Gaps and Opportunities in the Diagnosis and Treatment of Pancreatic Cancer

Caban, Miłosz; Małecka-Wojciesko, Ewa

doi:10.3390/cancers15235577

Cited by 4 publications

(2 citation statements)

References 183 publications

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“…A population-based study conducted in Rochester, Minnesota, USA, found that approximately 1 % of participants with new-onset diabetes aged 50 years or older had diabetes secondary to pancreatic cancer. It is early and comprehensive diagnosis, according to Caban M. and Malecka-Wojciesko E., as well as screening of the disease in the general population and directly in highrisk groups with the use of various biomarkers of pancreatic cancer, that will allow to diagnose the pathology before the appearance of distant metastases and apply radical surgical intervention [5].…”

Section: Discussionmentioning

confidence: 99%

Optimization of the selection of the volume of surgical intervention in cases of pronounced morphological and structural changes of the parenchyma in patients with a high risk of developing pancreatic cancer

Usenko,

Petrushenko,

Sukhodolia

et al. 2024

Rep. of Morph.

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Chronic pancreatitis is a common recurrent pathology of the pancreas. The long course of the inflammatory process, accompanied by chronicity, is often attributed to the causes that lead to the development of pancreatic cancer. The aim of the work is to study the morphological changes of the pancreas in rats and the level of matrix metalloproteinases and tissue inhibitor of metalloproteinases in patients with complicated forms of chronic pancreatitis and a high risk of developing pancreatic cancer in order to optimize the selection of the volume of surgical intervention. A histological study of the pancreas of rats with chronic pancreatitis and chronic pancreatitis on the background of diabetes was carried out. 27 patients operated on during 2020-2022 were examined. In 15 of them, we were unable to clearly and convincingly differentiate of chronic pancreatitis from pancreatic cancer, since quite often the clinical symptoms and diagnostic picture of these diseases are similar. In the remaining 12 patients it was confirmed with all the inherent clinical signs of chronic pancreatitis and ductal hypertension. Matrix metalloproteinases (MMP-1, -2, -3, -8, -9, -10) and tissue inhibitor of metalloproteinases were studied. The obtained results were processed statistically. Morphological changes of the pancreas in rats correspond to high and moderate ductal dysplasia of the PanIN 2 and PanIN 3 class, which are direct predictors of pancreatic adenocarcinoma. In 22 patients moderate and severe exocrine insufficiency was observed, confirmed by a significant decrease in fecal elastase. An intraoperative biopsy of the changed tissue of the pancreas was performed. Among the 15 operated patients of the main group, 9 were diagnosed with diabetes mellitus and changes in MMTs and a peptide pool inherent in malignant tissue. Intraoperatively, after performing a punch biopsy, acinar metaplasia was detected in 3 patients, tissue changes characteristic of PanIN2-PanIN3 in 4 patients, and pancreatic cancer in the head area was confirmed in 3 patients. Changes in the protein profile of the plasma, clinical manifestations, as well as characteristic changes in the pancreas tissue, gave us grounds for performing extended resection interventions. Studying the morphological structure of the pancreas, using as many methods as possible for differential diagnosis between chronic pancreatitis and pancreatic cancer, as well as a comprehensive approach to the patient will allow for the most correct and effective intervention.

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Section: Discussionmentioning

confidence: 99%

Optimization of the selection of the volume of surgical intervention in cases of pronounced morphological and structural changes of the parenchyma in patients with a high risk of developing pancreatic cancer

Usenko,

Petrushenko,

Sukhodolia

et al. 2024

Rep. of Morph.

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“…It is also crucial to identify other guiding features from the anamnestic and physical evaluation and predispose promptly the correct imaging modality with adequate timing. Hence, the understanding of the features of pancreatic pain can be a diagnostic opportunity in the clinical setting, particularly for pancreatic cancer [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Neuropancreatology: The Nervous System and Pain Management in Pancreatic Diseases

Nicoletti,

Vitale,

Paratore

et al. 2024

Life

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The intricate network of the pancreatic nervous system plays a fundamental role in physiologic functions of the endocrine and exocrine pancreas. Several pancreatic diseases affect the normal functionality of the pancreatic nervous system. This chronic derangement leads to anatomical alterations, such as neural hypertrophy and increased nerve density. Perineural invasion is a prominent feature of pancreatic cancer, contributing to cancer progression and metastasis. Despite the fact that these pathogenic mechanisms are still incompletely studied and understood, the constant occurrence of these alterations highlights their importance in the pathophysiology of the pancreatic diseases. The occurrence of anatomical changes is strictly linked to the appearance of pain. Pancreatic pain has peculiar features, and its management is complex in clinical practice. In the present review, the evidence on lifestyle, pharmacological and interventional approaches for the management of pancreatic pain is presented. Analgesic therapy is the cornerstone of pain treatment. However, it is important to identify the individual characteristic of the patients and personalize the approach to pain management. Nevertheless, the incomplete efficacy of these strategies makes this field an area of unmet needs. The study of neuroplasticity is crucial to understand the mechanisms that regulate the pathophysiology of pancreatic diseases. Several trials testing new drugs with specific neuromodulatory effects are ongoing. However, further studies are needed to investigate crucial targets to develop novel therapies for the modulation of the nervous system and the prevention of complications of pancreatic diseases. This comprehensive review summarizes the importance of the nervous system in pancreatic diseases with a special focus on its anatomy and physiology, its pathophysiological features and clinical relevance in pancreatic disease, the treatment of pancreatic pain, and the identification of future trends of research.

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Significance of Phytoconstituents in Modulating Cell Signalling Pathways for the Treatment of Pancreatic Cancer

Porwal,

Rastogi,

Chandra

et al. 2024

Rev. Bras. Farmacogn.

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Gaps and Opportunities in the Diagnosis and Treatment of Pancreatic Cancer

Cited by 4 publications

References 183 publications

Optimization of the selection of the volume of surgical intervention in cases of pronounced morphological and structural changes of the parenchyma in patients with a high risk of developing pancreatic cancer

Optimization of the selection of the volume of surgical intervention in cases of pronounced morphological and structural changes of the parenchyma in patients with a high risk of developing pancreatic cancer

Neuropancreatology: The Nervous System and Pain Management in Pancreatic Diseases

Significance of Phytoconstituents in Modulating Cell Signalling Pathways for the Treatment of Pancreatic Cancer

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