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| 1 | Real-world study of surgical treatment of pancreatic cancer in China: annual report of China Pancreas Data Center (2016-2020)显示文摘Objective: In 2015, the Chinese Pancreatic Association of the Chinese Society of Surgery of the Chinese Medical Association launched a national multicenter online system for registration of surgical treatment of pancreatic cancer in China, called China Pancreas Data Center (CPDC). With continued effort, the CPDC has developed over time. Herein, we report the general results of the CPDC from January 2016 to January 2020 to present the real-world situation of surgical treatment of pancreatic cancer in China.Methods: The data of the CPDC from January 2016 to January 2020 were retrieved and analyzed in this real-world study, including the data on patient demographics, comorbidities, diagnostic modalities, neoadjuvant treatment, surgical procedures, postoperative complications and treatment, pathological examinations, postoperative adjuvant treatment, survival, and risk factors.Results: A total of 13,595 cases from 70 centers in 28 provinces were retrieved for analysis. This study reported the largest cohort of patients who underwent surgical treatment for pancreatic cancer in China to date. More cases were derived from the Eastern regions, among which Shanghai, Beijing, and Zhejiang ranked in the top three. The peak age of the patients ranged from 60 to 69 years. The ratio of males to females was 1.5:1. Overall, 64.3% of the tumors were located in the head and neck of the pancreas, and 35.7% in the body and tail of the pancreas. Of the patients, 23.0% underwent positron-emission tomography-computed tomography, 21.6% underwent endoscopic ultrasound, and 4.8% underwent preoperative biopsy. Two percent of the patients underwent neoadjuvant treatment, while 68.9% underwent R0 surgical resection (margin free of tumor cells). Of the latter, 78.6% of the operations were open procedures, 12.6% were laparoscopic procedures, 2.9% were robotic procedures, and 3.7% were converted to open procedures. The in-hospital mortality rate after surgery was 0.4%. The incidence of grade 2 and grade 3 postoperative pancreatic fistulas was 25.5% and 2.5%, respectively. The incidence of complications based on the Clavien-Dindo classification was 17.9% of grade II, 4.3% of grade IIIa, 1% of grade IIIb, and 0.6% of grade IV. Of the patients, 28.9% underwent postoperative adjuvant chemotherapy. The 1-year, 2-year, and 3-year overall survival of these patients were 77%, 51%, and 38%, respectively. In the 8542 patients who underwent R0 resection, the 1-year, 2-year, and 3-year overall survival and disease-free survival were 77% , 54%, and 43%, and 68%, 49%, and 41%, respectively. The factors related to the prognosis of these patients were also identified after uni-and multi-variate analyses.Conclusion: The surgical quality, safety, and long-term survival of the patients in CPDC are similar to those of international high-volume pancreatic centers. However, neoadjuvant and postoperative adjuvant chemotherapy should be improved. | Wenming Wu Yi Miao Yinmo Yang Wenhui Lou Yupei Zhao | 2022 | Journal of Pancreatology2022，5，1： | 7 |
| 2 | 保留十二指肠的胰头切除术治疗良性肿瘤、囊性肿瘤及神经内分泌瘤的系统分析显示文摘背景保留十二指肠的胰头切除术是替代胰十二指肠切除术治疗良性肿瘤、囊性肿瘤及神经内分泌瘤的可行之选。方法检索Pubmed、Embase及Cochrane数据库中保留十二指肠胰头切除术的研究结果。根据手术指征、围手术期并发症及微创应用等纳入1994年1月至2021年3月的38项队列研究共702例患者的临床资料。结果共702例患者分别因良性肿瘤、癌前病变、囊性肿瘤、胰腺神经内分泌肿瘤、十二指肠乳头周围腺瘤等行保留十二指肠的胰头切除术。702例患者中,214例(30.5%)行保留十二指肠的部分胰头切除术,488例(69.5%)行保留十二指肠的全胰头切除术,后者中微创手术占17.3%。两种术式的术后早期严重并发症发生率(术后B及C级胰瘘、胆瘘、腹腔出血及腹腔脓肿)均<10%,围手术期病死率分别为0和1.02%。经中位时间为(50.7±21.1)个月的随访,局部复发率为2.8%(15/404)。结论保留十二指肠的胰头切除术应作为胰头部分支胰管型导管内乳头状肿瘤、实性假乳头状肿瘤、黏液性囊腺瘤、>2 cm的有或无功能的良性内分泌肿瘤外科治疗的首选术式。 | Hans G.Beger Benjamin Mayer Yinmo Yang Bertram Poch | 2021 | 中华外科杂志2021，59，7： | 6 |
