• Title, Summary, Keyword: Pancreatic cancer

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Extended versus peripancreatic lymph node dissection for the treatment of left-sided pancreatic cancer

  • Lee, Huisong;Heo, Jin Seok;Choi, Seong Ho;Choi, Dong Wook
    • Annals of Surgical Treatment and Research
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    • v.92 no.6
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    • pp.411-418
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    • 2017
  • Purpose: The pathways of lymphatic metastases differ according to the tumor location in pancreatic cancer patients. However, it is unclear whether extended lymph node dissection (LND) is essential for all left-sided pancreatic cancer. The aim of this study is to evaluate the survival outcomes according to the extent of LND and tumor location in patients with left-sided pancreatic cancer. Methods: January 2005 to December 2013, we retrospectively identified 107 patients who underwent curative intent surgery for left-sided pancreatic cancer. The left-sided pancreatic cancer was defined as a tumor located in pancreatic body or tail. The extent of LND was divided into 2 groups: extended LND and peripancreatic LND. The extended LND group included celiac and superior mesenteric LNs. Results: We included 107 patients with left-sided pancreatic cancer; 59 patients with pancreatic body cancer and 48 patients with pancreatic tail cancer. The median follow-up period was 17 months (range, 3-110 months). Fifty patients with pancreatic body cancer and 30 patients with pancreatic tail cancer underwent extended LND. In patients with pancreatic body cancer, extended LND was associated with improved disease-free survival (DFS) (P = 0.010) and overall survival (P = 0.014). However, extended LND was not associated with DFS in patients with pancreatic tail cancer. Conclusion: Extended LND could improve survival in patients with pancreatic body cancer. However, extended LND had no survival benefit for the treatment of pancreatic tail cancer.

Establishment of a Pancreatic Cancer Stem Cell Model Using the SW1990 Human Pancreatic Cancer Cell Line in Nude Mice

  • Pan, Yan;Gao, Song;Hua, Yong-Qiang;Liu, Lu-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.437-442
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    • 2015
  • Aim: To establish a pancreatic cancer stem cell model using human pancreatic cancer cells in nude mice to provide a platform for pancreatic cancer stem cell research. Materials and Methods: To establish pancreatic cancer xenografts using human pancreatic cancer cell line SW1990, nude mice were randomly divided into control and gemcitabine groups. When the tumor grew to a volume of $125mm^3$, they treated with gemcitabine at a dose of 50mg/kg by intraperitoneal injection of 0.2ml in the gemcitabine group, while the mice in control group were treated with the same volume of normal saline. Gemcitabine was given 2 times a week for 3 times. When the model was established, the proliferation of pancreatic cancer stem cells was observed by clone formation assay, and the protein and/or mRNA expression of pancreatic stem cell surface markers including CD24, CD44, CD133, ALDH, transcription factors containing Oct-4, Sox-2, Nanog and Gli, the key nuclear transcription factor in Sonic Hedgehog signaling pathway was detected by Western blot and/or RT-PCR to verify the reliability of this model. Results: This model is feasible and safe. During the establishment, no mice died and the weight of nude mice maintained above 16.5g. The clone forming ability in gemcitabine group was stronger than that of the control group (p<0.01). In gemcitabine group, the protein expression of pancreatic cancer stem cell surface markers including CD44, and ALDH was up-regulated, the protein and mRNA expression of nuclear transcription factor including Oct-4, Sox-2 and Nanog was also significantly increased (P<0.01). In addition, the protein expression of key nuclear transcription factor in Sonic Hedgehog signaling pathway, Gli-1, was significantly enhanced (p<0.01). Conclusions: The pancreatic cancer stem cell model was successfully established using human pancreatic cancer cell line SW1990 in nude mice. Gemcitabine could enrich pancreatic cancer stem cells, simultaneously accompanied by the activation of Sonic Hedgehog signaling pathway.

