Inflammatory bowel disease (IBD) is a disorder of immune and microbial dysregulation, induced by environmental factors in a genetically predisposed individual. Studies on IBD-associated genes have demonstrated that Paneth cells (PC) are central to the pathogenesis of IBD, especially in the development of Crohn′s disease (CD). The morphology, quantity and function of PC are easily affected by susceptible genes. In the intestine, PC participate in the formation of stem cell niche and secrete antimicrobial particles, which plays a vital role in regulating intestinal microbiota and maintaining intestinal mucosal homeostasis. Meanwhile, the proliferation and maturation of PC are also dependent on the symbiotic microbiota in the intestine. This review focuses on the interaction of susceptible genes, PC and intestinal microbiota, as well as their influence on the occurrence and development of IBD.

Inflammatory bowel disease (IBD) is a disorder of immune and microbial dysregulation, induced by environmental factors in a genetically predisposed individual. Studies on IBD-associated genes have demonstrated that Paneth cells (PC) are central to the pathogenesis of IBD, especially in the development of Crohn′s disease (CD). The morphology, quantity and function of PC are easily affected by susceptible genes. In the intestine, PC participate in the formation of stem cell niche and secrete antimicrobial particles, which plays a vital role in regulating intestinal microbiota and maintaining intestinal mucosal homeostasis. Meanwhile, the proliferation and maturation of PC are also dependent on the symbiotic microbiota in the intestine. This review focuses on the interaction of susceptible genes, PC and intestinal microbiota, as well as their influence on the occurrence and development of IBD.

Objective To determine the value of preoperative clinical, biochemical, cross-sec-tional imaging features and results of fine-needle aspiration for predicting malignancy in cystic neo-plasms of the pancreas (CNP). Methods The medical records of 69 patients receiving operations for CNP between 1994 and 2008 in our hospital were reviewed retrospectively. The predictive effect of va-rious preoperative factors such as sex, location, clinical manifestation, maximum diameters, tumor marker, pancreatic duct obstruction and calcification on the malignant potential of CNP was evaluated by Single and multi-factor analysis, fine needle aspiration (FNA) and intraoperative frozen-section ex-amination of the pancreatic transection margin was investigated. Results All the 69 patients were con-firmed pathologically. Of the 69 patients, 13 suffered from serous cystic neoplasms, 30 from mucinous cystic neoplasms,7 from intraductal papillary mucinous neoplasms,12 from solid pseudopapillary neo-plasms and 7 from cystic neoplasms. Forty-four lesions were diagnosed as malignant or borderline.Univariate analysis should that jaundice, raised CEA and/or CA19-9, maximum diameters and solid component of cystic neoplasmshad were of statistical significance for the risk of malignancy in CNP.The sensitivity was 34.1% (15/44), 47.7 % (21/44), 88.6%(39/44),72.7%(32/44) and specificity 96% (24/25), 84% (23/25), 68% (17/25),72% (18/25), respectively. The last three were identified as independent predictive factors for malignancy by multivariate analysis. Three cases were accurately diagnosed out of the 9 undergoing FNA preoperatively. One of 7 patients with intraductal papillary mucinous neoplasms (IPMN) undenwent total pancreatetomy for transection margin positivity.Conclusion Most malignant CNP can be accurately diagnosed preoperatively from a typical clinical,biochemical and cross-sectional imaging picture. FNA is only used in the patients who are potential candidates for nonoperative management. Margin analysis is necessary for pancreatic resection.