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Pancreatic involvement in celiac disease

World Journal of Gastroenterology 2022年第24期28卷 2680-2688页

作者： Daniel Vasile Balaban Iulia Enache marina ciochina Alina Popp Mariana Jinga Department of Internal Medicine and Gastroenterology Carol Davila University of Medicine and PharmacyBucharest 020021Romania Dr.Carol Davila Central Military Emergency University Hospital Bucharest 020021Romania Department of Pediatrics Carol Davila University of Medicine and PharmacyBucharest 020021Romania National Institute for Mother and Child Health Bucharest 020021Romania

Celiac disease(CD)is well recognized as a systemic,chronic autoimmune disease mainly characterized by gluten-sensitive enteropathy in genetically predisposed individuals but with various extraintestinal *** of the affected organs in CD is the pancreas,consisting of both endocrine and exocrine *** the last decades there has been increasing interest in the pancreatic changes in CD,and this has been reflected by a great number of publications looking at this extraintestinal involvement during the course of *** pancreatic endocrine changes in CD,focusing on type 1 diabetes mellitus,are well documented in the literature,the relationship with the exocrine pancreas has been less *** review summarizes currently available evidence with regard to pancreatic exocrine alterations in CD,focusing on risk of pancreatitis in CD patients,association with autoimmune pancreatitis,prevalence and outcomes of pancreatic exocrine insufficiency in newly diagnosed and gluten-free diet treated CD patients,and the link with cystic *** addition,we discuss mechanisms behind the associated pancreatic exocrine impairment in CD and highlight the recommendations for clinical practice.

关键词： Pancreas Celiac disease Autoimmune Pancreatitis Cystic fibrosis Exocrine insufficiency

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Clinical characteristics and outcomes in carbohydrate antigen 19-9 negative pancreatic cancer

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World Journal of Clinical Oncology 2022年第7期13卷 630-640页

作者： Daniel Vasile Balaban Flavius Stefan Marin George Manucu Andreea Zoican marina ciochina Victor Mina Cristina Patoni Catalina Vladut Sandica Bucurica Raluca Simona Costache Florentina Ionita-Radu Mariana Jinga Department of Gastroenterology Carol Davila University of Medicine and PharmacyDr.Carol Davila Central Military Emergency University HospitalBucharest 020021Romania Department of Gastroenterology and Digestive Oncology Hôpital CochinParis 75014France Department of Gastroenterology Carol Davila University of Medicine and PharmacyProf Dr.Agrippa Ionescu Clinical Emergency HospitalBucharest 020021Romania

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a leading cause of death from cancer *** markers like carbohydrate antigen 19-9(CA 19-9)have been proven valuable as a diagnostic tool and a predictor for tumor staging and response to *** To delineate the phenotype of normal CA 19-9 PDAC according to clinical features,disease staging and prognosis as compared with high CA 19-9 PDAC *** We performed a retrospective single-center analysis of all PDAC cases admitted in our Gastroenterology department over a period of 30 mo that were diagnosed by endoscopic ultrasound-guided tissue *** were divided into two groups according to CA 19-9 levels over a threshold of 37 U/*** performed a comparison between the two groups with regard to demographic and clinical data,biomarkers,tumor staging and 6-mo *** Altogether 111 patients were recruited with 29 having documented normal CA 19-9(<37 U/mL).In the CA 19-9 negative group of patients,20.68%had elevated levels of both CEA and CA 125,13.79%for CA 125 only whilst 17.24%for CEA *** two groups had similar demographic *** pain was more frequently reported in positive vs negative CA 19-9 PDAC cases(76.83%vs 55.17%),while smoking was slightly more prevalent in the latter group(28.04%vs 31.03%).Tumors over 2 cm were more frequently seen in the positive CA 19-9 group,reflecting a higher proportion of locally advanced and metastatic neoplasia(87.7%vs 79.3%).Sixmonth survival was higher for the negative CA 19-9 group(58.62%vs 47.56%).CONCLUSION Elevated CA 19-9 at diagnosis seems to be associated with a more pronounced symptomatology,high tumor burden and poor prognosis compared to negative CA 19-9 PDAC *** and CA 125 can be adjunctive useful markers for PDAC,especially in CA 19-9 negative cases.

关键词： Pancreatic cancer Carbohydrate antigen 19-9 Survival Lewis Outcome

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