幽门螺杆菌感染与胰腺癌风险之间的相关性：一项荟萃分析

目的 探究H.pylori感染与胰腺癌之间的相关性。方法 通过对PubMed、Web of Science数据库中关于H.pylori与胰腺癌的相关文献进行检索，使用Stata 13.0对检索出的文献数据进行统计分析。结果 共纳入文献12篇，包含10项病例对照研究和2项队列研究。结果显示，总体上胰腺癌与H.pylori感染之间的相关性未被证实(OR=1.20,95%CI:0.92～1.57);病例对照研究(OR=1.20,95%CI:0.88～1.65)和队列研究(OR=1.17,95%CI:0.84～1.62)亚组分析也未显示胰腺癌与H.pylori感染间有相关性；地域亚组分析显示欧洲地区(OR=1.45,95%CI:1.07～1.95)H.pylori感染导致胰腺癌风险增加，而在美国(OR=0.95,95%CI:0.49～1.82)与亚洲地区(OR=1.00,95%CI:0.59～1.71)两者间无相关性。CagA-H.pylori菌株感染(OR=1.32,95%CI:1.07～1.63)会增加胰腺癌的风险，而CagA+H.pylori菌株感染(OR=0.97,95%CI:0.78...     

克罗恩病危险因素的病例对照研究

目的:探讨国内克罗恩病(Crohn'sdisease,CD)患者与饮食有关的可能危险因素.方法:本研究采用1∶4配对病例对照研究,对比分析CD患者和对照人群的饮食因素,采用条件Logistic回归进行单因素与多因素分析.结果:特征分析,鱼类、豆类、禽类、水果是否削皮、色拉油、甜食、茶类在两组的构成情况有差异.单因素分析具有统计学显著性的变量有3个(P<0.20):鱼类(OR=0.48,95%CI:0.25-0.93)、豆类(OR=0.46,95%CI:0.24-0.87)、甜食(OR=2.30,95%CI:1.11-4.48);多因素回归分析得到具有统计学意义的相关因素有两个(P<0.05):豆类(OR=0.460,95%CI:0.217-0.974)和甜食(OR=2.292,95%CI:1.063-4.959).结论:单因素分析和多因素分析都具有统计学显著性的变量有鱼类、甜食,前者可能为一保护性因素,而后者可能为一危险性因素.     

胰腺癌和慢性胰腺炎的相关因素

目的:对比胰腺癌(pancreatic carcinoma,PC)和慢性胰腺炎(chronic pancreatitis,CP)的相关因素,为临床早期发现PC提供一定帮助.方法:对比分析新疆医科大学第一附属医院2005-01/2010-06住院胰腺癌(pancreaticcarcinoma,PC)患者265例及同期住院期间慢性胰腺炎(chronic pancreatitis,CP)患者294例,并进行单因素分析及多因素的非条件Logistic回归分析胰腺癌相关因素.结果:单因素分析显示:年龄、民族、吸烟、吸烟>20支/d、饮酒、饮酒>40g/d且>10年、糖尿病、胆石症、血、尿淀粉酶、空腹血糖水平、门冬氨酸氨基转移酶、丙氨酸氨基转移酶、CA19-9水平在2组间差异有统计学意义(P<0.05).多因素非条件Logistic回归分析显示:年龄(OR=1.607,P<0.05),CA19-9>35KU/L(OR=1.004,P<0.05),空腹血糖>6.4mmol/L(OR=1.453,P<0.05)是胰腺癌发生的独立危险因素.对265例胰腺癌患者用Logistic回归方程预测发现251例胰腺癌,正确率为94.7%;对294例慢性胰腺炎患者中用Logistic回归方程预测有282例非胰腺癌,正确率为95.9%;总正确率为95.3%.结论:对具备年龄、CA19-9、空腹血糖水平等高危因素的CP患者应定期监测空腹血糖及CA19-9,以期早期发现PC,对临床工作具有指导意义.     

