Incidence of Cancer in The Course of Chronic Pancreatitis

Talamini, Giorgio; Falconi, Massimo; Bassi, Claudio; Sartori, Nora; Salvia, Roberto; Caldiron, E.; Frulloni, Luca; Francesco, Vincenzo Di; Vaona, B.; Bovo, P.; Vantini, Italo; Pederzoli, Paolo; Cavallini, Giorgio

doi:10.1111/j.1572-0241.1999.01075.x

Cited by 172 publications

(93 citation statements)

References 27 publications

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“…In fact, the standardized incidence ratio was 26.3 (95% CI 19.9-34.2) for all patients, 16.5 (95% CI 11.1-23.7) for patients with two or more years of follow-up, and 14.4 (95% CI 8.5-22.8) for patients with five or more years of follow-up. These data have been confirmed in other reports [51,53,55,60]. We need further studies to reevaluate the real risk rate of pancreatic adenocarcinoma in patients with chronic pancreatitis.…”

Section: C4supporting

confidence: 75%

“…Cohort studies [52][53][54][55][56][57][58][59][60] confirmed the relationship between chronic pancreatitis and pancreatic cancer. It should be underlined that the findings of the cohort studies must be viewed in the light of potential methodological problems: first, the recruitment of patients began from 1946 to 1973 in most studies [53][54][55][56]59,60], when it was difficult to distinguish chronic pancreatitis from pancreatic cancer; second, cancer was not confirmed histologically in all patients evaluated; third, a number of patients may have had a slower-growing cancer, such as a cystadenocarcinoma or intraductal papillary neoplasia. Finally, the possible presence of a misclassification bias is well reported in the study of Lowenfels [56].…”

Section: C4mentioning

confidence: 87%

“…Suspicion of cancer: Three different settings should be considered: 1. the association between chronic pancreatitis and pancreatic cancer [57,60]; 2. the need to distinguish between central intraductal papillary mucinous neoplasms (IPMN) and chronic pancreatitis to avoid incorrect conservative management; 3. the need to diagnose an autoimmune pancreatitis to avoid unnecessary resections. The improvement in preoperative diagnostic tools (EUS, CT, MRI, PET, histology, laboratory tests) allows the correct diagnosis in most cases of malignancy suspicion.…”

Section: Statement (El 4 − Rg C)mentioning

confidence: 99%

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Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

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112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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Section: C4supporting

confidence: 75%

Section: C4mentioning

confidence: 87%

Section: Statement (El 4 − Rg C)mentioning

confidence: 99%

See 1 more Smart Citation

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

Self Cite

166

112

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“…Chronic pancreatitis is also a major risk factor for pancreatic cancer, one of the most intractable conditions (48,49). Our findings revealing a molecular and cellular mechanism behind the reduction in CVB5 load and attenuation of pancreatitis upon IL-33 treatment represent a significant advance in our knowledge in this important medical condition.…”

Section: Discussionmentioning

confidence: 86%

The IL-33/ST2 Pathway Controls Coxsackievirus B5–Induced Experimental Pancreatitis

Sesti-Costa

Silva

Proença-Modena

et al. 2013

The Journal of Immunology

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Coxsackievirus B (CVB) is a common cause of acute and chronic infectious myocarditis and pancreatitis. Th1 cells producing IFN-γ and TNF-α are important for CVB clearance, but they are also associated with the pathogenesis of inflammatory lesions, suggesting that the modulation of Th1 and Th2 balance is likely important in controlling CVB-induced pancreatitis. We investigated the role of IL-33, which is an important recently discovered cytokine for induction of Th2-associated responses, in experimental CVB5 infection. We found that mice deficient in IL-33R, T1/ST2, significantly developed more severe pancreatitis, had greater weight loss, and contained higher viral load compared with wild-type (WT) mice when infected with CVB5. Conversely, WT mice treated with rIL-33 developed significantly lower viral titers, and pancreatitis was attenuated. Mechanistic studies demonstrated that IL-33 enhances the degranulation and production of IFN-γ and TNF-α by CD8+ T and NK cells, which is associated with viral clearance. Furthermore, IL-33 triggers the production of IL-4 from mast cells, which results in enhanced differentiation of M2 macrophages and regulatory T cells, leading to the attenuation of inflammatory pancreatitis. Adoptively transferred mast cells or M2 macrophages reversed the heightened pancreatitis in the T1/ST2−/− mice. In contrast, inhibition of regulatory T cells exacerbated the disease in WT mice. Together, our findings reveal an unrecognized IL-33/ST2 functional pathway and a key mechanism for CVB5-induced pancreatitis. These data further suggest a novel approach in treating virus-induced pancreatitis, which is a major medical condition with unmet clinical needs.

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“…Additionally, studies of recent years have confirmed chronic pancreatitis to be a premalignant condition leading to pancreatic carcinoma [24,25] .…”

mentioning

confidence: 99%