| 3 | Molecular characterization of circulating tumor cells in pancreatic ductal adenocarcinoma:potential diagnostic and prognostic significance in clinical practice显示文摘Background:The clinical value of heterogeneous sub-populations of circulating tumor cells(CTCs)in pancreatic ductal adenocarcinoma(PDAC)remains unclear.Methods:Peripheral blood samples were obtained from 67 PDAC patients.CTCs were isolated by employing CD45 negative enrichment technique and further characterized for epithelial to mesenchymal transition(EMT)or human equilibrative nucleoside transporter-1(hENT-1).The relationships between CTCs sub-phenotypes with clinicopathological factors or post-operative recurrence in PDAC patients were analyzed.Results:EMT related CTCs could be isolated and identified from the 81%of patients(54/67),and both the total count(median:5 vs.17/mL,P<0.0001)and M-CTC percentage(median:0.2 vs.0.345,P=0.0244)of CTCs could differentiate local/regional with metastatic disease.Multivariate analysis showed that both AJCC stage(P=0.025)and M-CTC percentage(P=0.001)were independent prognostic indicators of recurrence free survival(RFS)in resected patients.Moreover,Kaplan-Meier survival analysis showed that M-CTC after 2 courses of chemotherapy was significantly associated with inferior RFS(49.5 weeks vs.undefined,P=0.0288).No significant correlation in hENT-1 expression was found between CTCs and matched tumor tissues,and further multivariate analysis suggested hENT-1 expression in CTCs as independent prognostic factor for RFS(P=0.016).Patients with low hENT-1 expression in CTCs had decreased RFS(32 weeks vs.undefined,P=0.0337).Conclusions:CTCs could be the promising diagnostic biomarkers in PDAC patients,and phenotypic profiling of CTCs based on EMT or hENT-1 could help establish novel prognostic biomarkers in resected patients undergoing adjuvant gemcitabine-based chemotherapy. | Xudong Zhao Yongsu Ma Xiu Dong Zhengkui Zhang Xiaodong Tian Xiaohang Zhao Yinmo Yang | 2021 | Hepatobiliary Surgery and Nutrition2021，10，6： | 3 |
| 4 | Validation and modification of the AJCC 8th TNM staging system for pancreatic ductal adenocarcinoma in a Chinese cohort:A nationwide pancreas data center analysis显示文摘Objective:To validate the 8 th edition of the American Joint Committee on Cancer(AJCC)staging system for pancreatic ductal adenocarcinoma(PDAC)in a Chinese cohort of radically resected patients and to develop a refined staging system for PDAC.Methods:Data were collected from the China Pancreas Data Center(CPDC)for patients with resected PDAC in 2016 and 2017,and cancer-specific survival(CSS)was evaluated using the Kaplan-Meier method and log-rank test.Univariate and multivariate analyses based on Cox regression were performed to identify prognostic factors.The recursive partitioning analysis(RPA),Kaplan-Meier method,and log-rank test were performed on the training dataset to generate a proposed modification for the 8 th TNM staging system utilizing the preoperative carbohydrate antigen(CA)19-9 level.Validation was performed for both staging systems in the validation cohort.Results:A total of 1,676 PDAC patients were retrieved,and the median CSS was significantly different between the 8 th TNM groupings,with no significant difference in survival between stage IB and IIA.The analysis of T and N stages demonstrated a better prognostic value in the N category.Multivariate analysis showed that the preoperative serum CA19-9 level was the