Chronic pancreatitis is a risk factor for pancreatic cancer and incidence increases with duration of disease: A systematic review and meta-analysis

Gandhi, Sonal; Fuente, Jaime de la; Murad, Mohammad Hassan; Majumder, Shounak

doi:10.14309/ctg.0000000000000463

Cited by 52 publications

(29 citation statements)

References 52 publications

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“…Chronic pancreatitis is a fibrotic reaction of the pancreatic connective tissue due to an ongoing inflammation that can damage both endocrine and exocrine pancreas (3). The most worrisome complication of CP is the increased risk for developing PDAC, which can be 2.3 -18.5 folds higher (4)(5)(6)(7). On the other hand, 10-20% of CP cases can be mass forming and mimic PDAC, which may cause misdiagnosis and overtreatment (8).…”

Section: Introductionmentioning

confidence: 99%

Multitasking dynamic contrast enhanced magnetic resonance imaging can accurately differentiate chronic pancreatitis from pancreatic ductal adenocarcinoma

et al. 2023

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Background and aimsAccurate differentiation of chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) is an area of unmet clinical need. In this study, a novel Multitasking dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) technique was used to quantitatively evaluate the microcirculation properties of pancreas in CP and PDAC and differentiate between them.MethodsThe Multitasking DCE technique was able to acquire one 3D image per second during the passage of MRI contrast agent, allowing the quantitative estimation of microcirculation properties of tissue, including blood flow Fp, plasma volume fraction vp, transfer constant Ktrans, and extravascular extracellular volume fraction ve. Receiver operating characteristic (ROC) analysis was performed to differentiate the CP pancreas, PDAC pancreas, normal control pancreas, PDAC tumor, PDAC upstream, and PDAC downstream. ROCs from quantitative analysis and conventional analysis were compared.ResultsFourteen PDAC patients, 8 CP patients and 20 healthy subjects were prospectively recruited. The combination of Fp, vp, Ktrans, and ve can differentiate CP versus PDAC pancreas with good AUC (AUC [95% CI] = 0.821 [0.654 – 0.988]), CP versus normal pancreas with excellent AUC (1.000 [1.000 – 1.000]), PDAC pancreas versus normal pancreas with excellent AUC (1.000 [1.000 – 1.000]), CP versus PDAC tumor with excellent AUC (1.000 [1.000 – 1.000]), CP versus PDAC downstream with excellent AUC (0.917 [0.795 – 1.000]), and CP versus PDAC upstream with fair AUC (0.722 [0.465 – 0.980]). This quantitative analysis outperformed conventional analysis in differentiation of each pair.ConclusionMultitasking DCE MRI is a promising clinical tool that is capable of unbiased quantitative differentiation between CP from PDAC.

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Section: Introductionmentioning

confidence: 99%

Multitasking dynamic contrast enhanced magnetic resonance imaging can accurately differentiate chronic pancreatitis from pancreatic ductal adenocarcinoma

et al. 2023

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“…Chronic pancreatitis was previously reported to be a risk factor for PDAC [ 45 , 46 ]. Long-standing inflammation increases cell turnover and stellate cell proliferation, promoting carcinogenesis [ 47 , 48 ]. Nevertheless, it was not prognostic in our cohort ( p ≥ 0.05) as for NCCN 2022 guidelines.…”

Section: Discussionmentioning

confidence: 99%

CXCR4-CXCL12-CXCR7 and PD-1/PD-L1 in Pancreatic Cancer: CXCL12 Predicts Survival of Radically Resected Patients

