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The Chinese guidelines for neoadjuvant therapy of pancreatic cancer(2020)

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Journal of Pancreatology 2021年第4期4卷 135-145页

作者： Taiping Zhang Wenming Wu Yinmo Yang Yupei Zhao on behalf of Chinese pancreatic Surgery Association Chinese Medical Association and pancreatic Disease Committee of China Research Hospital Association Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical College Department of General Surgery Peking University First HospitalBeijingChina 不详

Aiming to keep pace with the renewal of international guidelines and refine the domestic treatment system of pancreatic cancer,the Chinese pancreatic Surgery Association,Chinese Medical Association and pancreatic Disease Committee of China Research Hospital Association launched this Chinese guidelines for neoadjuvant therapy of pancreatic cancer(2020 edition).Based on the Grading of Recommendations Assessment,Development,and Evaluation system,the guidelines have conducted a discussion on the indication,regimen selection,therapeutic effect evaluation,pathological diagnosis,surgery strategy,*** guidelines have quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in neoadjuvant therapy of pancreatic *** guidelines have highlighted the role of multiple disciplinary team and represented the conversion of treatment concepts in pancreatic *** therapy has prolonged the survival of part of pancreatic cancer ***,more high-quality clinical researches are in urgent need to improve the level of evidence,optimize the clinical practice,and improve the survival of patients.

关键词： Antineoplastic combined chemotherapy protocols Clinical research Multiple disciplinary team Neoadjuvant therapy pancreatic neoplasms

pancreatic cancer–Endosonography

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The Chinese-German Journal of Clinical Oncology 2007年第2期6卷 123-128页

作者： Stefan Kahl Kerstin Schütte Peter Malfertheiner Department of Gastroenterology Municipal Hospital Magdeburg Birkenallee 39130 Magdeburg Germany

EUS is the most sensitive imaging procedure for the detection of small solid pancreatic masses and is accurate in determining vascular invasion of the portal venous system. Even compared to the new CT-techniques EUS provides excellent results in preoperative staging of solid pancreatic tumors. Compared to helical CT-techniques EUS is less accurate in detecting tumor involvement of superior mesenteric artery. EUS staging and EUS-guided FNA can be performed in a single-step procedure, to establish the diagnosis of cancer. There is no known negative impact of tumor cell seeding due to EUS-FNA. Without FNA EUS and additional methods are not able to reliably distinguish between inflammatory and malignant masses.

关键词： adenocarcinoma diagnosis digestive system neoplasms endosonography neoplasm staging pancreatic neoplasms pancreatitis review literature surgery ultrasonography, interventional

Expression and Significance of Cyclooxygenase-2 in Human pancreatic Carcinomas

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The Chinese-German Journal of Clinical Oncology 2005年第2期4卷 121-123页

作者：王海霞陈其奎贾柳萍王莉广东省南海市人民医院消化内科 528000

The inhibition of cyclooxygenase-2 (COX-2) by nonstcroidal anti-inflammatorydrugs may prevent the occurrence and decrease the incidence of gastrointestinal malignant *** study was designed to detect the expression patterns of COX-2 in human normal, benign, andmalignant pancreatic tissues and investigate the correlation between the expression of COX-2 andBcl-2 in malignant pancreatic tissues, which may help to demonstrate the functional role of COX-2and Bcl-2 in pancreatic carcinogenesis and carcinoma development. Methods: Immunohistologicalanalysis of COX-2 and Bcl-2 was performed on different human pancreatic samples, including malignanttissues. The correlation between COX-2 and Bcl-2, as well as clinic-pathological characteristics ofpancreatic carcinoma was evaluated by statistic analysis. Results: COX-2 and Bcl-2 proteins weredetected in 22 of 30 (73.3%) and 20 of 30 (66.7%) malignant pancreatic tissues, which were higherthan those in normal and benign tissues (P pancreatic carcinoma (r=0.470, P 0.05). Conclusion: COX-2 protein is over-expressed in human malignantpancreatic tissues. The co-expression of COX-2 and Bcl-2 might play an important role in theregulation of apoptosis of pancreatic carcinoma cells.