我国西北地区代谢因素与胰腺癌的相关性

目的:探讨中国西北地区汉族人群代谢因素与胰腺癌的相关性,为胰腺癌防治提供新策略.方法:以2008-2014年就诊于西安交通大学第二附属医院的384例胰腺癌患者作为病例组,采用同期就诊于西安交通大学第二附属医院的744例与病例组患者性别、年龄相匹配的非肿瘤、非代谢性相关疾病的住院患者作为对照组.用病例对照研究的方法计算比值比(odds ratio,OR)及95%可信区间(confidence interval,95%CI),分析代谢综合征各因素与胰腺癌的相互关系,包括代谢综合征的高血压、高血糖、高脂血症、肥胖4个方面.结果:与同期非肿瘤、非代谢性相关疾病的住院患者相比,汉族人群高血糖为胰腺癌的危险因素,OR值及95%CI为1.74(1.49-2.03);高血压可能为胰腺癌的保护因素,但结果无统计学意义;在单因素分析时,肥胖及高血脂也为胰腺癌的危险因素(P0.05),OR值分别为1.49和1.99,但在进一步进行多因素分析时,高血脂与胰腺癌发病的相关性并无统计学意义.对代谢综合征各因素在胰腺癌患者中的分布特点进行分析时发现,与对照组患者相比,胰腺癌患者中同时存在3种或3种以上代谢紊乱的患者比例较高,差异具有统计学意义(P0.05).结论:与非肿瘤、非代谢性相关疾病患者相比,我国西北地区汉族人群中高血糖可能为胰腺癌的危险因素,高脂血症及肥胖与胰腺癌虽然在单因素分析中呈现相关性,但需要进一步的研究证实;与非肿瘤、非代谢性相关疾病患者相比,胰腺癌患者中同时存在3种或3种以上代谢紊乱的比例较高.     

肝硬化患者自发性细菌性腹膜炎危险因素的Meta分析

目的:综合分析肝硬化患者自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)的危险因素,为临床制定有效的预防控制措施提供科学依据.方法:计算机检索数据库PubMed、Web of Science、OVID,中国学术期刊全文数据库(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(Chinese BioMedical Literature Database,CBM)、万方数据库中发表的有关国内外肝硬化患者SBP相关危险因素的研究,筛选出符合纳入排除标准的文献,参照纽卡斯尔-渥太华量表(The Newcastle-Ottawa Scale,NOS)对纳入文献进行质量评价,应用RevMan 5.3软件进行Meta分析.结果:共纳入31篇文献,累计样本量病例组2125例,对照组5755例.结果显示既往SBP史(OR=6.70,4.68-9.59)、消化道出血(OR=3.39,2.38-4.84)、便秘(OR=3.97,2.58-6.11)、Child-Pugh分级C级(OR=3.51,2.56-4.81)、低血清白蛋白(WMD=-3.47,-4.76--2.17)、高血清总胆红素(WMD=19.06,12.56-25.56)、腹水蛋白≤10 g/L(OR=6.63,5.62-7.63)、凝血酶原时间延长(WMD=2.01,1.22-2.8)为肝硬化患者SBP的危险因素;Child-Pugh分级A级(OR=0.21,0.11-0.41)和腹水蛋白10 g/L(OR=0.15,0.12-0.19)为肝硬化患者SBP的保护因素;年龄、性别、肝炎后肝硬化、肝性脑病、Child-Pugh分级B级和合并糖尿病与肝硬化患者SBP关系不显著.结论:肝硬化患者SBP的发生与多种因素密切相关,临床中应注重以上指标,采取相应的防治措施,降低SBP发生率,提高肝硬化患者的生存率.     

