreático/epidemiologia , Carcinoma Ductal Pancreático/cirurgia , Fumar Cigarros/epidemiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/cirurgia , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais
8.
Lancet Gastroenterol Hepatol ; 5(7): 698-710, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32135127

RESUMO

Pancreatic ductal adenocarcinoma is most frequently detected at an advanced stage. Such late detection restricts treatment options and contributes to a dismal 5-year survival rate of 3-15%. Pancreatic ductal adenocarcinoma is relatively uncommon and screening of the asymptomatic adult population is not feasible or recommended with current modalities. However, screening of individuals in high-risk groups is recommended. Here, we review groups at high risk for pancreatic ductal adenocarcinoma, including individuals with inherited predisposition and patients with pancreatic cystic lesions. We discuss studies aimed at finding ways of identifying pancreatic ductal adenocarcinoma in high-risk groups, such as among individuals with new-onset diabetes mellitus and people attending primary and secondary care practices with symptoms that suggest this cancer. We review early detection biomarkers, explore the potential of using social media for detection, appraise prediction models developed using electronic health records and research data, and examine the application of artificial intelligence to medical imaging for the purposes of early detection.


Assuntos
Carcinoma Ductal Pancreático/diagnóstico , Diagnóstico por Imagem/instrumentação , Detecção Precoce de Câncer/métodos , Neoplasias Pancreáticas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inteligência Artificial , Biomarcadores Tumorais/análise , Aprendizado Profundo , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Diagnóstico por Imagem/tendências , Registros Eletrônicos de Saúde/instrumentação , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Cisto Pancreático/genética , Cisto Pancreático/patologia , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/mortalidade , Fatores de Risco , Mídias Sociais/instrumentação
9.
Gastroenterol. hepatol. (Ed. impr.) ; 43(3): 142-154, mar. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-190791

RESUMO

Post-operative morbidity of pancreatectomies occurs in up to 40-50% of patients, even in modern series. There is a need to find a simple scale in order to identify patients with increased risk of developing major post-operative complications after pancreatic resections. Many studies have been published on sarcopenia and surgical outcomes. Aspects of sarcopenia are presented, along with a systematic review using PRISMA guidelines, in order to search for articles about sarcopenia and pancreatic surgery. The impact of sarcopenia on morbidity and mortality in pancreatic resections is still unclear. The studies presented have been carried out over long periods of time, and many of them compare patients with different diseases. There are also different definitions of sarcopenia, and this can influence the results, as some of the reviewed articles have already shown. It is necessary to unify criteria, both in the definition and in the cut-off values. Prospective studies and consensus on sarcopenia diagnosis should be achieved


La morbilidad postoperatoria de las pancreatectomías alcanza hasta el 40-50% de los pacientes, incluso en series modernas. Es necesaria una escala simple, capaz de identificar a los pacientes con mayor riesgo de desarrollar complicaciones postoperatorias después de las resecciones pancreáticas. Se han publicado múltiples estudios sobre sarcopenia y resultados quirúrgicos. En este trabajo revisamos aspectos sobre la sarcopenia, realizando una revisión sistemática, de acuerdo con las guías PRISMA, buscando artículos sobre sarcopenia y cirugía pancreática. El impacto de la sarcopenia en la morbimortalidad tras pancreatectomías aún no está claro. Los estudios presentados se han llevado a cabo en largos períodos de tiempo, muchos de ellos comparan pacientes con diferentes enfermedades. Además, la definición de sarcopenia es variada, pudiendo influir en los resultados como ya demuestran algunos de los artículos revisados. Deben realizarse estudios prospectivos, siendo necesario también unificar criterios en la definición y puntos de corte de la sarcopenia


Assuntos
Humanos , Complicações Pós-Operatórias/epidemiologia , Sarcopenia/epidemiologia , Pancreatectomia/métodos , Indicadores de Morbimortalidade , Sarcopenia/complicações , Pancreatectomia/mortalidade , Pancreatectomia/estatística & dados numéricos , Neoplasias Pancreáticas/epidemiologia
10.
Am J Gastroenterol ; 115(5): 706-715, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32205645