D’Alterio

Giardino

Scognamiglio

et al. 2022

Cells

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Pancreatic ductal adenocarcinoma (PDAC) is currently the most deadly cancer. Although characterized by 5–20% of neoplastic cells in the highly fibrotic stroma, immunotherapy is not a valid option in PDAC treatment. As CXCR4-CXCL12 regulates tumor invasion and T-cell access and PD-1/PD-L1 controls immune tolerance, 76 PDACs were evaluated for CXCR4-CXCL12-CXCR7 and PD-1/PD-L1 in the epithelial and stromal component. Neoplastic CXCR4 and CXCL12 discriminated PDACs for recurrence-free survival (RFS), while CXCL12 and CXCR7 discriminated patients for cancer-specific survival (CSS). Interestingly, among patients with radical resection (R0), high tumor CXCR4 clustered patients with worse RFS, high CXCL12 identified poor prognostic patients for both RFS and CSS, while stromal lymphocytic-monocytic PD-L1 associated with improved RFS and CSS. PD-1 was only sporadically expressed (<1%) in focal lymphocyte infiltrate and does not impact prognosis. In multivariate analysis, tumoral CXCL12, perineural invasion, and AJCC lymph node status were independent prognostic factors for RFS; tumoral CXCL12, AJCC Stage, and vascular invasion were independent prognostic factors for CSS. CXCL12’s poor prognostic meaning was confirmed in an additional perspective-independent 13 fine-needle aspiration cytology advanced stage-PDACs. Thus, CXCR4-CXCL12 evaluation in PDAC identifies prognostic categories and could orient therapeutic approaches.

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“…Chronic pancreatitis characterized by redness and swelling inflammation in the pancreas can be induced by factors such as heavy alcohol consumption[ 23 ], smoking, and gallstones[ 24 ]. It is a risk factor for the initiation of the progression of PDAC[ 25 ] or PC[ 26 ]. In the United States, 1.04% of patients with chronic pancreatitis were diagnosed with PDAC, which was higher than the rate in the control group (0.2%)[ 27 ].…”

Section: Pathogenesis Of Pancreatic Cancer and Relative Molecular Mec...mentioning

confidence: 99%

Clinical diagnosis and management of pancreatic cancer: Markers, molecular mechanisms, and treatment options

Zhang¹,

Liu²,

Yang³

2022

World J Gastroenterol

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Pancreatic cancer (PC) is the third-leading cause of cancer deaths. The overall 5-year survival rate of PC is 9%, and this rate for metastatic PC is below 3%. However, the PC-induced death cases will increase about 2-fold by 2060. Many factors such as genetic and environmental factors and metabolic diseases can drive PC development and progression. The most common type of PC in the clinic is pancreatic ductal adenocarcinoma, comprising approximately 90% of PC cases. Multiple pathogenic processes including but not limited to inflammation, fibrosis, angiogenesis, epithelial-mesenchymal transition, and proliferation of cancer stem cells are involved in the initiation and progression of PC. Early diagnosis is essential for curable therapy, for which a combined panel of serum markers is very helpful. Although some mono or combined therapies have been approved by the United States Food and Drug Administration for PC treatment, current therapies have not shown promising outcomes. Fortunately, the development of novel immunotherapies, such as oncolytic viruses-mediated treatments and chimeric antigen receptor-T cells, combined with therapies such as neoadjuvant therapy plus surgery, and advanced delivery systems of immunotherapy will improve therapeutic outcomes and combat drug resistance in PC patients. Herein, the pathogenesis, molecular signaling pathways, diagnostic markers, prognosis, and potential treatments in completed, ongoing, and recruiting clinical trials for PC were reviewed.

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Chronic pancreatitis is a risk factor for pancreatic cancer and incidence increases with duration of disease: A systematic review and meta-analysis

Cited by 52 publications

References 52 publications

Multitasking dynamic contrast enhanced magnetic resonance imaging can accurately differentiate chronic pancreatitis from pancreatic ductal adenocarcinoma

Multitasking dynamic contrast enhanced magnetic resonance imaging can accurately differentiate chronic pancreatitis from pancreatic ductal adenocarcinoma

CXCR4-CXCL12-CXCR7 and PD-1/PD-L1 in Pancreatic Cancer: CXCL12 Predicts Survival of Radically Resected Patients

Clinical diagnosis and management of pancreatic cancer: Markers, molecular mechanisms, and treatment options

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