脑卒中发生肺部感染危险因素的Meta分析

目的用Meta分析方法研究脑卒中患者发生肺部感染危险因素。方法检索PubMed、EBSCO、Cochrane、中国知网及万方数据库中2010-01~2015-08有关脑卒中发生肺部感染危险因素的文献,对符合纳入标准的文献进行质量评价和数据提取后,采用Stata统计软件进行Meta分析。结果共纳入8篇文献,其中病例组606例,对照组3 104例,Meta分析结果显示:高龄(OR=3.19,95%CI=1.34~7.56)、糖尿病(OR=2.54,95%CI=1.64~3.92)、吸烟(OR=2.26,95%CI=1.24~4.12)、吞咽困难(OR=2.50,95%CI=1.08~5.77)、意识障碍(OR=2.47,95%CI=1.69~3.62)是脑卒中患者发生肺部感染的危险因素,而性别与脑卒中患者发生肺部感染无显著相关性(OR=2.06,95%CI=0.89~4.74)。结论该研究结果显示高龄、合并糖尿病、吸烟、吞咽困难及意识障碍的脑卒中患者容易发生肺部感染。     

老年胃溃疡患病的相关影响因素

目的分析老年人胃溃疡患病相关影响因素,为临床防治提供依据。方法老年胃溃疡患者50例作为病例组,以同期健康体检的健康老年人150名对照组,按照1∶3病例对照研究方法。通过多因素条件Logistic回归分析筛选主要影响因素。结果多因素Logistic回归分析显示:老年胃溃疡患病有4个主要危险因素和1个保护因素,分别是年龄(OR=8.98)、吸烟(OR=8.64)、饮酒(OR=2.91)、饮食因素(OR=3.59)和文化程度(OR=0.08)。结论年龄、吸烟、饮酒、饮食因素为老年胃溃疡发病的危险因素,文化程度为保护性因素。     

我国西北地区生殖因素与胰腺癌的相关性

目的:探讨中国西北地区汉族女性人群生殖因素与胰腺癌的相关性,为胰腺癌防治提供新策略.方法:以2008-2014年就诊于西安交通大学第二附属医院的154例女性胰腺癌患者作为病例组,采用同期就诊于西安交通大学第二附属医院的251例与病例组患者性别、年龄相匹配的非内分泌、非妇科相关疾病的女性住院患者作为对照组.用病例对照研究的方法计算比值比(odds ratio,OR)及95%可信区间(95%CI),分析生殖因素各因素与胰腺癌的相互关系,包括胎次、月经初潮年龄、绝经年龄3个方面.结果:与非内分泌、非妇科相关疾病的女性住院患者相比,汉族女性人群多胎生育(≥3胎)为胰腺癌的危险因素,O R值为2.42,95%CI为1.43-4.10;在单因素分析时,绝经妇女较未绝经妇女发生胰腺癌的风险高,OR值为4.65,月经初潮年龄14岁的女性较月经初潮年龄≤14岁的女性发生胰腺癌的风险低.但在进一步进行多因素分析时,月经初潮年龄及绝经年龄与胰腺癌的发病并无相关性.对胎次与胰腺癌的分布进行研究时发现,与非胰腺癌患者相比,胰腺癌患者中生育3胎以上的患者比例高,结果有统计学意义.结论:与非内分泌、非妇科相关疾病的女性患者相比,汉族女性人群中多胎生育可能为胰腺癌的危险因素,绝经年龄、月经初潮年龄与胰腺癌的发病无关;与非胰腺癌患者相比,胰腺癌患者中生育3胎以上的患者比例高.     

胰腺癌切除术后辅助放化疗治疗疗效的Meta分析

目的:通过Meta分析探讨辅助放化疗在胰腺癌术后患者治疗中的意义.方法:计算机检索Pubmed(1970/2011-07)、EMbase(1974/2011-07)、Cochrane图书馆(2011年第7期)、中国生物医学文献数据库(1978/2011-07)、ASCO等论文集检索相关发表及未发表的文献,查找有关胰腺癌术后辅助放化疗的临床试验研究.由2名评价者独立选择试验、提取资料和评估方法学质量,而后采用Cochrane协作网RevMan5.0软件进行统计分析.对辅助治疗组和观察组2年生存率、5年生存率进行Meta分析.结果:8个随机对照临床试验共1507例患者纳入分析,放化疗联合治疗组与观察组比较,2年生存率比较,生存优势为OR=1.96,95%CI(1.55,2.48),结果具有统计学意义;5年生存率比较,生存优势为OR=1.89,95%CI(1.41,2.53),结果具有统计学意义.结论:现有证据支持胰腺癌术后进行辅助放化疗可提高生存率.     

