No abstract available.
Autoimmune Diseases/*diagnosis ; Female ; Humans ; Male ; Pancreatic Neoplasms/*diagnosis ; Pancreatitis, Chronic/*diagnosis ; Tumor Markers, Biological/*blood

Gastroenteropancreatic neuroendocrine neoplam (GEP-NEN) is a rare group of tumors with its incidence rising significantly in recent decades. Because of the late presentation of the disease and limitations in conventional biomarkers, about 50% of GEP-NEN patients manifests advanced disease when diagnosed. Therefore, it is vital to identify circulating biomarkers which can not only be used for early diagnosis but also accurately evaluating the biological behavior of GEP-NEN. This review summarizes the advances of circulating biomarkers in diagnosing and evaluating efficacy of treatment in GEP-NEN. Well-known circulating biomarkers include chromogranin A (CgA), pancreastatin (PST), chromogranin B (CgB), neuron-specific enolase (NSE) and pancreatic peptide(PP). Novel biomarkers including circulating tumor cell(CTC), microRNA and NETest are promising biomarkers with potential clinical benefit, but further researches are needed before their clinical applications.
Biomarkers, Tumor ; blood ; Chromogranin A ; blood ; Chromogranin B ; blood ; chemistry ; Gastrointestinal Neoplasms ; blood ; chemistry ; diagnosis ; genetics ; Humans ; MicroRNAs ; blood ; Neoplastic Cells, Circulating ; Neuroendocrine Tumors ; blood ; chemistry ; diagnosis ; genetics ; Pancreatic Neoplasms ; blood ; chemistry ; diagnosis ; genetics ; Pancreatic Polypeptide ; blood ; Phosphopyruvate Hydratase ; blood

OBJECTIVETo evaluate the effect of receptor-binding cancer antigen expressed on SiSO cells (RCAS1) as serum tumor marker on the diagnosis of pancreatic cancer.

METHODSReceiver-operating characteristics (ROC) curve methods were used to assay the serum content of RCAS1, CA19-9 and CA242 in 46 patients with pancreatic cancer, 18 patients and 20 normal tissues of chronic pancreatitis detected by enzyme linked immunosorbent assay (ELISA), and the results were analyzed by statistics methods. The expressions of RCAS1 protein were analyzed by immunohistochemical method in 32 patients with pancreatic cancer, 10 patients with chronic pancreatitis and 6 cases of normal pancreatic specimens.

RESULTSThe serum levels of RCAS1, CA19-9 and CA242 in pancreatic cancer were higher than that in chronic pancreatitis respectively (P < 0.01). The area under curve of RCAS1, CA19-9 and CA242 were 0.826, 0.804 and 0.737, respectively. Subgroup analysis indicated that the RCAS1 and CA19-9 levels of pancreatic cancer patients without obstructive jaundice were lower than those for patients with obstructive jaundice (P < 0.01). CA19-9 levels of patients with resectable pancreatic cancer were lower than those with unresectable pancreatic cancer (P < 0.01). Immunohistochemistry showed that the expression rates of RCAS1 in pancreatic cancer and chronic pancreatitis were 87.5% and 40.0%, respectively (P < 0.05).

CONCLUSIONSIn diagnosis of pancreatic cancer, the clinical value of RCAS1 is available. And the combination test of RCAS1 and CA19-9 have clinical value to evaluate if the pancreatic cancer can be resected before operation.

Antigens, Neoplasm ; blood ; Antigens, Tumor-Associated, Carbohydrate ; blood ; Biomarkers, Tumor ; blood ; CA-19-9 Antigen ; blood ; Humans ; Pancreatic Neoplasms ; blood ; diagnosis ; ROC Curve

BACKGROUND/AIMS: The plasma DNA concentration of patients with cancer is known to be higher than normal controls. Increased DNA concentration and tumor-specific genes in plasma can be used as tumor markers in some cancers. This study was designed to evaluate whether quantification of plasma DNA concentration by using real-time PCR is useful as a tumor marker in the diagnosis of pancreatic cancer. METHODS: Twenty-four patients (M:F=16:8, mean age; 60.5+/-11.5 years) with pancreatic cancer were recruited for this study. Fifteen patients with chronic pancreatitis and fifteen healthy persons were selected as controls (M:F=26:4, 53.5+/-11.2 years). The concentration of plasma DNA was determined by real-time PCR for telomerase reverse transcriptase gene. RESULTS: Plasma DNA concentration in patients with pancreatic cancer (46.4+/-63.2 ng/mL) was higher than that of chronic pancreatitis (p=0.041) and normal controls (p=0.030). The sensitivity and specificity in detecting pancreatic cancer were 75% and 70% respectively when the cut-off value of plasma DNA concentration was set at 46.9 ng/mL. CONCLUSIONS: Plasma DNA concentration in patients with pancreatic cancer was higher than that of controls. However, its sensitivity and specificity is not high enough to be used as a tumor marker for pancreatic cancer.
Adult ; Aged ; DNA, Neoplasm/*blood ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/*diagnosis ; Pancreatitis, Chronic/diagnosis ; Polymerase Chain Reaction ; Tumor Markers, Biological/*blood