RESUMO

INTRODUCTION: Proton pump inhibitors (PPIs) are commonly used for gastrointestinal disorders; given they increase the systemic levels of gastrin, a trophic hormone, there is a concern about their carcinogenicity. This study evaluated the association between PPI use and gastrointestinal cancers. METHODS: We performed a nested case-control study in a large, community-based integrated healthcare setting. Cases were adults with gastric (n = 1,233), colorectal (n = 18,595), liver (n = 2,329), or pancreatic cancers (n = 567). Each case was matched with up to 10 controls by age, sex, race/ethnicity, medical facility, and enrollment duration. The primary exposure was defined as ≥2-year cumulative PPI supply. Data were obtained from pharmacy, cancer registry, and electronic medical record databases. Associations were evaluated using conditional logistic regression and adjusted for multiple confounders. We also evaluated the cancer risks separately by PPI dose, duration of use, and dose and duration. RESULTS: PPI use of ≥2-years was not associated with the risks of gastric (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 0.81-1.42), colorectal (OR: 1.05, 95% CI: 0.99-1.12), liver (OR: 1.14, 95% CI: 0.91-1.43), or pancreatic cancers (OR: 1.22, 95% CI: 0.89-1.67), compared to non-users. In exploratory analyses, elevated cancer risks were primarily restricted to those with ≥10 years of PPI use, but no consistent associations were found for increasing PPI dose and/or duration of use. DISCUSSION: PPI use of ≥2 years was not associated with increased risks of gastrointestinal cancers. The cancer risks associated with PPI use of ≥10 years requires further study.


Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Pancreáticas/epidemiologia , Inibidores da Bomba de Prótons/administração & dosagem , Neoplasias Gástricas/epidemiologia , Idoso , California/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Sistema de Registros , Fatores de Risco
11.
PLoS One ; 15(2): e0227622, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32023280

RESUMO

BACKGROUND: Occupation was assessed as possible risk factors for prostate (PCa) and pancreatic cancer in a large Canadian worker cohort. METHODS: The Canadian Census Health and Environment Cohort (CanCHEC) was derived from linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). From the total sample of 1,931,110 persons, we identified and derived two samples of 28,610 men and 3,220 men and women with a past history of PCa and pancreatic cancer diagnoses, respectively. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals for occupation. RESULTS: In Canadian men aged 24-64 years, the highest elevated risks of PCa were observed for library clerks (HR = 2.36, 95% CI:1.12-4.97), medical radiation technologists (HR = 1.66, 95% CI:1.04-2.65), telecommunications and line cable workers (HR = 1.62, 95% CI: 1.22-3.16) and commissioned police officers (HR = 1.54, 95% CI: 1.10-2.16. The highest elevated risk for pancreatic cancer were observed for commissioned police officers (HR = 4.34, 95% CI: 1.85-10.21), photographic and film processors (HR = 3.97, 95% CI:1.69-9.34), railway and motor transport labourers (HR = 3.94, 95% CI: 1.67-9.29), and computer engineers (HR = 3.82, 95%CI: 1.52-9.61). CONCLUSION: These findings emphasize the need for further study of job-related exposures and the potential influence of non-occupational factors such as screening practices.


Assuntos
Ocupações , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/epidemiologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Adulto , Canadá/epidemiologia , Intervalos de Confiança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Adulto Jovem
12.
BMC Med Genet ; 21(1): 41, 2020 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-32093636

RESUMO

BACKGROUND: ABO gene polymorphisms have been reported to be associated with the risk of multiple cancers and cardiocerebrovascular diseases. However, the results remained controversial. In this study, we conducted a systematic review and meta-analysis to clarify the association between two SNPs (rs505922 and rs657152) in ABO gene and cancers/cardiocerebrovascular diseases. METHOD: All eligible case-control studies come from PubMed, Embase and Web of Science up to Jan. 1, 2019. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the corresponding associations. Sensitivity analysis, publication bias assessment, and heterogeneity test were performed using STATA 12.0. RESULTS: A total of nineteen articles involving twenty-two case-control populations were included according to inclusion and exclusion criteria. Twelve populations (20,820 cases and 27,837 controls) were used to evaluate the relationship between rs505922 and overall cancers and nine populations (22,275 cases and 71,549 controls) were included to assess the association between rs505922 and cardiocerebrovascular diseases. The results showed a significant association between the rs505922 polymorphism and cancers (CvsT: OR = 1.13, 95%CI = 1.05-1.22, P = 0.001), and cardiocerebrovascular diseases (OR = 1.36, 95%CI = 1.19-1.57, P < 0.001). Five populations (8660 cases and 10,618 controls) were included to evaluate association between rs657152 and cancers and five populations (8105 cases and 6712 controls) were included to estimate the relationship between rs657152 and cardiocerebrovascular diseases. The result of meta-analysis reveals that rs657152 was significantly associated with cancers (OR = 1.18, 95%CI = 1.13-1.23, P < 0.001) and cardiocerebrovascular diseases (OR = 1.54, 95%CI = 1.24-1.92, P < 0.001). CONCLUSION: Our study suggested that ABO polymorphisms might serve as a risk factor of pancreatic cancers and cardiocerebrovascular diseases.