关键词： pancreatic neoplasms cyclooxygenase immunohistochemistry

A contemporary evidence basis for neoadjuvant chemotherapy in upfront resectable pancreatic adenocarcinoma:a systematic review of the literature

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Journal of Pancreatology 2020年第1期3卷 12-20页

作者： Stonko David P. He Jin Zheng Lei Blair Alex B. The pancreatic Cancer Precision Medicine Center of Excellence Program Johns Hopkins University School of MedicineBaltimoreMDUSA Section of Hepatobiliary and pancreatic Surgery Division of Surgical OncologyJohns Hopkins HospitalBaltimoreMDUSA Division of Oncology Johns Hopkins University School of MedicineBaltimoreMDUSA

pancreatic ductal adenocarcinoma(PDAC)is an aggressive cancer with poor *** control through surgical resection paired with radiotherapy and chemotherapy comprise the primary tenets of *** exists regarding the timing of treatment and ordering of systemic therapy and resection in the management of early stage *** goal of this study was to review the literature and describe the contemporary evidence basis for the role of neoadjuvant therapy(NAT)in the setting of upfront resectable(UP-R)*** databases were searched in parallel to identify relevant original articles investigating neoadjuvant therapy where at least 1 study arm contained UP-R PDAC;studies with only borderline resectable or locally advanced disease were *** to the diversity in NAT regimens and study design between trials,qualitative analyses were performed to investigate patient selection,impact on perioperative and survival outcomes,safety,and cost ***-five studies met inclusion criteria,of which 24 unique trials are discussed here in *** studies included those trials using single agents as well as more recent trials comparing modern multiagent therapies,and several large database *** the data suggest that NAT is safe,may confer survival benefit for appropriately selected patients,is cost effective,and is an appropriate approach for UP-R ***,the risk for disease progression during upfront medical therapy,requires appropriate patient identification and close monitoring,and emphasizes the need for further discovery of more effective chemotherapeutics,useful biomarkers or molecular profiles,and additional prospective comparative studies.

关键词： Neoadjuvant therapy pancreatic ductal adenocarcinoma pancreatic neoplasms Preoperative chemotherapy Resectable pancreatic cancer Upfront resectable

The detection and significance of polycyclic aromatic hydrocarbons in human pancreatic cancer

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The Chinese-German Journal of Clinical Oncology 2012年第3期11卷 146-148页

作者： Shuntao Liu Limin Lun Clinical Laboratory The Affiliated Hospital of Medical College Qingdao UniversityQingdao 266061China

Objective:The aim of this study was to investigate the effect of polycyclic aromatic hydrocarbons (PAHs) on the occurrence of human pancreatic ***:PAHs in human pancreatic cancer,adjacent pancreatic cancer tissues and tissues without pancreatic cancer were extracted by ultrasonic extraction (UE).And then the extracts were cleaned up by solid phase extraction and analyzed by high performance liquid chromatography (HPLC) with fluorescence ***:Four kinds of PAHs were detected,which were chrysene,2-methylanthracene,pyrene and benzo (a) *** contents of the four PAHs were not statistically significant between pancreatic cancer and adjacent tissues (P > 0.05).The contents of 2-methylanthracene,pyrene and benzo (a) pyrene in pancreatic cancer and adjacent tissues were higher than tissues without pancreatic cancer,the differences were statistically significant (P pancreatic tissues were not statistically significant (P > 0.05).Conclusion:PAHs were found in human pancreatic *** pancreatic tissues have extremely strong ability of bio-concentrating *** might play an important role in the occurrence of human pancreatic cancer.