Dietary Factors and Risk of Pancreatic Cancer: a Multi-Centre Case-Control Study in China

  • Liu, Shu-Zheng;Chen, Wan-Qing;Wang, Ning;Yin, Meng-Meng;Sun, Xi-Bin;He, Yu-Tong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7947-7950
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    • 2014
  • Background: Pancreatic cancer is the sixth leading cause of cancer death with an increasing trend in China. Dietary intake is believed to play an important role in pancreatic cancer carcinogenesis. The aim of this paper was to evaluate associations between some dietary factors and risk of pancreatic cancer in a multi-centre case-control study conducted in China. Materials and Methods: Cases (n=323) were ascertained from four provincial cancer hospitals. Controls (n=323) were randomly selected from the family members of patients without pancreatic cancer in the same hospitals, 1:1 matched to cases by gender, age and study center. Data were collected with a questionnaire by personal interview. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using conditional logistic regression. Results: Tea intake (OR =0.49; 95%CI: 0.30-0.80) was associated with a half reduction in risk of pancreatic cancer. Reduced vegetable consumption (P trend: 0.04) was significant related to pancreatic cancer. Although no significant association was found for meat and fruit, ORs were all above or below the reference group. A protective effect was found for fruit (OR=1.73 for consumption of 1-2 times/week vs more than 3 times/week; 95%CI: 1.05-2.86). A high intake of meat was associated to a higher risk of pancreatic cancer (OR=0.59 for consumption of 1-2 times/week vs. more than 3 times/week; 95%CI: 0.35-0.97). Conclusions: The present study supports fruit consumption to reduce pancreatic cancer risk and indicates that high consumption of meat is related to an elevated risk. Direct inverse relations with tea and vegetable intake were also confirmed.

Anti-cancer Mechanism of Docosahexaenoic Acid in Pancreatic Carcinogenesis: A Mini-review

  • Park, Mirae;Kim, Hyeyoung
    • Journal of Cancer Prevention
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    • v.22 no.1
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    • pp.1-5
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    • 2017
  • Pancreatic cancer is a highly aggressive malignant tumor of the digestive system and radical resection, which is available to very few patients, might be the only possibility for cure. Since therapeutic choices are limited at the advanced stage, prevention is more important for reducing incidence in high-risk individuals with family history of pancreatic cancer. Epidemiological studies have shown that a high consumption of fish oil or ${\omega}3-polyunsaturated$ fatty acids reduces the risk of pancreatic cancers. Dietary fish oil supplementation has shown to suppress pancreatic cancer development in animal models. Previous experimental studies revealed that several hallmarks of cancer involved in the pathogenesis of pancreatic cancer, such as the resistance to apoptosis, hyper-proliferation with abnormal $Wnt/{\beta}-catenin$ signaling, expression of pro-angiogenic growth factors, and invasion. Docosahexaenoic acid (DHA) is a ${\omega}3-polyunsaturated$ fatty acid and rich in cold oceanic fish oil. DHA shows anti-cancer activity by inducing oxidative stress and apoptosis, inhibiting $Wnt/{\beta}-catenin$ signaling, and decreasing extracellular matrix degradation and expression of pro-angiogenic factors in pancreatic cancer cells. This review will summarize anti-cancer mechanism of DHA in pancreatic carcinogenesis based on the recent studies.

Nutritional Support for Patients with Pancreatic Cancer (췌장암에서 영양 치료)

  • Jung, Min Kyu
    • The Korean Journal of Gastroenterology
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    • v.74 no.2
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    • pp.87-94
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    • 2019
  • Pancreatic cancer is the ninth common malignancy in South Korea. It has a dismal prognosis with a 5-year overall survival rate of less than 10%, and pancreatic cancer is associated with cancer cachexia, which is defined as the loss of muscle mass that is not reversible by conventional nutritional support. Cachexia is noted in over 85% of all pancreatic cancer patients and it is strongly related with the disease's mortality. Nearly 30% of pancreatic cancer deaths are due to cachexia rather than being due to the tumor burden. Therefore, it is crucial to discover the mechanisms behind the development of muscle wasting in pancreatic cancer patients and find novel therapeutics for targeting cachexia. This review deals with the current understanding about the development of cachexia and nutritional support in those patients suffering with pancreatic cancer.

