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Pancreatic Cancer: Biomarkers, Risk Factors, Early Detection

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (25 June 2022) | Viewed by 10680

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Special Issue Editors

Prof. Dr. Ewa Małecka-Wojciesko

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Guest Editor

Department of Digestive Tract Diseases, Medical University of Lodz, 90-153 Lodz, Poland
Interests: pancreatitis; pancreatic cancer; inflammatory bowel disease; faecal microbiota transplantation
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Grażyna Rydzewska

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Guest Editor

1. Central Clinical Hospital of Ministry of Internal Affairs and Administration, 02-507 Warsaw, Poland
2. Collegium Medicum, Jak Kochanowski University, 25-516 Kielce, Poland
Interests: IBD; COVID and GI disease; chronic pancreatitis; acute pancreatitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diagnostics and treatment of pancreatic cancer (PDAC) represent a great challenge for modern medicine. PDAC is a highly malignant diagnosis, characterised by rapid local progression and distant metastasis formation. This is the fourth-leading cause of cancer-related deaths worldwide.

PDAC screening in general population is not cost effective but may be considered in high-risk groups, such as early onset diabetes or patients with genetic disorders characterised by an increased risk in PDAC, such as Lynch syndrome (HNPCC), familial adenomatous polyposis (FAP), Peutz–Jeghers syndrome, familial atypical multiple mole melanoma (FAMMM), hereditary breast and ovarian cancer (HBOC) and others.

Recently, there has been great interest in developing new PDAC serum biomarkers: diagnostic, prognostic, and predictive. The routinely used biomarker, CA 19-9, is not helpful in early stage PDAC detection, but hopefully, the new markers alone or in panels may improve the PDAC diagnostics.

The most common management of early stage PDAC is radical surgery, which is rarely possible upon diagnosis. In the event of a tumour involving only the pancreas, the 5-year survival likelihood is 32%; for tumours infiltrating nearby structures, it is 12%; for PDAC with distant metastases, it is as low as 3%. Therefore, there is a strong need for further research to improve PDAC early detection and management.

Prof. Dr. Ewa Małecka-Wojciesko
Prof. Dr. Grażyna Rydzewska
Guest Editors

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Keywords

pancreatic ductal adenocarcinoma
PDAC biomarkers
early onset diabetes
hereditary pancreatitis
Peutz-Jegher's syndrome
pancreatic tumour
PDAC risk factors

Published Papers (4 papers)

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Research

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8 pages, 883 KiB

Open AccessArticle

Gender-Specific Coagulation Profiles of Peripheral and Portal Blood May Help to Differentiate Malignant from Benign Pancreatic Tumour—Pilot Study

by Aneta Szmiel, Alicja Majos, Wojciech Ciesielski, Anna Kumor, Janusz Strzelczyk, Krzysztof Szwedziak, Piotr Hogendorf and Adam Durczyński

J. Clin. Med. 2022, 11(6), 1573; https://doi.org/10.3390/jcm11061573 - 13 Mar 2022

Viewed by 1688

Abstract

Objective: Pancreatic adenocarcinoma (PDAC) and mass forming chronic pancreatitis (CP) can be easily misdiagnosed due to their resemblances in clinical, radiological, and biochemical criteria. In our previous study, we reported a very high concentration of D-Dimers in portal blood in patients with pancreatic cancer which may help to differentiate malignant from benign pancreatic tumours. In this study, we aim to describe other portal and peripheral coagulation profiles of PDAC in comparison to CP patients, as well to test the hypothesis; thus, it is possible to distinguish pancreatic malignancy and benign tumour based on these parameters. Methods: We included retrospectively 115 patients with the absence of venous thromboembolism (VTE), qualified to surgical treatment due to pancreatic tumours, both PDAC and CP. Patients underwent surgery in General and Transplant Surgery Unit of Medical University of Lodz between December 2011 and February 2014. Patients with distant metastases diagnosed before or during the surgery were excluded. The coagulation profile, which includes fibrinogen, activated partial thromboplastin time (aPTT), prothrombin time (PT), and thrombin time (TT), was determined in blood samples from the portal and peripheral vein taken intraoperatively. Results: The fibrinogen level was higher and the aPTT index shortened in the peripheral and portal blood of the PDAC group, which reflects the well-known link between PDAC and general hypercoagulability. Furthermore, these effects are sex-specific. The mean age in the CP group was lower than in the PDAC group (54.63 ± 12.37 vs. 63.77 ± 3.23, p < 0.001) and correlated with the fibrinogen distribution in male patients with CP (portal r = 0.34; p = 0.07; peripheral r = 0.39; p = 0.04). We calculated sex-specific logistic regression models (male: peripheral aPTT and age, AUC: 0.795, female: portal fibrinogen and age, AUC: 0.805), both maintaining the good discrimination properties after V-fold cross validation (0.759, 0.742). Conclusions: Our study shows that the differences between coagulation profiles in PDAC and CP patients not only seems to be a reflection of gender-specific biological features, but also helps to discriminate between them. The main goal of the study was to explore the biology of pancreatic cancer and lay a solid base for further investigations of PDAC biomarkers. This paper is the first to describe the detailed coagulation profile in portal blood in patients with pancreatic solid tumors. At present, the clinical application of our results is not clear; however, we hope that it may improve our understanding of this complex disease. Full article

