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Pancreas Mar 2020Radiologic characterization of pancreatic lesions is currently limited. Computed tomography is insensitive in detecting and characterizing small pancreatic lesions.... (Review)
Review
Radiologic characterization of pancreatic lesions is currently limited. Computed tomography is insensitive in detecting and characterizing small pancreatic lesions. Moreover, heterogeneity of many pancreatic lesions makes determination of malignancy challenging. As a result, invasive diagnostic testing is frequently used to characterize pancreatic lesions but often yields indeterminate results. Computed tomography texture analysis (CTTA) is an emerging noninvasive computational tool that quantifies gray-scale pixels/voxels and their spatial relationships within a region of interest. In nonpancreatic lesions, CTTA has shown promise in diagnosis, lesion characterization, and risk stratification, and more recently, pancreatic applications of CTTA have been explored. This review outlines the emerging role of CTTA in identifying, characterizing, and risk stratifying pancreatic lesions. Although recent studies show the clinical potential of CTTA of the pancreas, a clear understanding of which specific texture features correlate with high-grade dysplasia and predict survival has not yet been achieved. Further multidisciplinary investigations using strong radiologic-pathologic correlation are needed to establish a role for this noninvasive diagnostic tool.
Topics: Disease-Free Survival; Humans; Neoplasm Grading; Pancreatic Neoplasms; Predictive Value of Tests; Radiographic Image Interpretation, Computer-Assisted; Risk Assessment; Risk Factors; Tomography, X-Ray Computed
PubMed: 32168248
DOI: 10.1097/MPA.0000000000001495 -
PloS One 2021Pancreatic cancer remains a significant public health problem with an ever-rising incidence of disease. Cancers of the pancreas are characterised by various molecular...
Pancreatic cancer remains a significant public health problem with an ever-rising incidence of disease. Cancers of the pancreas are characterised by various molecular aberrations, including changes in the proteomics and genomics landscape of the tumour cells. Therefore, there is a need to identify the proteomic landscape of pancreatic cancer and the specific genomic and molecular alterations associated with disease subtypes. Here, we carry out an integrative bioinformatics analysis of The Cancer Genome Atlas dataset, including proteomics and whole-exome sequencing data collected from pancreatic cancer patients. We apply unsupervised clustering on the proteomics dataset to reveal the two distinct subtypes of pancreatic cancer. Using functional and pathway analysis based on the proteomics data, we demonstrate the different molecular processes and signalling aberrations of the pancreatic cancer subtypes. In addition, we explore the clinical characteristics of these subtypes to show differences in disease outcome. Using datasets of mutations and copy number alterations, we show that various signalling pathways previously associated with pancreatic cancer are altered among both subtypes of pancreatic tumours, including the Wnt pathway, Notch pathway and PI3K-mTOR pathways. Altogether, we reveal the proteogenomic landscape of pancreatic cancer subtypes and the altered molecular processes that can be leveraged to devise more effective treatments.
Topics: Cluster Analysis; Gene Ontology; Humans; Mutation; Neoplasm Grading; Pancreatic Neoplasms; Proteogenomics; Proteomics; Signal Transduction
PubMed: 34506537
DOI: 10.1371/journal.pone.0257084 -
The application of single-cell sequencing in pancreatic neoplasm: analysis, diagnosis and treatment.British Journal of Cancer Jan 2023Pancreatic neoplasms, including pancreatic ductal adenocarcinoma (PDAC), intraductal papillary mucinous neoplasm (IPMN) and pancreatic cystic neoplasms (PCNs), are the... (Review)
Review
Pancreatic neoplasms, including pancreatic ductal adenocarcinoma (PDAC), intraductal papillary mucinous neoplasm (IPMN) and pancreatic cystic neoplasms (PCNs), are the most puzzling diseases. Numerous studies have not brought significant improvements in prognosis and diagnosis, especially in PDAC. One important reason is that previous studies only focused on differences between patients and healthy individuals but ignored intratumoral heterogeneity. In recent years, single-cell sequencing techniques, represented by single-cell RNA sequencing (scRNA-seq), have emerged by which researchers can analyse each cell in tumours instead of their average levels. Herein, we summarise the new current knowledge of single-cell sequencing in pancreatic neoplasms with respect to techniques, tumour heterogeneities and treatments.
Topics: Humans; Adenocarcinoma, Mucinous; Pancreatic Neoplasms; Carcinoma, Pancreatic Ductal; Pancreas
PubMed: 36307645
DOI: 10.1038/s41416-022-02023-x -
Revista Espanola de Enfermedades... Mar 2022We present the case of a 37-year-old female with abdominal pain in the epigastrium radiating to the right flank of a month of evolution. On physical examination, the...