Assuntos
Sistema ABO de Grupos Sanguíneos/genética , Transtornos Cerebrovasculares/genética , Neoplasias Pancreáticas/genética , Polimorfismo de Nucleotídeo Único , Alelos , Estudos de Casos e Controles , Transtornos Cerebrovasculares/epidemiologia , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Neoplasias Pancreáticas/epidemiologia , Fatores de Risco
13.
14.
J Surg Res ; 250: 53-58, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32018143

RESUMO

BACKGROUND: Necrotizing pancreatitis (NP) presents a unique clinical challenge because of its complex and lengthy disease course. Pancreatic necrosis occurs in 10%-20% of acute pancreatitis cases and may result from any etiology. Scattered reports describe pancreatic tumors causing NP; however, the relationship between these disease processes is not clear. We have treated patients whose NP was caused by pancreatic ductal adenocarcinoma (PDAC) and therefore sought to clarify the clinical outcomes of these patients. METHODS: Patients treated between 2005 and 2018 for NP caused by PDAC were identified. The relationship between NP and PDAC was examined, and the clinical courses of both disease processes were evaluated. RESULTS: Among 647 patients treated for NP, seven patients (1.1%) had PDAC and NP. The mean age at NP diagnosis was 60.6 y (range, 49-66). Two patients had postprocedural pancreatitis after cancer diagnosis, and the remaining five patients had NP caused by PDAC. Median duration between diagnoses of NP and PDAC was 5.6 mo (range, 3.5-21.8). For PDAC treatment, four patients received chemotherapy alone, one received palliative radiation therapy, and one died without oncologic management. One patient underwent operative resection of PDAC. Median survival was 12.7 mo (range, 0.4-49.9). CONCLUSIONS: PDAC may be a more common cause of NP than previously considered and should be considered in patients with NP of appropriate age in whom etiology is otherwise unclear. Prompt diagnosis facilitates optimal treatment in this challenging clinical situation.


Assuntos
Carcinoma Ductal Pancreático/epidemiologia , Neoplasias Pancreáticas/epidemiologia , Pancreatite Necrosante Aguda/etiologia , Idoso , Carcinoma Ductal Pancreático/complicações , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/terapia , Diagnóstico Diferencial , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico , Pancreatite Necrosante Aguda/mortalidade , Pancreatite Necrosante Aguda/cirurgia , Pancreatite Necrosante Aguda/terapia , Estudos Retrospectivos , Resultado do Tratamento
15.
Cancer Epidemiol ; 65: 101691, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32088651

RESUMO

BACKGROUND: A growing body of evidence has suggested an association between Hepatitis C virus (HCV) infection and risk of pancreatic cancer (PAC). Herein, we conducted a meta-analysis of available evidence to explore this association. METHODS: We systematically retrieved studies that investigated the association between HCV infection and risk of PAC. Pooled odds ratio (OR) with corresponding 95 % confidence interval (CI) of PAC for patients with HCV infection was calculated using the fixed- or random-effects model. RESULTS: A total of 16 studies (8 cohort and 8 case-control) were included in this meta-analysis. Combined, patients with HCV infection were more likely to develop PAC than people without it (pooled OR = 1.51, 95 % CI: 1.31, 1.74; I2 = 63.49 %, p-value for heterogeneity< 0.001). Studies that adjusted their results for diabetes, chronic pancreatitis, alcohol intake, and smoking showed lower ORs than studies that did not adjust for them. CONCLUSION: HCV infection was associated with increased risk of PAC, but this association was attenuated among studies that adjusted their results for potential risk factors for PAC. Future prospective cohort studies are needed to confirm this association.