ApoM基因rs805296多态性与冠心病相关性的Meta分析

目的:系统评价ApoM基因rs805296多态性与冠心病相关性。方法:检索PubMed、EMbase、The Cochrane Library、中国知网、万方数据库、维普,搜集ApoM基因rs805296多态性与冠心病相关性的病例-对照研究,检索时限均从建库至2018年3月。由2名研究者独立筛选文献、资料提取,使用Newcastle-Ottawa Scale(NOS)评价研究质量,并评价纳入研究的偏倚风险后,采用RevMan 5.3和Stata12.0进行Meta分析。结果:本研究共纳入8项病例对照研究(病例组1 675例,对照组1 735例)。Meta分析结果显示:Apo M基因rs805296多态性与冠心病的发生有关(C vs.T:OR=1.76,95%CI:1.50~2.06,P=0.00;CC+CT vs.TT:OR=1.85,95%CI:1.56~2.20,P=0.00;CC vs.CT+TT:OR=1.92,95%CI:1.08~3.40,P=0.03;TC vs.TT:OR=1.83,95%CI:1.53~2.19,P=0.00;CC vs.TT:OR=2.15,95%CI:1.21~3.81,P=0.009)。结论:Apo M基因rs805296多态性与冠心病有关,C等位基因是其潜在危险因素。     

Islet amyloid polypeptide is not a satisfactory marker for detecting pancreatic cancer

BACKGROUND & AIMS: Islet amyloid polypeptide (IAPP) levels are elevated in pancreatic cancer and may be a useful marker of pancreatic cancer-associated diabetes. The aim of this study was to compare the sensitivity and specificity for pancreatic cancer of IAPP with that of CA19-9, examine clinical characteristics of diabetes in pancreatic cancer, and define the relationship of IAPP to diabetes of pancreatic cancer. METHODS: Fasting serum glucose, IAPP, and CA 19-9 were measured in 130 subjects with pancreatic cancer, 250 subjects with other pancreatic and peripancreatic diseases, and 116 controls. In pancreatic cancer patients, we noted tumor stage and the presence and duration of diabetes. RESULTS: IAPP was markedly elevated in pancreatic cancer, especially in patients with diabetes. However, the sensitivity of IAPP for pancreatic cancer was less than that of CA 19-9 (40% vs. 75%; P < 0.001). Diabetes was present in 46% of pancreatic cancers and 55% of resectable tumors. In pancreatic cancer with diabetes, the sensitivity of IAPP was only 50%. In resectable cancer it was 27%. CONCLUSIONS: IAPP is elevated in pancreatic cancer but is not sensitive enough to replace or complement existing tests. Diabetes occurs early and frequently in pancreatic cancer. Development of a sensitive and specific marker for pancreatic-associated diabetes might lead to diagnosis of resectable pancreatic cancer.     

Establishment of risk model for pancreatic cancer in Chinese Han population

AIM: To investigate risk factors for pancreatic cancer and establish a risk model for Han population. METHODS: This population-based case-control study was carried out from January 2002 to April 2004. One hundred and nineteen pancreatic cancer patients and 238 healthy people completed the questionnaire which was used for risk factor analysis. Logistic regression analysis was used to calculate odds ratio (ORs), 95% confidence intervals (Cls) andβvalue, which were further used to establish the risk model. RESULTS: According to the study, people who have smoked more than 17 pack-years had a higher risk to develop pancreatic cancer compared to non-smokers or light smokers (not more than 17 pack-years) (OR 1.98; 95% CI 1.11-3.49, P= 0.017). More importantly, heavy smokers in men had increased risk for developing pancreatic cancer (OR 2.11; 95%CI 1.18-3.78, P=0.012) than women. Heavy alcohol drinkers (>20 cup-years) had increased risk for pancreatic cancer (OR 3.68; 95%CI 1.60-8.44). Daily diet with high meat intake was also linked to pancreatic cancer. Moreover, 18.5% of the pancreatic cancer patients had diabetes mellitus compared to the control group of 5.8% (P= 0.0003). Typical symptoms of pancreatic cancer were anorexia, upper abdominal pain, bloating, jaundice and weight loss. Each risk factor was assigned a value to represent its importance associated with pancreatic cancer. Subsequently by adding all the points together, a risk scoring model was established with a value higher than 45 as being at risk to develop pancreatic cancer. CONCLUSION: Smoking, drinking, high meat diet and diabetes are major risk factors for pancreatic cancer. A risk model for pancreatic cancer in Chinese Han population has been established with an 88.9% sensitivity and a 97.6% specificity.     

