AimTo explore whether C-reactive protein (CRP) mediates the risk of body mass index (BMI) in pancreatic cancer (PC) and calculate the mediate proportion of CRP in this possible mechanism.MethodsBased on two-sample Mendelian randomization (TSMR), a two-step Mendelian randomization (TM) model was conducted to determine whether CRP was a mediator of the causal relationship between BMI and PC. The multivariable Mendelian randomization (MVMR) study was designed for mediating analysis and to calculate the mediating proportion mediated by CRP.ResultsBMI has a positive causal relationship with PC (n = 393 SNPs, OR = 1.484, 95% CI: 1.021–2.157, p< 0.05). BMI has a positive causal relationship with CRP (n = 179 SNPs, OR = 1.393, 95% CI: 1.320–1.469, p< 0.05). CRP has a positive causal relationship with PC (n = 54 SNPs, OR = 1.348, 95% CI: 1.004–1.809, p< 0.05). After adjusting CRP, BMI has no causal relationship with PC (n = 334 SNPs, OR = 1.341, 95% CI: 0.884–2.037, p< 0.05). After adjusting BMI, there was still a positive causal relationship between CRP and PC (n = 334 SNPs, OR = 1.441, 95% CI: 1.064–1.950, p< 0.05). The mediating effect of CRP was 29%.ConclusionsIn clinical practice, while actively advocating for weight loss among obese patients, we should focus on chronic inflammation levels in obese patients as well. In addition, anti-inflammatory dietary patterns and appropriate physical activity are important in preventing PC.

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Background Gardner syndrome is a subtype of familial adenomatous polyposis (FAP), characterized by a combination of adenomatous intestinal polyps and extracolonic lesions such as multiple osteomas, dental abnormalities, and soft tissue tumors. Although 12% of patients with intestinal polyposis of FAP may occur intra-abdominal desmoid tumors, pregnancy complicating with giant abdominal desmoid tumors is a relatively rare case. Case presentation A 28-year-old pregnant woman was diagnosed with Gardner syndrome in whom an intra-abdominal tumor was found a year after undergoing a laparoscopic total colectomy due to family adenomatous polyposis. At 32 weeks’ gestation, she presented to our department for the third time complaining upper abdominal pain caused by the giant abdominal mass about 21 × 12 cm2 in size. After multidisciplinary consultation and discussion, the decision of fetal preservation treatment was made. After the delivery of a baby girl, abdominal mass resection was performed, and pathological examination revealed a fibrous adenoma. The patient was discharged after a week and was uneventful in the follow-up for half a year. Conclusions Gardner syndrome is characterized by typical syndrome including family adenomatous polyposis and extra-intestinal tissue tumor. Were desmoid tumors rarely as large as fetus and local aggressively. In our case, we selected surgery to remove the intra-abdominal desmoid tumor after the natural delivery of the fetus and no abnormalities were observed during the 6 months follow-up. Women during pregnancy have an increased risk for the development of desmoid tumors, likely with the sex hormone to be one of the triggers. Therefore, we suggested that when a patient with Gardner syndrome desire to conceive again, they should go to the hospital for a regular review at least once every 3 months.

Perpose: Pancreatic cancer has a poor prognosis and is considered one of the most lethal tumors. ITGA2, a gene highly expressed in various tumor tissues, is a promising candidate for cancer therapy. The objective of this study is to assess the presence of ITGA2, MET and PD-L1 in pancreatic cancer, while also identifying ITGA2, CD4 and CD8 as potential survival indicators for patients suffering from this disease. Experimental Design: We examined the expression of ITGA2, MET, E-cad, PD-L1, CD4, and CD8 proteins in 62 pancreatic cancer tissue samples using multi-tissue immunofluorescence and immunohistochemistry techniques.This study examined how the protein expression of ITGA2, E-cad, and PD-L1 relate to clinicopathological features in patients diagnosed with pancreatic cancer. Additionally, the study examined the correlation between protein expression of ITGA2, CD4, and CD8 in pancreatic cancer and their relationship with clinicopathological features and prognosis. Results In our study, we observed the expression of ITGA2, E-cad, and PD-L1 in both tumor and stroma tissues of pancreatic cancer. Interestingly, the expression of E-cad and PD-L1 was higher in the stroma (average = 25.827% and average = 34.346%, respectively) compared to the tumor (average = 19.973% and average = 20.042%, respectively). Additionally, we found a positive correlation between ITGA2 and E-cad, as well as PD-L1 in the tumor region (r = 0.55, P < 0.001 and r = 0.51, P < 0.001, respectively), and PD-L1 in the stroma region (r = 0.51, P < 0.001).In this study, the correlation between ITGA2, E-cad, and PD-L1 with tumor marker CA-199 and lymph node metastasis was observed (P < 0.05). Additionally, the expression levels of ITGA2, CD4, and CD8 were found to be significantly higher in pancreatic cancer tissues compared to adjacent tissues (P < 0.05) as determined by immunohistochemical analysis.The protein expressions were found to be correlated with the degree of differentiation, TNM stage, lymph node metastasis, and local invasion in pancreatic cancer patients (all P < 0.05), while no significant correlation was observed with age, gender, tumor location, and tumor size (all P > 0.05).the study found that the protein expression of ITGA2 was negatively correlated with CD4 and CD8 (r = -0.344, P < 0.005 and r = -0.398, P < 0.005). The follow-up was successful in 95.0% of the 62 patients with pancreatic cancer, with a follow-up time ranging from 3 to 64 months. Furthermore, the study found that the expression of ITGA2, CD4, and CD8 was correlated with the survival time of patients after surgery (all P < 0.05).The study analyzed the clinicopathological data of 62 patients diagnosed with pancreatic cancer through univariate COX regression analysis. The findings indicated that the prognosis of patients was associated with various factors such as histological grade, TNM stage, local invasion, lymph node metastasis, and the expression intensity of ITGA2, CD4, and CD8 (all P < 0.05). However, multivariate regression analysis highlighted that only local invasion was an independent prognostic factor for overall survival (P < 0.05). Conclusions ITGA2 has been identified as a potential target for the treatment and prevention of pancreatic cancer. Studies have shown that increased expression of ITGA2 is associated with poor prognosis in pancreatic cancer patients, and may impact the immune microenvironment by affecting the expression of PD-L1, CD4, and CD8. This suggests that ITGA2 could serve as a valuable entry point for developing new therapies for pancreatic cancer.