关键词： pancreatic neoplasms polycyclic aromatic hydrocarbons (PAHS) high performance liquid chromatography (HPLC)

Surgical treatment of nonfunctioning islet cell tumor: report of 41 cases

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Hepatobiliary & pancreatic Diseases International 2004年第3期3卷 469-472页

作者： Ke-Jian Guo, Hai-Hui Liao, Yu-Lin Tian, Ren-Xuan Guo, San-Guang He and Kui Shen Department of Surgery, First Affiliated Hospital, Chi-na Medical University, Shenyang 110001 , China Department of Surgery First Affiliated Hospital China Medical University Shenyang 110001 China.

BACKGROUND: Nonfunctioning islet cell tumor (NIT)as a rare pancreatic endocrine neoplasm is characterized byunspecific clinical symptoms and is hard to diagnose. InChina, NIT accounts for 15%-41% in pancreatic endocrineneoplasms just next to insulinoma. In this study, weevaluated the surgical modalities of ***: From January 1978 through February 2002, 41patients with NIT were treated at the Department of Sur-gery of the First Affiliated Hospital, China Medical Univer-sity, Shenyang, China. Tumors in the head of the pancreaswere noted in 28 patients, and in the body or in the tail in13 patients. The mean diameter of the tumors was 10. 7cm. Fifteen patients underwent enucleation and 21 receivedpancreatectomy. Tumors were unresectable in 5 patientsbecause of extensive infiltration. The mean diameter was9.6 cm in patients treated by enucleation, 13.1 cm in thoseby pancreaticoduodenectomy, 9.9 cm in those by distalpancreatectomy, and 11.6 cm in those with ***: The curative resection rate was 88% (n =36),and the complication rate after enucleation and pancreatec-tomy was 33% ( n = 5 ) and 14% (n=3), respectively. Nolocal recurrence was found after both enucleation and pan-createctomy. Liver metastases occurred in 3 patients treatedby ***: Both enucleation and pancreatectomy areeffective for NIT of the pancreas. No local recurrence hasbeen found in patients treated by the two surgical proce-dures. The complication rates of the two modalities arecomparable.

关键词： pancreatic neoplasms islet cell surgery

A clinical study on continuous transarterial infusion chemotherapy and systemic venous chemotherapy with gemcitabine and 5-fluorouracil in treating patients with advanced pancreatic carcinoma

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The Chinese-German Journal of Clinical Oncology 2007年第5期6卷 457-460页

作者： Guobin Hong Jingxing Zhou Jianghong Luo Linfeng Xu Yaoting Chen Rongjian Jiang Department of Radiology The Second Affiliated Hospital Sun Yat-sen University Guangzhou 510120 China

Objective: To compare the curative effectiveness of continuous transarterial infusion chemotherapy and systemic venous chemotherapy in treating patients with advanced pancreatic cancer, and to evaluate the value of selective continu-ous transarterial infusion chemotherapy in treating advanced pancreatic cancer. Methods: Of the 51 patients with advanced pancreatic cancer receiving chemotherapy with gemcitabine and 5-fluorouracil, 25 patients were treated with selective con-tinuous transarterial infusion chemotherapy, 26 were treated with systemic venous chemotherapy, and curative effective-ness was analyzed retrospectively. Curative effectiveness included tumor volume, clinical benefit response (CBR), acute and subacute toxic reactions of antitumor drugs, survival rate and median survival time. Results: The objective effective rate in transarterial group was 32.0% versus 23.1% in systemic group without any significant difference (P = 0.475). Clinical benefit rates in transarterial group and systemic group were 80.0% and 50.0% respectively (P = 0.025). The 6-, 9-and 12-month accumulated survival rates and median survival time in transarterial group were higher than those of the systemic group (P = 0.002), the differences were statistically significant. However, the adverse reactions between the two groups were not statistically significant. Conclusion: Compared with systemic chemotherapy, continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic cancer, it is safe and reliable, and the adverse reactions is less.