We present the case of a 37-year-old female with abdominal pain in the epigastrium radiating to the right flank of a month of evolution. On physical examination, the epigastric mass was palpated, firm and painless. Computed tomography (CT) showed a cystic tumor in the body and tail of the pancreas with solid areas and defined borders (12 x 10 cm), which displaced structures. Endoscopic ultrasound (EUS)-guided fine needle biopsy was performed, with a cytology consistent with solid pseudopapillary tumor (SPT). Subsequently, a distal pancreatectomy with tumor resection and nodal dissection were performed. Cytology reported discohesive cells, some arranged around capillaries, with small nuclei with clefts, CK7 negative and β-catenin positive. After four years of follow-up, there is no evidence of recurrence.
Topics: Abdominal Pain; Adult; Biopsy, Fine-Needle; Endosonography; Female; Humans; Pancreas; Pancreatectomy; Pancreatic Neoplasms
PubMed: 34689567
DOI: 10.17235/reed.2021.8345/2021 -
Khirurgiia 2021To analyze the features of diagnosis and treatment of pancreatic tumors.
OBJECTIVE
To analyze the features of diagnosis and treatment of pancreatic tumors.
MATERIAL AND METHODS
This report is based on the results of 389 surgeries for different pancreatic neoplasms performed in the abdominal surgery department of the Vishnevsky Center of Surgery between 2016 and 2020.
RESULTS
Most serous cystic adenomas don't require surgical treatment. At the same time, mucinous cystic neoplasms should be exsiced. Intraductal papillary mucinous neoplasms type I and III should be surgically treated in organ-sparing fashion. Minimally invasive enucleation is desirable for solid pseudopapillary neoplasm. There is a high risk of post-pancreatecomy pancreatitis and fistula in patients with pancreatic neuroendocrine tumors. Pancreatic fistula and hemorrhage occurred in 23% and 17% of cases after pancreaticoduodenectomy (=211), respectively.
CONCLUSION
The choice of surgical strategy for pancreatic tumors is a quite complex problem. Technical features of surgeries require special experience. Surgical treatment of patients with pancreatic tumors should be carried out in specialized pancreatic centers.
Topics: Humans; Pancreas; Pancreatectomy; Pancreatic Neoplasms; Pancreaticoduodenectomy
PubMed: 34608775
DOI: 10.17116/hirurgia20211015 -
Clinical Journal of Gastroenterology Jun 2021A woman in her 20s visited our hospital with a chief complaint of abdominal distension and back pain. She was diagnosed with a cystic tumor (diameter 16 cm) in the tail...
A woman in her 20s visited our hospital with a chief complaint of abdominal distension and back pain. She was diagnosed with a cystic tumor (diameter 16 cm) in the tail of the pancreas and underwent a combined distal pancreatectomy, splenectomy, and left adrenalectomy. Histopathologically, the tumor presented as a mucinous cystic neoplasm with an undifferentiated carcinoma component of the pancreas. In addition, the cells demonstrated a partial rhabdoid-like morphology. These findings were considered relatively typical for a mucinous cystic neoplasm in the tail of the pancreas in a young woman. However, NRAS mutation, which is rare in pancreatic tumors, was detected.
Topics: Carcinoma; Female; GTP Phosphohydrolases; Humans; Membrane Proteins; Mutation; Pancreas; Pancreatectomy; Pancreatic Neoplasms
PubMed: 33710503
DOI: 10.1007/s12328-021-01380-z -
Histopathology Nov 2021Serous (cystic) neoplasm (SCN) of the pancreas is generally benign, and surgical treatment is recommended in only a limited number of cases. To avoid unnecessary...
AIMS
Serous (cystic) neoplasm (SCN) of the pancreas is generally benign, and surgical treatment is recommended in only a limited number of cases. To avoid unnecessary surgery, an accurate diagnosis of SCN is essential. In the present study, we aimed to identify new immunohistochemical markers with which to distinguish SCN from other tumours.
METHODS AND RESULTS
We compared the comprehensive gene expression profiles of SCN with those of normal pancreas and pancreatic ductal adenocarcinoma (PDAC). We selected the candidate molecules that were up-regulated in SCN, were minimally expressed or unexpressed in PDAC, and had specific and available antibodies suitable for immunohistochemistry, and then analysed their immunohistochemical expression in various tumours. We selected aquaporin 1 (AQP1), stereocilin (STRC), fibroblast growth factor receptor 3 (FGFR3), and transmembrane protein 255B (TMEM255B), which were diffusely expressed in SCN cells in 79%, 100%, 100% and 100% of SCN cases. AQP1 was not expressed in other tumours, except in 20% of mucinous cystic neoplasms (MCNs) and 19% of PDACs. STRC was rarely expressed in MCNs, neuroendocrine neoplasms (NENs), and PDACs. FGFR3 was expressed in 31% of intraductal papillary mucinous neoplasms (IPMNs), 50% of intraductal oncocytic papillary neoplasms, 40% of NENs, 30% of acinar cell carcinomas, 40% of solid pseudopapillary neoplasms, and 52% of PDACs. TMEM255B was not expressed in the other tumours, except in 50% of MCNs, 80% of gastric-subtype IPMNs, and 29% of PDACs. All antigens were usually expressed in a small proportion of cells when they were positive in tumours other than SCN.
CONCLUSIONS
These findings indicate that AQP1 and STRC, and potentially TMEM255B, may act as SCN markers.
Topics: Adenocarcinoma, Mucinous; Aquaporin 1; Biomarkers, Tumor; Diagnosis, Differential; Gene Expression Profiling; Humans; Immunohistochemistry; Intercellular Signaling Peptides and Proteins; Membrane Proteins; Pancreas; Pancreatic Neoplasms
PubMed: 34288030
DOI: 10.1111/his.14456 -
Journal of Hepato-biliary-pancreatic... Oct 2022
Topics: Humans; Pancreatic Cyst; Pancreatic Neoplasms; Tomography, X-Ray Computed
PubMed: 33090626
DOI: 10.1002/jhbp.846 -
Cancer Metastasis Reviews Sep 2021The ever-growing perception of cancer stem cells (CSCs) as a plastic state rather than a hardwired defined entity has evolved our understanding of the functional and... (Review)
Review
The ever-growing perception of cancer stem cells (CSCs) as a plastic state rather than a hardwired defined entity has evolved our understanding of the functional and biological plasticity of these elusive components in malignancies. Pancreatic cancer (PC), based on its biological features and clinical evolution, is a prototypical example of a CSC-driven disease. Since the discovery of pancreatic CSCs (PCSCs) in 2007, evidence has unraveled their control over many facets of the natural history of PC, including primary tumor growth, metastatic progression, disease recurrence, and acquired drug resistance. Consequently, the current near-ubiquitous treatment regimens for PC using aggressive cytotoxic agents, aimed at ''tumor debulking'' rather than eradication of CSCs, have proven ineffective in providing clinically convincing improvements in patients with this dreadful disease. Herein, we review the key hallmarks as well as the intrinsic and extrinsic resistance mechanisms of CSCs that mediate treatment failure in PC and enlist the potential CSC-targeting 'natural agents' that are gaining popularity in recent years. A better understanding of the molecular and functional landscape of PCSC-intrinsic evasion of chemotherapeutic drugs offers a facile opportunity for treating PC, an intractable cancer with a grim prognosis and in dire need of effective therapeutic advances.
Topics: Drug Resistance, Neoplasm; Humans; Neoplastic Stem Cells; Pancreas; Pancreatic Neoplasms; Prognosis
PubMed: 34453639
DOI: 10.1007/s10555-021-09979-x -
Genes Jan 2020Next-generation sequencing has led to the recent discovery of several novel pancreatic cancer susceptibility genes. These genes include ataxia telangiectasia mutated (),... (Review)
Review
Next-generation sequencing has led to the recent discovery of several novel pancreatic cancer susceptibility genes. These genes include ataxia telangiectasia mutated (), a serine/threonine kinase that is an integral component of DNA repair. Pathogenic germline variants are frequently identified in patients with pancreatic ductal adenocarcinoma (PDAC) with and without a family history of the disease. Loss of is also a frequent somatic event in the development of PDAC. These discoveries have advanced our understanding of the genetic basis of pancreatic cancer risk and will impact patient care through appropriate patient-risk stratification; personalized screening and early detection efforts; and, for some, targeted therapy.
Topics: Animals; Ataxia Telangiectasia Mutated Proteins; Carcinoma, Pancreatic Ductal; DNA Repair; Germ-Line Mutation; Humans; Neoplasm Proteins; Pancreas; Pancreatic Neoplasms; Risk Factors
PubMed: 31963441
DOI: 10.3390/genes11010108