(This article belongs to the Special Issue Pancreatic Cancer: Biomarkers, Risk Factors, Early Detection)

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11 pages, 1847 KiB

Open AccessArticle

Alpha Smooth Muscle Actin (αSMA) Immunohistochemistry Use in the Differentiation of Pancreatic Cancer from Chronic Pancreatitis

by Katarzyna Winter, Monika Dzieniecka, Janusz Strzelczyk, Małgorzata Wągrowska-Danilewicz, Marian Danilewicz and Ewa Małecka-Wojciesko

J. Clin. Med. 2021, 10(24), 5804; https://doi.org/10.3390/jcm10245804 - 11 Dec 2021

Cited by 5 | Viewed by 2837

Abstract

Aim: Fibrosis is observed both in pancreatic cancer (PDAC) and chronic pancreatitis (CP). The main cells involved in fibrosis are pancreatic stellate cells (PSCs), which activate alpha smooth muscle actin (αSMA), which is considered to be the best-known fibrosis marker. The aim of the study was to evaluate the expression of the αSMA in patients with PDAC and CP as the possible differentiation marker. Methods: We enrolled 114 patients undergoing pancreatic resection: 83 with PDAC and 31 with CP. Normal fragments of resected specimen from 21 patients represented the control tissue. The immunoexpressions of αSMA were detected in tissue specimens with immunohistochemistry (Abcam antibodies, GB). Results: Mean cytoplasmatic expression of αSMA protein in PDAC stromal cells was significantly higher compared to CP: 2.42 ± 0.37 vs 1.95 ± 0.45 (p < 0.01) and control group 0.61 ± 0.45 (p < 0.01). Strong immunoexpression of the αSMA protein was found in the vast majority (80.7%) of patients with PDAC, in about half (58%) of patients with CP, and not at all in healthy tissue. The expression of αSMA of different intensity was found in all patients with PDAC and CP, while in healthy tissue was minimal or absent. In PDAC patients, αSMA expression was significantly higher in tumors of diameter higher than 3 cm compared to smaller ones (p = 0.017). Conclusions: Presented findings confirm the significant role of fibrosis in both PDAC and CP; however, they do not confirm the role of αSMA as a marker of differentiation. Full article

(This article belongs to the Special Issue Pancreatic Cancer: Biomarkers, Risk Factors, Early Detection)

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Review

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23 pages, 3253 KiB

Open AccessReview

Pancreatic Incidentaloma

by Miłosz Caban and Ewa Małecka-Wojciesko

J. Clin. Med. 2022, 11(16), 4648; https://doi.org/10.3390/jcm11164648 - 9 Aug 2022

Cited by 5 | Viewed by 2855

Abstract

Pancreatic incidentalomas (PIs) represent a clinical entity increasingly recognized due to advances in and easier access to imaging techniques. By definition, PIs should be detected during abdominal imaging performed for indications other than a pancreatic disease. They range from small cysts to invasive cancer. The incidental diagnosis of pancreatic cancer can contribute to early diagnosis and treatment. On the other hand, inadequate management of PIs may result in overtreatment and unneeded morbidity. Therefore, there is a strong need to evaluate the nature and clinical features of individual PIs. In this review, we summarize the major characteristics related to PIs and present suggestions for their management. Full article

(This article belongs to the Special Issue Pancreatic Cancer: Biomarkers, Risk Factors, Early Detection)

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17 pages, 608 KiB

Open AccessReview

Simple Serum Pancreatic Ductal Adenocarcinoma (PDAC) Protein Biomarkers—Is There Anything in Sight?

by Monika Kapszewicz and Ewa Małecka-Wojciesko

J. Clin. Med. 2021, 10(22), 5463; https://doi.org/10.3390/jcm10225463 - 22 Nov 2021

Cited by 10 | Viewed by 2153

Abstract

A poor PDAC prognosis is due to a lack of effective treatment and late diagnosis. The early detection of PDAC could significantly decrease mortality and save lives. Idealbiomarkers for PDAC should be cost-effective, detectable in easily accessible biological material, and present in sufficient concentration in the earliest possible phase of the disease. This review addresses newly selected, simple protein biomarkers—new ones such as thrombospondin-2, insulin-linked binding protein 2, lysophosphatidic acid, and autotaxin and conventional ones such as Ca19-9, inflammatory factors, and coagulation factors. Their possible use in the early detection of PDAC, differentiation from benign diseases, prognosis, and treatment response prediction is discussed. We also address the usefulness of possible combinations of biomarkers in diagnostic panels. Full article

(This article belongs to the Special Issue Pancreatic Cancer: Biomarkers, Risk Factors, Early Detection)

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