Lack of Associations between Genetic Polymorphisms in GSTM1, GSTT1 and GSTP1 and Pancreatic Cancer Risk: A Multi-Institutional Case-Control Study in Japan

  • Yamada, Ikuhiro;Matsuyama, Masato;Ozaka, Masato;Inoue, Dai;Muramatsu, Yusuke;Ishii, Hiroshi;Junko, Ueda;Ueno, Makoto;Egawa, Naoto;Nakao, Haruhisa;Mori, Mitsuru;Matsuo, Keitaro;Nishiyama, Takeshi;Ohkawa, Shinichi;Hosono, Satoyo;Wakai, Kenji;Nakamura, Kozue;Tamakoshi, Akiko;Kuruma, Sawako;Nojima, Masanori;Takahashi, Mami;Shimada, Kazuaki;Yagyu, Kiyoko;Kikuchi, Shogo;Lin, Yingsong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.391-395
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    • 2014
  • Background: We aimed to evaluate the role of genetic polymorphisms in tobacco carcinogen-metabolizing genes and their interactions with smoking in a hospital-based case-control study of Japanese subjects. Materials and Methods: We examine the associations of pancreatic cancer risk with genetic polymorphisms in GSTM1, GSTT1 and GSTP1, phase II enzymes that catalyze the conjugation of toxic and carcinogenic electrophilic molecules. The study population consisted of 360 patients and 400 control subjects, who were recruited from several medical facilities in Japan. Unconditional logistic regression methods were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between genotypes and pancreatic cancer risk. Results: Among the control subjects, the prevalence of the GSTM1-null genotype and the GSTT1-null genotype was approximately 56% and 48%, respectively. Cases and controls were comparable in terms of GSTM1 and GSTT1 genotype distributions. Neither of the deleted polymorphisms in GSTM1 and GSTT1 was associated with the risk of pancreatic cancer, with an age- and sex-adjusted OR of 0.99 (95%CI: 0.74-1.32) for the GSTM1-null genotype, and 0.98 (95%CI: 0.73-1.31) for the GSTT1-null genotype. The OR was 0.97 (95%CI: 0.64-1.47) for individuals with the GSTM1 and GSTT1-null genotypes compared with those with the GSTM1 and GSTT1- present genotypes. No synergistic effects of smoking or GST genotypes were observed. Conclusions: Our results indicate no overall association between the GSTM1 and GSTT1 deletion polymorphisms and pancreatic cancer risk in the Japanese subjects in our study.

Pancreatic Compression during Lymph Node Dissection in Laparoscopic Gastrectomy: Possible Cause of Pancreatic Leakage

  • Ida, Satoshi;Hiki, Naoki;Ishizawa, Takeaki;Kuriki, Yugo;Kamiya, Mako;Urano, Yasuteru;Nakamura, Takuro;Tsuda, Yasuo;Kano, Yosuke;Kumagai, Koshi;Nunobe, Souya;Ohashi, Manabu;Sano, Takeshi
    • Journal of Gastric Cancer
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    • v.18 no.2
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    • pp.134-141
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    • 2018
  • Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. Materials and Methods: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. Results: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. Conclusions: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.

SELDI-TOF MS Combined with Magnetic Beads for Detecting Serum Protein Biomarkers and Establishment of a Boosting Decision Tree Model for Diagnosis of Pancreatic Cancer

  • Qian, Jing-Yi;Mou, Si-Hua;Liu, Chi-Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1911-1915
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    • 2012
  • Aim: New technologies for the early detection of pancreatic cancer (PC) are urgently needed. The aim of the present study was to screen for the potential protein biomarkers in serum using proteomic fingerprint technology. Methods: Magnetic beads combined with surface-enhanced laser desorption/ionization (SELDI) TOF MS were used to profile and compare the protein spectra of serum samples from 85 patients with pancreatic cancer, 50 patients with acute-on-chronic pancreatitis and 98 healthy blood donors. Proteomic patterns associated with pancreatic cancer were identified with Biomarker Patterns Software. Results: A total of 37 differential m/z peaks were identified that were related to PC (P < 0.01). A tree model of biomarkers was constructed with the software based on the three biomarkers (7762 Da, 8560 Da, 11654 Da), this showing excellent separation between pancreatic cancer and non-cancer., with a sensitivity of 93.3% and a specificity of 95.6%. Blind test data showed a sensitivity of 88% and a specificity of 91.4%. Conclusions: The results suggested that serum biomarkers for pancreatic cancer can be detected using SELDI-TOF-MS combined with magnetic beads. Application of combined biomarkers may provide a powerful and reliable diagnostic method for pancreatic cancer with a high sensitivity and specificity.