Cystic lesions of the pancreas are being incidentally recognized with increasing frequency and become a common finding in clinical practice. Despite of recent remarkable advances of radiological and endoscopic assessment and a better understanding of natural history of certain subgroups of cystic lesions, differentiating among lesions and making an optimal management plan is still challenging. A multimodal approach should be performed to evaluate incidentally detected cystic lesions. Emerging evidence supports selective nonoperative management for the majority of patients with cystic lesions, but, for those in whom a suspicion of malignancy remains, surgery is indicated. Concerning long-term follow-up, there is limited data to support the ideal modality, intensity, and duration. Therefore, evidence-based guidelines for the diagnosis, management, and follow-up of cystic lesions of the pancreas should be established.
Cystadenocarcinoma, Mucinous/diagnosis/epidemiology/therapy ; Cystadenocarcinoma, Papillary/diagnosis/epidemiology/therapy ; Cystadenocarcinoma, Serous/diagnosis/epidemiology/therapy ; Humans ; Incidence ; Incidental Findings ; Pancreatic Cyst/*diagnosis/epidemiology/therapy ; Pancreatic Neoplasms/*diagnosis/epidemiology/therapy ; Tomography, X-Ray Computed ; Tumor Markers, Biological/blood

OBJECTIVETo detect the serum specific proteins in pancreatic cancer patients and establish diagnostic model by surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) technique.

METHODSTwenty-nine serum samples from patients of pancreatic cancer were collected before surgery and an additional 57 serum samples from age and sex matched individuals without cancer were used as controls, SELDI-TOF-MS technique and WCX magnetic beads were used to detect the protein fingerprint expression of all the serum samples and the resulting profiles between pancreatic cancer patients and controls were analyzed with biomarker wizard system, established the model using biomarker patterns system software. A double-blind test was used to determine the sensitivity and specificity of the classification model.

RESULTSA panel of four biomarkers (relative molecular weight are 5705, 4935, 5318 and 3243 Da) were selected to set up a decision trees as the classification model for screening pancreatic cancer effectively. The result yielded a sensitivity of 100%, specificity of 97.4%. The double-blind test challenged the model with a sensitivity of 88.9% and a specificity of 89.5%.

CONCLUSIONSSELDI-TOF-MS offers a unique platform for the proteomic detection of serum in pancreatic cancer patients. It also offers a noninvasive method to further study the proteomic changes in the development and progression of pancreatic cancer.

Biomarkers, Tumor ; blood ; Blood Proteins ; analysis ; Early Detection of Cancer ; Humans ; Mass Screening ; Pancreatic Neoplasms ; blood ; diagnosis ; Proteomics ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Pancreatic endocrine tumours (PETs) are uncommon tumours with typical morphology characterised by relatively uniform cuboidal cells arranged in nests and festoons, with distinctive nuclear salt-and-pepper chromatin. A lipid-rich variant poses diagnostic difficulties in the midst of other pancreatic tumours and metastatic goblet cell carcinoid. A 22-year-old man presented with symptoms of abdominal pain and jaundice. His liver function test and blood glucose level were normal, but computed tomography of the abdomen suggested the presence of a tumour in the head of the pancreas. Specimen obtained by pancreaticoduodenectomy revealed an infiltrating yellow-tan tumour composed of nests and a cribriform arrangement of polygonal vacuolated cells with pyknotic nuclei, along with focal classical areas of PET. Two foci of early serous microcystic adenoma were seen. Immunohistochemistry contributed to the arrival of a conclusive diagnosis. Von Hippel-Lindau disease was excluded in our patient, as other supportive classical features of the syndrome were absent.
Adenoma ; Blood Glucose ; metabolism ; Carcinoid Tumor ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Lipids ; chemistry ; Male ; Neoplasm Metastasis ; Neuroendocrine Tumors ; diagnosis ; pathology ; Pancreatic Neoplasms ; diagnosis ; pathology ; Pancreaticoduodenectomy ; Young Adult