New-onset diabetes and pancreatic cancer.

BACKGROUND & AIMS: Although many individuals with pancreatic cancer have diabetes, the association between new-onset diabetes mellitus and the subsequent incidence of pancreatic cancer is unclear. METHODS: We conducted a retrospective cohort study to estimate the incidence of pancreatic cancer subsequent to a new diabetes diagnosis and to evaluate factors associated with a subsequent pancreatic cancer diagnosis. We used the Veterans Health Administration National Patient Care Database to assemble a cohort of 1,421,794 US veterans without prior diabetes or pancreatic cancer diagnoses. We recorded coding for new diabetes diagnoses (> or =2 International Classification of Diseases-9 codes for diabetes within a 12-month period), pancreatic cancer, age, sex, race, and common gastrointestinal symptoms. RESULTS: A total of 36,631 (2.6%) of the 1,421,794 veterans were diagnosed with new-onset diabetes in 1999; 149 subsequently received a diagnosis of pancreatic cancer. Pancreatic cancer incidence in patients with new-onset diabetes (83.8/100,000 person-years) was 2.2-fold higher (95% confidence interval, 1.84-2.56) than in nondiabetics, and was highest during the first 2 years after diabetes diagnosis. One additional pancreatic cancer was diagnosed for every 332 new diabetics over 6 years. A subsequent pancreatic cancer diagnosis (among new-onset diabetics) was associated independently with younger age groups, changes in bowel habits, constipation, epigastric pain, and malnutrition. CONCLUSIONS: New-onset diabetes was associated with a significantly increased rate of pancreatic cancer diagnosis, particularly in the first 2 years after diabetes diagnosis. Factors associated with pancreatic cancer diagnosis included younger age groups and the presence of gastrointestinal symptoms. The absolute incidence of pancreatic cancer was low.     

Apoptosis of human pancreatic cancer cells induced by Triptolide

AIM： To investigate apoptosis in human pancreatic cancer cells induced by Triptolide （TL）, and the relationship between this apoptosis and expression of caspase-3＇ bcl-2 and bax. METHODS： Human pancreatic cancer cell line SW1990 was cultured in DMEM media for this study. MTT assay was used to determine the cell growth inhibitory rate in vitro. Flow cytometry and TUNEL assay were used to detect the apoptosis of human pancreatic cancer cells before and after TL treatment. RT-PCR was used to detect the expression of apoptosis-associated gene caspase-3＇ bcl-2 and bax. RESULTS： TL inhibited the growth of human pancreatic cancer cells in a dose-and time-dependent manner. TL induced human pancreatic cancer cells to undergo apoptosis with typically apoptotic characteristics. TUNEL assay showed that after the treatment of human pancreatic cancer cells with 40 ng/mL TL for 12 h and 24 h, the apoptotic rates of human pancreatic cancer cells increased significantly. RT-PCR demonstrated that caspase-3 and bax were significantly up-regulated in SW1990 cells treated with TL while bcl-2 mRNA was not. CONCLUSION： TL is able to induce the apoptosis in human pancreatic cancer cells. This apoptosis may be mediated by up-regulating the expression of apoptosisassociated caspase-3 and bax gene.     