strongest prognostic indicator among all the independent risk factors.All patients with CA19-9>500 U/mL had similar survival,and we proposed a new staging system by combining IB and IIA and stratifying all patients with high CA19-9 into stage III.The modified staging system had a better performance for predicting CSS than the 8 th AJCC staging scheme.Conclusions:The 8 th AJCC staging system for PDAC is suitable for a Chinese cohort of resected patients,and the N category has a better prognostic value than the T category.Our modified staging system has superior accuracy in predicting survival than the 8 th AJCC TNM staging system. | Hao Hu Chang Qu Bingjun Tang Weikang Liu Yongsu Ma Yiran Chen Xuehai Xie Yan Zhuang Hongqiao Gao Xiaodong Tian Yinmo Yang | 2021 | Chinese Journal of Cancer Research2021，33，4： | 3 |
| 5 | MicroRNAs as potential therapeutic targets for pancreatic cancer显示文摘Pancreatic cancer is one of the most aggressive malignancies. The poor prognosis of pancreatic cancer patients is mainly attributed to low diagnostic rate at the early stage, highly aggressive nature coupled with the inadequate efficacy of current chemotherapeutic regimens. Novel therapeutic strategies are urgently needed for pancreatic cancer. MicroRNAs (miRNAs) play an important regulatory role in key processes of cancer development. The aberrant expression of miRNAs is often involved in the initiation, progression, and metastasis of pancreatic cancer. The discovery of tumor suppressor miRNAs provides prospects for the development of a novel treatment strategy for pancreatic cancer. We reviewed recent progress on the understanding of the role of miRNAs in pancreatic cancer, highlighted the efficient application of miRNAs-based therapies for pancreatic cancer in animal models and clinical trials, and proposed future prospects. This review focuses on the promise of integrating miRNAs into the treatment of pancreatic cancer and provides guidance for the development of precision medicine for pancreatic cancer. | Xiangyu Chu Dan Wei Xinxin Liu Di Long Xiaodong Tian Yinmo Yang | 2022 | Chinese Medical Journal2022，，1： | 1 |
| 6 | The Chinese guidelines for neoadjuvant therapy of pancreatic cancer(2020)显示文摘Aiming to keep pace with the renewal of international guidelines and refine the domestic treatment system of pancreatic cancer,the Chinese Pancreatic Surgery Association,Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association launched this Chinese guidelines for neoadjuvant therapy of pancreatic cancer(2020 edition).Based on the Grading of Recommendations Assessment,Development,and Evaluation system,the guidelines have conducted a discussion on the indication,regimen selection,therapeutic effect evaluation,pathological diagnosis,surgery strategy,etc.The guidelines have quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in neoadjuvant therapy of pancreatic cancer.The guidelines have highlighted the role of multiple disciplinary team and represented the conversion of treatment concepts in pancreatic cancer.Neoadjuvant therapy has prolonged the survival of part of pancreatic cancer patients.However,more high-quality clinical researches are in urgent need to improve the level of evidence,optimize the clinical practice,and improve the survival of patients. | Taiping Zhang Wenming Wu Yinmo Yang Yupei Zhao on behalf of Chinese Pancreatic Surgery Association Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association | 2021 | Journal of Pancreatology2021，4，4： | 1 |