The most common pancreatic cancer is adenocarcinoma. Primary adenosquamous cell carcinoma of the pancreas is very rare and aggressive. A 46-year-old man presented with a 3-month history of dyspepsia and a 7-kg weight loss. The physical examination showed tenderness of the right upper quadrant of the abdomen. There was no jaundice. Amylase and lipase were elevated. CA 19-9 was elevated to 566.7 U/mL. Gastroduodenoscopy showed a hard ulceroinfiltrative mass with a yellowish exudate that bled readily on touch in the second portion of the duodenum. Abdominal computed tomography showed a 7.1 x 6.3-cm heterogeneously enhancing mass in the pancreatic head. The pancreatic mass had invaded the duodenum wall, gastric antrum, and gastroduodenal artery sheath. Fine-needle aspiration biopsy of the pancreatic mass revealed adenosquamous cell carcinoma, anaplastic type. We concluded that an adenosquamous cell carcinoma of pancreas had invaded the duodenal mucosa causing ulceration.
Amylases/blood ; Biopsy, Fine-Needle ; CA-19-9 Antigen/blood ; Carcinoma, Adenosquamous/blood/complications/*diagnosis/pathology ; Duodenoscopy ; Duodenum/pathology ; Humans ; Intestinal Mucosa/pathology ; Lipase/blood ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms/blood/complications/*diagnosis/pathology ; Tomography, X-Ray Computed

OBJECTIVETo find the potential serum specific miRNAs with diagnostic value in early pancreatic cancer and study the alteration of miRNAs levels in the process of origin and development of pancreatic cancer and discuss the diagnostic value of miRNAs in early pancreatic cancer.

METHODSDMBA-induced rat model was established. The miRNAs expression profile of early stage was screened out by microarray. And confirmation study was performed.

RESULTSThe 35 and 12 abnormally expressed miRNAs were acquired in pancreatic tissue and blood respectively. There were no significant differences between normal pancreas and pancreatic cancer in expressions of hsa-let-7c, hsa-miR-122-5p, hsa-miR-142-5p, hsa-miR-199a-3p and hsa-miR-451a (P > 0.05).

CONCLUSIONSmiRNAs are the potential biomarkers of early pancreatic cancer. The establishment of the miRNAs expression profile has build the foundation of exploring the molecular mechanism of origin of pancreatic cancer.

Animals ; Biomarkers, Tumor ; blood ; metabolism ; Disease Models, Animal ; Male ; MicroRNAs ; blood ; metabolism ; Pancreas ; metabolism ; Pancreatic Neoplasms ; diagnosis ; genetics ; Prognosis ; Rats ; Rats, Sprague-Dawley ; Transcriptome

OBJECTIVETo investigate the clinical features, diagnostic and therapeutic strategy of pancreatic acinar cell carcinoma.

METHODSThe data of pancreatic acinar cell carcinoma patients who underwent surgical operations from January 2002 to January 2012 were retrospectively reviewed.

RESULTSSix cases of pancreatic acinar cell carcinoma, identified with pathology were collected, including 3 males and 3 females with the average of 47.8 yeas old. Upper abdominal pain was present in 5 cases, weight loss was present in 4 cases with the average of 12.5 kg. Other symptoms included nausea/vomiting, back pain and obstructive jaundice. The serum CA19-9 and CA24-2 level were significantly elevated in 2 cases. CT scan, MRI and DSA were the main imaging methods to diagnose this disease. However, no case was diagnosed as pancreatic acinar cell carcinoma before operation. All cases were confirmed by the pathological examination. Relatively high rates of surgical resection, long operative time, more blood loss and combined multi-organ resection were the characteristics of this disease's operative surgical procedures. The average period of postoperative follow-up process was 60 months, and the mean survival time was (32 ± 8) months.

CONCLUSIONSThe clinical features and biological behavior of pancreatic acinar cell carcinoma are different from those of ductal adenocarcinoma, while the relatively specific clinical manifestations and imaging changes will be helpful for qualitative diagnosis before operation. As it has high rate of resection and better prognosis, more radical surgical strategies should be carried out for patients of this disease.

Adult ; CA-19-9 Antigen ; blood ; Carcinoma, Acinar Cell ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate