Objective To summary the principle of magnetic resonance spectroscopy imaging and its application progress in diagnosis and differential diagnosis of pancreatic cancer. Methods The newest related literatures of home and abroad were collected and reviewed. Results Magnetic resonance spectroscopy imaging was a technology using the magnetic resonance phenomena and chemical shift phenomena to measure molecular organization. The spectroscopy most commonly used in clinical and scientific research includes 1H， 31P， and 23Na. Conclusion Magnetic resonance spectroscopy as the only approach to noninvasive quantitative provding biochemical information in vivo， has an important significance to the diagnosis and differential diagnosis of pancreatic cancer.
Objective To observe the expression of Galectin-3 and Galectin-1 in pancreatic cancer and explore the relationship between the expression and pathological grading. Methods Forty specimens of pancreatic carcinoma tissue and thirty-one specimens of normal pancreas tissue were selected, which were confirmed by surgical resection and pathology from 2002 to 2009. The expression of Galectin-3 mRNA and Galectin-1 mRNA in pancreatic cancer cell lines SW1990, PANC-1 and ASPC -1 was detected by means of reverse transcriptase-polymerase chain reaction; the expression of Galectin-3 protein and Galectin-1 protein in SW1990, PANC-1 and ASPC-1 was detected by means of immunocytochemistry; the expression of Galectin-3 protein and Galectin-1 protein in pancreatic cancer and normal pancreatic tissue was detected by means of immunohistochemistry. Results In SW1990, PANC-1 and ASPC-1, Galectin-3 mRNA signal and protein were detected, but no Galectin-1 mRNA signal or protein was detected. There was no expression of Galectin-3 protein or Galectin-1 protein in the 31 specimens of normal pancrease tissue, while there were Galectin-3 protein and Galectin-1 protein expressed in the 40 specimens of pancreatic cancer tissue. In the 40 specimens of pancreatic cancer tissue, the expression of Galectin-3 protein was observed in pancreatic cancer cells, but not in fibroblasts or matrix cells around the cancer mass; while the expression of Galectin-1 protein was observed in fibroblasts and matrix cells around the cancer mass, but not observed in pancreatic cancer cells. There was no significant association between the expression of Galectin-3 protein in pancreatic cancer and pathological grading (P>0.05); while the expression of Galectin-1 protein in pancreatic cancer was related to the pathological grading, and the expression of Galectin-1 protein was significant higher in poorly differentiated tumors than that in well/moderately differentiated tumors (P<0.05). Conclusions Galectin-3 or Galectin-1 is not expressed in normal pancreases; Galectin-3 is expressed in pancreatic cancer cells; Galectin-1 is expressed in fibroblasts and matrix cells around the cancer mass. The expression of Galectin-1 is related with the differentiation of pancreatic cancer.
Objective To search for the significant gene indicators in the diagnosis of pancreatic cancer. Methods Literatures about genetic diagnosis of pancreatic cancer were collected and reviewed. Results K-ras, p53, DPC4 and telomerase genes were considered to play important roles in the diagnosis of pancreatic cancer. Conclusion Detection of the genes related to pancreatic cancer may be of helpful in early diagnosis of pancreatic cancer.
Objective To investigate the inhibitory effects of RNA interference (RNAi) expression vector on the expression of survivin in pancreatic cancer cell PANC-1. Methods The protein and mRNA expressions of survivin were examined with immunofluorescence and RT-PCR. The survivin gene was cloned into the T-vector and sequenced. The RNAi expression vectors targeting survivin, named si-svv-1 and si-svv-2 respectively according to whether they harbored a mutation or no mutation, were constructed and transfected into PANC-1 cells with liposome. The expression of survivin mRNA was detected with RT-PCR. Apoptosis of PANC-1 cells was analyzed with DNA ladder and FACS. Results There was a high degree expression of survivin in PANC-1 cells. The expression of survivin was not inhibited by RNAi expression vectors si-svv-1, but inhibited about (72.43±8.04)% by si-svv-2 and the apoptosis rate of PANC-1 cells increased to （12.36±1.44）% after 72 h. Conclusion The RNAi expression vector can effectively inhibit the expression of survivin in pancreatic cancer cell PANC-1 cells and induce the apoptosis in PANC-1 cells.
Objective To detect the activity of lactate dehydrogenase (LDH) and LDH isoenzyme, and to explore the relation between biological behavior ofpancreatic cancer and glycolysis. MethodsConsecutive 12 cases of pancreatic ductal adenocarcinoma and 12 benign lesions such as insulinoma from October 2006 to July 2008 were collected, as well as normal pancreatic tissues. The total activity of the LDH was detected by the LDH testing kits, and the iosenzyme pattern of LDH was inspected by the France Sebia hydrasys. ResultsCompared to the normal tissue, LDH activity ofpancreatic cancer and adjacent non-cancerous tissue was significantly higher (P＜0.05). LDH iosenzyme pattern in cancer tissue was also significantly different, the percentage of LDH4 and LDH5 increased obviously, and were greater than that innormal tissue (P＜0.05). ConclusionThe alteration of LDH activity and its isoenzyme pattern are possibly related to the pathogenesis of pancreatic cancer. Inhibit the LDH activity may be a new therapeutic strategy.
Objective To explore the risk factors of postoperative anxiety in patients with pancreatic cancer undergoing total pancreatectomy. Methods A total of 31 patients who underwent total pancreatectomy for pancreatic cancer between July 2011 and December 2016 were collected and analyzed in this retrospective study. The patients’ postoperative Self-Rating Anxiety Scale scores were collected, and the exposure factors were analyzed to identify the risk factors of postoperative anxiety through univariate analysis and multiple logistic regression analysis by SPSS 21.0 statistical software. Results In the 31 patients, there were 17 males and 14 females, with an average age of (66.16±9.09) years, an average body mass index of (21.11±3.10) kg/m2, and an average postoperative hospital stay of (14.58±7.47) days. There were 23 patients (74.2%) with postoperative anxiety, and 30 patients (96.8%) with hyperglycosemia required insulin therapy. The total perioperative mortality was 3.2%. In the univariate analysis, age (P=0.012), smoking history (P=0.043), preoperative diabetes mellitus (P=0.012), postoperative bile leakage (P=0.043), and postoperative abdominal infection (P=0.026) were related factors of the postoperative anxiety. In the multiple logistic regression analysis, patients without preoperative diabetes was an independent risk factor of postoperative anxiety (P=0.013). Conclusions For patients undergoing total pancreatectomy, it is needed to pay attention to the patients’ postoperative psychological conditions and assess the postoperative anxiety, especially for those without preoperative diabetes. To improve the life quality and long-term survival of these patients, health education and psychological intervention are needed.
ObjectiveTo explore the dynamic changes of immune cell populations in Panc02 pancreatic cancer bearing immunocompetent mice. MethodsThe C57BL6/J mice syngeneic pancreatic cancer cell line Panc02 were subcutaneously implanted to establish the immunocompetent murine pancreatic cancer bearing model.According to the tumor size, the tumor was classified into 4 stages, named T1-T4, respectively.The flow cytometry was performed to identify the dynamic changes of different cell populations, such as inflammatory cells (CD45+), T helper (Th) lymphocytes, cytotoxic T lymphocytes (CTL), B lymphocytes, granulocytes, macrophages, dendritic cells (DC), natural killer (NK) cells, and natural killer T (NKT) cells in the peripheral blood and tumor tissue. ResultsThree dynamic types of immune cells with the tumor progression were identified:consistent increase, consistent decrease, increase and then decrease.①In peripheral blood:The proportion of the Th lymphocytes, CTL, and B lymphocytes consistently decreased; The proportion of granulocytes consistently increased; The proportion of the DC, macrophages, NK cells, and NKT cells increased from T1 to T3 stage but sharply decreased at T4 stage.②In tumor tissue:The intratumoral CD45+ cells consis-tently increased; The proportion of the granucolyte, macrophages, and DC consistently increased; The proportion of the Th lymphocytes and the CTL consistently decreased; The proportion of the B lymphocytes did not change significantly; The proportion of the NK cells or NKT cells increased from T1 to T3 stage but sharply decreased at T4 stage. ConclusionWith pancreatic cancer progression, the immune cell populations show different dynamic change models, which imply their important roles in predicting the prognosis and the integrated treatments of pancreatic cancer.