A Study on Quality of Life of Advanced Hepatobiliary and Pancreatic Cancer patients Administered with Traditional Korean Cancer Treatment (간, 담도, 췌장의 진행암으로 한방병원에 내원한 환자의 삶의 질(FACT-G)에 대한 분석)

  • Choi, Chul-Min;Koh, Byung-Hee;Kim, Se-Hyun;Choi, Won-Cheol;Lee, Soo-Kyung
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.30-38
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    • 2008
  • Objectives: The main goals of cancer treatment are improvement of quality of life and survival prolongation. There is a limitation to prolonging the survival time in hepatobiliary and pancreatic cancer. The purpose of this study was to evaluate the quality of life of hepatobiliary and pancreatic cancer patients who visited for traditional Korean cancer treatment. Methods: We evaluated the quality of life of 23 hepatobiliary and pancreatic cancer patients who visited for oriental medicine treatment at East-West Neo Medical Center from June to October of 2007. FACT-G (Functional Assessment Cancer Therapy-General), used in this study, is a scale for evaluation of QOL confirmed validity and reliability, popularly used in many countries to evaluate QOL of cancer patients. Results: The average age of enrolled patients was 57. There were 10 hepatocellular carcinoma patients, 7 pancreatic cancer patients, 6 biliary tract cancer patients. Twenty one patients were in stage IV and 20 patients had distant metastases. By Sasang constitution, Taeumin were 7, Soyangin were 8, and Soeumuin were 8. The baselines of FACT-G score in the first visit were from 34.33 to 85, and the mean score was 67.3. The mean score of FACT-G in hepatocellular carcinoma patients was 67.5, that of pancreatic cancer patients was 62.5, and that of biliary tract cancer patients was 71. Conclusions: This study is valuable as an initial QOL study of hepatobiliary and pancreatic cancer patients who visited an oriental medical clinic. We believe that consistent studies will be necessary to demonstrate oriental treatment-related quality of life with hepatobiliary and pancreatic cancer.

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Pancreatic Cancer Incidence and Mortality Patterns in China, 2009

  • Chen, Wan-Qing;Liang, Di;Zhang, Si-Wei;Zheng, Rou-Shou;He, Yu-Tong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7321-7324
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    • 2013
  • Objective: To estimate the incidence and mortality rates for pancreatic cancer in China. Methods: After checking and reviewing the cancer registry data in 2009 from 72 cancer registry centers, we divided cancer registry areas into urban and rural areas. Incidence/mortality rates, age-specific incidence/mortality rates, age-standardized incidence/mortality rates, proportions, and cumulative incidence/mortality rates for pancreatic cancer were calculated. Results: The total number of newly diagnosed pancreatic cancer cases and deaths in 2009 were 6,220 and 5,650, respectively. The crude incidence rate in all cancer registry areas was 7.28/100,000 (males 8.24, females 6.29). The age-standardized incidence rate by Chinese standard population (ASR) was 3.35/100,000, with ranking at 7th among all cancers. Pancreatic cancer incidence rate was 8.19/100,000 in urban areas whereas it was 5.41/100 000 in rural areas. Cancer mortality rate in all cancer registry areas was 6.61/100,000 (males 7.45; females 5.75), with ranking at 6th among all cancers, and 7.42/100 000 in urban but 4.94/100000 in rural areas. Conclusions: Pancreatic cancer incidence and mortality rates have shown a gradual increase in China. Owing to the difficulty of early diagnosis, identification of high-risk population and modification of risk factors are important to reduce the burden of pancreatic cancer.