Assuntos
Hepatite C/epidemiologia , Hepatite C/patologia , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/virologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Masculino , Fatores de Risco
16.
Mol Carcinog ; 59(3): 304-310, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31912599

RESUMO

Pancreatic carcinoma (PC) is a type of highly lethal malignant tumor that has unfavorable outcomes. One major challenge in improving clinical outcomes is to identify novel biomarkers for prognosis. In this study, we developed an online consensus survival tool for pancreatic adenocarcinoma (OSpaad), which allows researchers and clinicians to analyze the prognostic value of selected genes in PC. OSpaad contains 1319 unique PC cases that have both gene expression data and correspondent clinical data from seven individual cohorts and provides four survival terms including overall survival, disease-specific survival, disease-free interval, progression-free interval for prognosis evaluation. To meet the different research needs, OSpaad allows users to limit survival analysis in subgroups by selecting different terms of clinical confounding factors such as TNM stage, sex, smoking time, lymph invasion, and race. Moreover, we showed that 97% (116 out of 120) previously reported prognostic biomarkers, including ERBB2, TP53, EGFR and so forth, were validated and confirmed their prognostic significance in OSpaad, demonstrating the well performance of survival analysis in OSpaad. OSpaad is a user-friendly online tool with a straightforward interface allowing clinicians and basic research scientists with even a limited bioinformatics background to easily screen and evaluate the prognostic value of genes in a large PC cohort. This online tool can be accessed at http://bioinfo.henu.edu.cn/PAAD/PAADList.jsp.


Assuntos
Neoplasias Pancreáticas/diagnóstico , Software , Biomarcadores Tumorais/análise , Seguimentos , Perfilação da Expressão Gênica , Humanos , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/genética , Prognóstico , Análise de Sobrevida
17.
Medicina (Kaunas) ; 56(2)2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31991566

RESUMO

Background and objectives: Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5-7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate are contradictory and it is not clear, which groups of patients benefit most. The aims of this study are to evaluate the effects of immunonutrition on the overall complication rate and the rate of severe and/or multiple complications in patients with pancreatic tumours stratified according to final histological diagnosis-patients with pancreatic ductal adenocarcinoma (PDAC) vs. other tumours-and nutritional state, using more sensitive Comprehensive Complication Index. Materials and Methods: Seventy consecutive patients scheduled for pancreatoduodenectomy because of pancreatic tumours were randomised into immunonutrition vs. control groups and stratified according to final histological diagnosis and nutritional status. Surgical outcomes were assessed postoperatively using Clavien-Dindo classification (CDC) and Comprehensive Complication Index (CCI). Results: No significant differences in the overall complication rates in immunonutrition vs. control, patients with malnutrition vs. no malnutrition, PDAC vs. other pancreatic tumours groups were detected. However, significant differences in the rates of severe and/or multiple complications in immunonutrition vs. control groups and in PDAC patients segregated according to immunonutrition were obtained using CCI. Conclusions: Patients with PDAC may experience greater benefits of immunonutrition as compared to patients with benign pancreatic diseases or less aggressive tumours, while nutritional status was not a determining factor for the efficacy of immunonutrition.


Assuntos
Fenômenos Fisiológicos da Nutrição , Neoplasias Pancreáticas/dietoterapia , Pancreaticoduodenectomia/métodos , Complicações Pós-Operatórias/etiologia , Idoso , Feminino , Humanos , Lituânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos
18.
Biochim Biophys Acta Rev Cancer ; 1873(1): 188326, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31707038

RESUMO

Pancreatic cancer is one of the leading determinants of global cancer mortality, and its incidence is predicted to increase, to become in 2030 the second most common cause of cancer-related death. Obesity and diabetes are recognized risk factors for the development of pancreatic cancer. In the last few decades an epidemic of diabetes and obesity has been spreading worldwide, forewarning an increase in incidence of pancreatic cancer. This review considers the most recent literature, covering the multiple molecular axis linking these three pathologies, aiming to draw a more comprehensive view of pancreatic cancer for a better theragnostic stratification of the population.