ObjectiveTo summarize the therapeutic targets of pancreatic cancer (PC). MethodsThe related literatures about the therapeutic targets of PC were reviewed. ResultsPC was one of the most challenging tumor in worldwide, and was characterized as a highly aggressive disease with poor overall prognosis and a high mortality rate. The hallmark of PC was its poor response to radio-and chemo-therapy. Current chemotherapeutic regimens could not provide substantial survival benefit with a clear increase in overall survival. Recently, several new approaches which could significantly improve the clinical outcome of PC had been described, involving signal-transduction pathways, immune response, stroma reaction, and epigenetic changes. ConclusionsMany therapeutic targets are involved in the treatment of PC. As current therapies failed to significantly improve the progression and the survival of PC, new therapeutic approaches and clinical studies are strongly required.
ObjectiveTo investigate the indications and clinical effect of pancreatoduodenectomy with extended lymphadenectomy for pancreatic head carcinoma. MethodsThe clinical data of 21 patients with pancreatic head carcinoma that performed pancreatoduodenectomy with extended lymphadenectomy between June 2010 to June 2011 in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were retrospective analyzed. The 21 patients included 15 men and 6 women with an age range of 36-57 years and an average age of 47.8 years. ResultsThere were 3 cases(14.3%), 9 cases(42.9%), 8 cases(38.1%), and 1 case(4.8%) in stageⅠ, ⅡA, ⅡB, andⅢ, respectively. Eighteen cases had a R0 resection(85.7%) and 3 cases had a R1 resection. The total number of resected lymph nodes were 14-43 with an average of 27.4. Lymph node invasion occurred in 10 cases(47.6%). The average operative time was 6.8 h(5-8.5 h) and the average amount of blood transfusion was 5.6 U(3-8 U). There was no death in this group and 5 cases(23.8%) had postoperative complications. Tree cases(14.3%) developed pancreatic fistula, 1 case(4.8%) developed bile leakage, 1 case(4.8%) developed abdominal hemorrhage, 1 case(4.8%) developed gastrointestinal bleeding, and 2 cases(9.5%) developed intractable diarrhea. Postoperative pathological results in high, medium, and low differentiated adenocarcinoma was 6 cases(28.6%), 10 cases(47.6%), and 5 cases(23.8%), respec-tively. Twenty one cases were followed-up, the follow-up time ranged from 5 to 40 months with a median time of 19 months. 1-, 2-, and 3-year cumulative survival rates was 66.7%, 38.1%, and 19%, respectively. ConclusionSelective application of pancreatoduodenectomy with extended lymphadenectomy in resectable pancreatic head carcinoma is conducive to increase the proportion of the radical resection and improve the prognosis, but the postoperative complications is higher.
Objective To summarize the progress of endoscopic diagnosis and therapy for pancreatic cancer. Methods Domestic and international publications online involving progress of diagnosis and therapy for pancreatic cancer by using endoscope in recent years were collected and reviewed. Results Recently, early diagnostic rate of pancreatic cancer increased with the development of endoscope and endoscopic technique such as endoscopic ultrasound, endoscopic ultrasound-guided fine needle aspiration, peroral pancreatoscopy, optical coherence tomography, ERCP, and cytology in pancreatic juice. Furthermore, varied therapies such as endoscopic ultrasound guided celiac plexus neurolysis, implantation of iodine 125-particles or pancreatic duct/bile duct stents were performed by endoscope for advanced pancreatic cancer. Conclusion Early diagnostic rate and novel therapeutic alternative of pancreatic cancer are supplied by digestive endoscopy.