Circulating myeloid-derived suppressor cells in patients with pancreatic cancer

BACKGROUND: Myeloid-derived suppressor cells (MDSCs) are heterogeneous cell types that suppress T-cell responses in cancer patients and animal models, some MDSC subpopula-tions are increased in patients with pancreatic cancer. The present study was to investigate a specific subset of MDSCs in patients with pancreatic cancer and the mechanism of MDSCs increase in these patients.
METHODS: Myeloid cells from whole blood were collected from 37 patients with pancreatic cancer, 17 with cholangiocarcinoma, and 47 healthy controls. Four pancreatic cancer cell lines were co-culturedwithnormalperipheralbloodmononuclearcells(PBMCs) to test the effect of tumor cells on the conversion of PBMCs to MDSCs. Levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) and arginase activity in the plasma of cancer patients were analyzed by enzyme-linked immunosorbent assay.
RESULTS: CD14+/CD11b+/HLA-DR- MDSCs were increased in patients with pancreatic or bile duct cancer compared with those in healthy controls, and this increase was correlated with clinical cancer stage. Pancreatic cancer cell lines induced PBMCs to MDSCs in a dose-dependent manner. GM-CSF and arginase activity levels were significantly increased in the se-rum of patients with pancreatic cancer.
CONCLUSIONS: MDSCsweretumorrelated:tumorcellsinduced PBMCs to MDSCs in a dose-dependent manner and circulating CD14+/CD11b+/HLA-DR- MDSCs in pancreatic cancer patients were positively correlated with tumor burden. MDSCs might be useful markers for pancreatic cancer detection and progression.     

Diagnosis of pancreatic cancer by detecting telomerase activity in pancreatic juice: comparison with K-ras mutations

OBJECTIVE: Telomerase activity is reported to be specific and very frequent in human malignancy. K-ras mutations are also very frequently detected in pancreatic cancer, but their specificity for pancreatic cancer is controversial. We examined the telomerase activity and K-ras mutations in pancreatic juice from patients with pancreatic disease. METHODS: Pancreatic juice was obtained endoscopically at endoscopic retrograde pancreatography from 10 patients with pancreatic cancer, three with chronic pancreatitis, and three with a normal pancreas. The telomerase activity in pancreatic juice was assayed by telomeric repeat amplification protocol. K-ras mutations in exon 1 codon 12 were examined by the two-step polymerase chain reaction combined with restriction enzyme digestion, followed by single-strand conformation polymorphism analysis and direct sequencing. RESULTS: Telomerase activity of >5.0 was detected in eight of 10 (80%) subjects with pancreatic cancer, but in none with chronic pancreatitis or normal pancreas. K-ras mutations were detected not only in eight of 10 (80%) subjects with pancreatic cancer but also in two of three with chronic pancreatitis and in one of three with a normal pancreas. CONCLUSIONS: It was shown that the detection of telomerase activity in pancreatic juice is a more useful diagnostic tool for pancreatic cancer than that of K-ras mutations.     

Diagnosis of pancreatic cancer by cytology and measurement of oncogene and tumor markers in pure pancreatic juice aspirated by endoscopy

BACKGROUND/AIMS: Cytological examination of pancreatic juice is useful in the diagnosis of an occult cancer of the pancreas. The early diagnosis of pancreatic carcinoma using traditional radiographic or ultrasonographic methods is extremely difficult. METHODOLOGY: In order to detect an early pancreatic cancer, cytological examination, measurement of tumor marker, and detection of K-ras point mutation were performed using the samples of pure pancreatic juice aspirated endoscopically in patients who had symptoms or findings that suggested pancreatic disease. RESULTS: By routine ERP-cytology, positive cytologic results were obtained in 15 (4%) out of 359 patients without a mass. With the aid of intra-operative cytodiagnosis, all 15 occult neoplasms of the pancreas were successfully resected. One patient died from another disease without evidence of recurrence. However, the other patients were alive with no evidence of recurrence for an average of 5.5 years following surgery. The patients who had negative ERP-cytology results were observed, but no further cases of pancreatic cancer were found. The CEA levels in the pure pancreatic juice were significantly higher in patients with pancreatic cancer than in those with pancreatitis. K-ras point mutation at codon 12 was detected not only in cases of pancreatic cancer, but also in cases of chronic pancreatitis as well as control subjects. CONCLUSIONS: Cytological examination of pancreatic juice is useful in the diagnosis of an early and potentially curable in situ cancer of the pancreas. The CEA levels in the pure pancreatic juice provided useful information for differentiating the pancreatic cancer from chronic pancreatitis. K-ras point mutation at codon 12 in pancreatic juice was considered to be useful in identifying patients at high risk for the development of pancreatic cancer.     