关键词： radiology, interventional pancreatic neoplasms clinical benefit response survival rate

Diagnosis and treatment of solidpseudopapillary tumors of the pancreas

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Hepatobiliary & pancreatic Diseases International 2005年第3期4卷 456-459页

作者： Xi Chen, Guang-Wen Zhou, Hui-Jiang Zhou, Cheng-Hong Peng and Hong-Wei Li Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China Department of Surgery Shanghai Institute of Digestive Surgery Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China. cc_vrai@***

Solid-pseudopapillary tumors (SPTs) of the pancreas have been reported as rare lesions with' low malignant potential' occurring mainly in young women. This study was designed to define the clinicopathological characteristics and the effect of surgical intervention. METHODS:A retrospective clinical analysis was made of 21 patients with solid-pseudopapillary tumor of the pancreas admitted from June 1994 to December 2004. RESULTS:Abdominal pain as the major complaint was found in 13 patients, and palpable abdominal mass in 7. Imaging examination showed the abdominal mass clearly, but diagnosis was not defined. In 12 patients, tumors were located in the pancreatic head and in 9 patients, in the pancreatic tail. The average diameter of the tumor was 9.5 cm (range, 3-20 cm). One patient had liver metastasis. The diagnosis of the tumor was proved pathologically during operation in 14 patients, and other 3 patients who had been diagnosed as having insulinoma and other malignant tumors were confirmed by paraffin section and enzyme labeling after operation. Eighteen patients (85.7% ) were followed up with a median period of 24 months, 1-60 months without tumor recurrence. CONCLUSION:Huge pancreatic masses of the pancreas in young women are suggestive of solid-pseudopapillary tumors. Aggressive surgical therapy can result in good prognosis in these patients.

关键词： pancreatic neoplasms pancreaticoduodenectomy

Patient-reported outcomes in subjects with neuroendocrine tumors of the pancreas

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World Journal of Gastroenterology 2009年第40期15卷 5067-5073页

作者： Raffaele Pezzilli Davide Campana Antonio M Morselli-Labate Maria C Fabbri Emilio Brocchi Paola Tomassetti Department of Digestive Diseases and Internal Medicine Sant'Orsola-Malpighi HospitalUniversity of Bologna

AIM: To assess the patient-reported outcomes (PROs) of pancreatic neuroendocrine tumor (PNET) patients. METHODS: Fifty-one consecutive patients (21 male, 30 female, 61.0 ± 10.3 years) with proven PNETs were studied. An SF-12 questionnaire capable of exploring the physical (PCS) and mental (MCS) aspects of daily life was used. Four questionnaires were also used [12 items General Health Questionnaire (GHQ-12) for non-psychotic psychiatric disorders, State Trait AnxietyInventory (STAI) Y-1 and Y-2 for anxiety and BDI-for depressive symptoms] to explore the psychological aspects of the disease. Forty-four sex-and age-matched Italian normative subjects were included and evaluated using the SF-12, STAI Y-1 and Y-2 ***: Seven patients refused to participate to the study; they were clinically similar to the 44 participants who agreed to complete the questionnaires. PNET patients had a PCS score (44.7 ± 11.0) were not signifi cantly different from the norms (46.1 ± 9.9, P = 0.610), whereas the MCS score was signifi cantly lower in patients (42.4 ± 13.0) as compared to the norms (48.2 ± 9.8, P = 0.036). GHQ-12 identified 11 patients (25.0%) as having non-psychotic psychiatric *** STAI scores were similar in the patients and inthe normative population. Finally, BDI-identifiedeight patients (18.2%) with moderate depression and 9 (20.5%) with mild depression whereas 27 patients (61.4%) had no ***: The PNET patients had a good physical but an impaired mental component of their quality of life; in addition, mild or moderate depressive symptoms are present in about 40% of PNET patients.

关键词： Endocrine gland neoplasms pancreatic neoplasms Somatostatin Quality of life Quality indicators Health care