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BackgroundSurgical resection is recommended for patients with resectable acinar cell carcinoma (ACC). The aim of this study was to investigate the clinical characteristics and surgical outcomes of resectable ACC in comparison to pancreatic ductal adenocarcinoma (PDAC).MethodA retrospective analysis was performed on all patients who consecutively underwent radical resection with pathologically confirmed ACC and PDAC from December 2011 to December 2018. Clinicopathologic characteristics and follow-up information were analyzed. A 1:3 propensity score matching (PSM) method was used to minimize the bias between ACC and PDAC.ResultsA total of 26 patients with ACC and 1351 with PDAC were included. Compared to PDAC, ACC tended to be larger (4.5 vs. 3.0 cm; p < 0.001) and more frequently located in the pancreatic body/tail (61.5% vs. 36.6%, p = 0.009), with lower total bilirubin levels, lower neutrophil lymphocyte ratio (NLR) levels and lower carbohydrate antigen 19-9 (CA19-9) levels and carcinoembryonic antigen (CEA) levels. There was no difference in postoperative morbidities in patients with ACC and PDAC. The median OS and RFS were longer in ACC when compared to PDAC (OS: 43.5 mo vs. 19.0 mo, p = 0.004; RFS: 24.5 mo vs. 11.6 mo, p = 0.023). After the 1:3 PSM, ACC remained to be a better histological type for OS (p = 0.024), but had comparable RFS with PDAC (p = 0.164).ConclusionPatients with ACC after radical resection had better OS than that with PDAC. However, ACC is also an aggressive tumor with a similar trend of RFS with PDAC after the matching, necessitating the multidisciplinary treatment for resectable ACC disease.  相似文献   
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The seventh leading cause of cancer-related death globally, pancreatic ductal adenocarcinoma (PDAC) involves the exocrine pancreas and constitutes greater than 90% of all pancreatic cancers. Surgical resection in combination with systemic chemotherapy with or without radiation remains the mainstay of treatment and the only potentially curative treatment option. While there has been improvement in systemic chemotherapy, long-term survival among patients with PDAC remains poor. Improvement in the understanding of tumorigenesis, genetic mutations, the tumor microenvironment (TME), immunotherapies, as well as targeted therapies continued to drive advances in PDAC treatment. We herein review the TME, genetic landscape, as well as various metabolic pathways associated with PDAC tumorigenesis relative to emerging therapies.  相似文献   
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BackgroundCentrally located pancreatic lesions are often treated with extended pancreaticoduodenectomy or distal pancreatectomy resulting in loss of healthy parenchyma and a high risk of diabetes and exocrine insufficiency. Robotic central pancreatectomy (RCP) is a parenchyma sparring alternative that has been shown safe and feasible [[1], [2]].MethodsIn this article, we describe our operative technique and the perioperative outcomes of a series of RCP for low-grade or benign pancreatic tumors.ResultsSix patients (5 female and 1 man) with a median age of 51.5 (44–68) years underwent a RCP for 2 serous cystadenomas, 2 mucinous cystic tumors, 1 neuroendocrine tumor, and 1 autoimmune pancreatitis. There were no conversions, intraoperative complications, or perioperative transfusions. Median operative time and was 240 (230–291) minutes and median blood loss was 100 (100–400) ml. The median hospital stay was 8 (5–27) days. There were no mortalities, reoperations, or readmissions. One patient developed a grade B pancreatic fistula which was successfully managed conservatively. All resections had free margins and the median tumor size was 2.5 (1.5–3.5) cm. After a mean follow-up of 46 months, no patients presented new-onset diabetes or exocrine insufficiency.ConclusionsRCP represents the least invasive option for both the patient and the pancreatic parenchyma. With a standardized technique, RCP results in low postoperative morbidity and excellent long-term pancreatic function. Although our results are excellent, POPF still represents the main complication of central pancreatectomy with an incidence ranging from 0 to 80% depending on multiple factors such as the surgeon, technique, and pancreatic texture.  相似文献   
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刘娇  卢熹微  曹军丽  郑磊  徐红梅 《西部医学》2022,34(9):1356-1360
目的 分析外周血循环肿瘤细胞(CTCs)检测与胰腺癌化疗反应、肿瘤复发转移的关系。方法 选取2018年2月~2019年10月我院收治的胰腺癌患者100例及同期健康体检者与胰腺良性疾病患者各30例为研究对象,检测其外周血CTCs表达情况,术后随访记录胰腺癌患者肿瘤复发转移及生存情况,分析CTCs表达与胰腺癌患者临床特征、化疗疗效及肿瘤复发转移的关系。结果 胰腺癌组CTCs阳性率明显高于良性疾病组与对照组(P<005);肿瘤分期Ⅲ~Ⅳ期、低分化患者CTCs阳性率明显高于Ⅰ~Ⅱ期、高/中分化患者(P<005);Logistic回归分析显示,胰腺癌患者肿瘤分期、分化程度与CTCs阳性有关(P<005);化疗客观缓解42例(4200%),疾病控制71例(7100%),疾病控制患者术后CTCs阳性率明显低于疾病进展患者(P<005);Kaplan Meier生存分析发现,术后CTCs阳性患者1年生存率明显低于CTCs阴性患者(x2=5114,P=0024),CTCs阳性患者1年内复发转移率明显高于CTCs阴性患者(x2=4479,P=0034)。结论 外周血CTCs表达情况与胰腺癌肿瘤分期、分化程度密切相关,术后CTCs阳性患者化疗疗效较差,存在更高肿瘤复发转移及死亡风险。  相似文献   
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目的 对大鼠胰腺导管干细胞(rPDSCs)分化形成类胰岛的诱导方法进行改良。 方法 在基础培养液DMEM/F12+10% FBS +1%青霉素/1%链霉素中,分别添加2、4、6和8 μmol/L全反式维A酸(ATRA),体外诱导rPDSCs分化形成类胰岛,筛选ATRA最适诱导浓度。以ATRA最适诱导浓度为基础,再分别采用基质胶(matrigel)培养,悬浮培养或悬滴培养方式体外诱导rPDSCs分化形成类胰岛,筛选最适诱导培养方式。采用细胞形态学,双硫腙(DTZ)染色,细胞免疫荧光染色,Real-time PCR和ELISA方法对诱导类胰岛进行检测。 结果 与对照组相比,在基础培养液中,添加6 μmol/L ATRA及采用基质胶培养方式诱导效果最好。诱导28 d,细胞富集分化形成胰岛样球形细胞团;DTZ染色呈阳性;在基因和蛋白水平上分别表达胰岛素(insulin)和胰腺十二指肠同源框1(Pdx1);葡萄糖刺激,释放胰岛素和C肽,且具有葡萄糖浓度依赖性。 结论 在基质胶培养方式下,采用6 μmol/L ATRA+DMEM/F12+10% FBS+1%青霉素/1%链霉素可以成功诱导rPDSCs体外分化形成类胰岛。  相似文献   
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