The clinical usefulness of 18-fluorodeoxyglucose positron emission tomography in the differential diagnosis, staging, and response evaluation after concurrent chemoradiotherapy for pancreatic cancer

GOALS: The aims of this study were to determine the clinical use of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the differential diagnosis of patients with suspected pancreatic cancer and in the determination of tumor response after concurrent chemoradiotherapy for pancreatic cancer. BACKGROUND: Despite advances in diagnostic tools for pancreatic cancer, it is difficult to differentiate pancreatic cancer from mass-forming pancreatitis. Even with current imaging modalities, it is also difficult to assess tumor response to therapeutic intervention. STUDY: One hundred two patients with suspected pancreatic cancer were selected for this study. Dynamic computerized tomography (CT) scan and FDG-PET were used sequentially to diagnose pancreatic cancer. After diagnostic confirmation their diagnostic yields were compared. We also evaluated the treatment response in 15 patients who underwent chemoradiation therapy with dynamic CT scan and FDG-PET and compared their results. RESULTS: In 93 out of 102 patients, pancreatic cancer was confirmed. FDG-PET showed higher diagnostic accuracy than CT scan (95.1% vs. 76.5%). FDG-PET was also superior to CT in the detection of liver metastasis. FDG-PET detected treatment response in 5 out of 15 cases after chemoradiation therapy, whereas CT could not detect any treatment response. Comparing responder and nonresponder, FDG-PET was able to predict significantly different prognosis (399 vs. 233 d, P<0.05). CONCLUSIONS: FDG-PET is a very useful tool in diagnosing pancreatic cancer. FDG-PET may be also used as an adjunct for determining the treatment modality of pancreatic cancer and evaluating tumor response to chemoradiation therapy.     

Elucidation of the relationship of BNIP3 expression to gemcitabine chemosensitivity and prognosis

AIM: To evaluate the significance of BNIP3 in the pathogenesis of pancreatic cancer, we analyzed the relationship between the expression of BNIP3 and survival rate of the patients with pancreatic cancer, or chemosensitivities in pancreatic cancer cell lines, particularly for gemcitabine, the first-line anti-tumor drug for pancreatic cancer. METHODS: To compare the expression level of BNIP3 with the resistance to gemcitabine, eight pancreatic cancer cell lines were subjected to gemcitabine treatment and the quantitative real-time RT-PCR method was used to evaluate BNIP3 expression. Immunohistochemical analysis was also performed using 22 pancreatic cancer specimens to study relationship between BNIP3 expression and survival rate. RESULTS: Although no significantly positive association between BNIP3 mRNA level and gemcitabine chemosensitivity was observed, pancreatic cancer cell lines that were sensitive to gemcitabine treatment tended to show high levels of BNIP3 expression. The converse, an absence of BNIP3 expression, was not correlated with gemcitabine resistance. We further compared the BNIP3 expression profiles of resected primary pancreaticcancer specimens with the prognosis of the patients, and found a tendency of favorable prognosis and low BNIP3 expression. CONCLUSION: High levels of BNIP3 expression cannot be used as one of the predicting factors for gemcitabine chemosensitivity, and some yet to be known factors will have to fill the gap for the accurate prediction of pancreatic cancer chemosensitivity to gemcitabine. However, BNIP3 expression may have an impact on prediction of prognosis of patients with pancreatic cancer.