Assuntos
Diabetes Mellitus/epidemiologia , Epidemias/estatística & dados numéricos , Obesidade/epidemiologia , Neoplasias Pancreáticas/epidemiologia , Comorbidade , Epidemias/prevenção & controle , Humanos , Incidência , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco
19.
Diabetes Res Clin Pract ; 159: 107981, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31870827

RESUMO

AIM: Observational studies and metanalyses of randomized trials on Dipeptidyl Peptidase-4 inhibitors (DPP4i) reported discordant results on the risk of pancreatitis and pancreatic cancer with this class of drugs. Aim of the present meta-analysis is the assessment of the effect of DPP4i treatment on the incidence of pancreatitis and pancreatic cancer, collecting all available evidence from randomized controlled trials. Methods Data Sources: an extensive Medline, Embase and Cochrane Database search for sitagliptin or vildagliptin or omarigliptin or saxagliptin or alogliptin or trelagliptin or anagliptin or linagliptin or gemigliptin or evogliptin or teneligliptin was performed up to up to September 30th, 2019. All trials performed on type 2 diabetes, with duration ≥24 weeks, and comparing of DPP4i with placebo or active drugs were collected. The study has been registered on PROSPERO (#153344). Mantel-Haenszel odds ratio (MH-OR) with 95% Confidence Interval (95% CI) was calculated for all outcomes defined above. Results A total of 165 eligible trials were identified. DPP-4 inhibitors were not associated with an increased risk of pancreatitis (MH-OR 1.13 [0.86, 1.47]) or pancreatic cancer (MH-OR 0.86 [0.60, 1.24]) with no significant differences across individual molecules of the class. CONCLUSIONS: available data do not support the hypothesis of an association of DPP4i treatment with pancreatitis. Present data do not suggest any association of DPP4i with pancreatic cancer, although they are insufficient to draw definitive conclusions.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Neoplasias Pancreáticas/epidemiologia , Pancreatite/epidemiologia , Adamantano/análogos & derivados , Adamantano/uso terapêutico , Dipeptídeos/uso terapêutico , Dipeptidil Peptidases e Tripeptidil Peptidases , Humanos , Hipoglicemiantes/uso terapêutico , Neoplasias Pancreáticas/induzido quimicamente , Pancreatite/induzido quimicamente , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Fosfato de Sitagliptina/uso terapêutico
20.
Int J Cancer ; 146(3): 610-616, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30861115

RESUMO

Statins (HMG-CoA reductase inhibitors) have antiinflammatory and possibly anticancer properties. We hypothesized that statin use is associated with lower risk of pancreatic cancer in patients with chronic pancreatitis. This nationwide population-based cohort study included all Danish patients diagnosed with incident chronic pancreatitis from 1 January 1996 to 31 December 2012. We used the Danish National Prescription Registry to ascertain information on statin prescriptions for members of the study population before and after their pancreatitis diagnosis. We computed crude incidence rates, incidence rate ratios (IRRs) and adjusted hazard ratios (HRs) with associated 95% confidence intervals (CIs) for pancreatic cancer, comparing statin users with nonusers. We computed HRs using Cox proportional hazards regression with statins treated as a time-varying exposure lagged by 1 year, adjusting for age, sex, socioeconomic status and individual comorbidities. The study included 8,311 chronic pancreatitis patients with a median age of 54 years. We observed 153 pancreatic cancers during 60,365 person-years of follow-up. The unadjusted IRR comparing statin users with nonusers was 1.00 (95% CI: 0.60-1.60). Adjustment for potential confounders only had a small impact on the estimate (adjusted HR: 0.90; 95% CI: 0.56-1.44). Our findings suggest that statin use is not associated with pancreatic cancer risk in patients with chronic pancreatitis.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Neoplasias Pancreáticas/epidemiologia , Pancreatite Crônica/complicações , Adulto , Idoso , Comorbidade , Dinamarca , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/etiologia , Neoplasias Pancreáticas/prevenção & controle , Pancreatite Crônica/epidemiologia , Sistema de Registros/estatística & dados numéricos , Fatores de Risco
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