| 7 | Guidelines for the diagnosis and treatment of acute pancreatitis in China (2021)显示文摘Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients.On the basis of previous guidelines and expert consensus,this guideline adopts an evidence-based,problem-based expression;synthesizes important clinical research data at home and abroad in the most recent 5 years;and forms 29 recommendations through multidisciplinary expert discussion,including diagnosis,treatment,and follow-up.It is expected to provide evidence support for the treatment of AP in the clinical setting in China. | Fei Li Shouwang Cai Feng Cao Rufu Chen Deliang Fu Chunlin Ge Chunyi Hao Jihui Hao Heguang Huang Zhixiang Jian Gang Jin Ang Li Haimin Li Shengping Li Weiqin Li Yixiong Li Tingbo Liang Xubao Liu Wenhui Lou Yi Miao Yiping Mou Chenghong Peng Renyi Qin Chenghao Shao Bei Sun Guang Tan Xiaodong Tian Huaizhi Wang Lei Wang Wei Wang Weilin Wang Junmin Wei Heshui Wu Wenming Wu Zheng Wu Changqing Yan Yinmo Yang Xiaoyu Yin Xianjun Yu Chunhui Yuan Taiping Zhang Yupei Zhao on behalf of the Chinese Pancreatic Surgery Association | 2021 | Journal of Pancreatology2021，4，2： | 1 |
| 8 | Consensus of clinical diagnosis and treatment for non-functional pancreatic neuroendocrine neoplasms with diameter<2 cm显示文摘In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial.In response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert opinions.This consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects. | Wu Wenming Cai Shouwang Chen Rufu Fu Deliang Ge Chunlin Hao Chunyi Hao Jihui Huang Heguang Jian Zhixiang Jin Gang Li Fei Li Haimin Li Shengping Li Weiqin LiYixiong Liang Tingbo Liu Xubao Lou Wenhui Miao Yi Mou Yiping Peng Chenghong Qin Renyi Shao Chenghao Sun Bei Tan Guang Wang Huaizhi Wang Lei Wang Wei Wang Weilin Wei Junmin Wu Heshui Wu Zheng Yan Changqing Yang Yinmo Yin Xiaoyu Yu Xianjun Yuan Chunhui Zhao Yupei | 2023 | Journal of Pancreatology2023，6，3： | 0 |
| 9 | The management strategy of pancreatic cancer in the era of systemic therapy-“Surgery First” or “Surgery Last”?显示文摘With the development of chemotherapy,targeted therapy and immunotherapy,the management of solid tumors has evolved from a single discipline to multi-disciplinary comprehensive treatment in recent years.The outcome of patients with malignant tumors,including several gastrointestinal cancers,has been continuously improved,along with a significant improvement in long-term survival rate.However,as a common malignant tumor of the digestive system,pancreatic cancer(PC)is still correlated with a very poor prognosis,characterized by the close parallel between incidence and mortality. | Yinmo Yang Xiaodong Tian | 2022 | Hepatobiliary Surgery and Nutrition2022，11，4： | 0 |
| 10 | Guidelines for the diagnosis and treatment of pancreatic cancer in China (2021)显示文摘The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer. | Yinmo Yang Xueli Bai Dapeng Bian Shouwang Cai Rufu Chen Feng Cao Menghua Dai Chihua Fang Deliang Fu Chunlin Ge Xiaochao Guo Chunyi Hao Jihui Hao Heguang Huang Zhixiang Jian Gang Jin Fei Li Haimin Li Shengping Li Weiqin Li Yixiong Li Hongzhen Li Tingbo Liang Xubao Liu Wenhui Lou Yi Miao Yiping Mou Chenghong Peng Renyi Qin Chenghao Shao Bei Sun Guang Tan Xiaodong Tian Huaizhi Wang Lei Wang Wei Wang Weilin Wang Junmin Wei Heshui Wu Wenming Wu Zheng Wu Jingyong Xu Changqing Yan Xiaoyu Yin Xianjun Yu Chunhui Yuan Taiping Zhang Jixin Zhang Jun Zhou Yupei Zhao on behalf of the Chinese Pancreatic Surgery Association | 2021 | Journal of Pancreatology2021，4，2： | 0 |
| 11 | Exosomal miR-485-3p derived from pancreatic ductal epithelial cells inhibits pancreatic cancer metastasis through targeting PAK1显示文摘Background:Cell competition is an important feature in pancreatic cancer(PC)progression,but the underlying mechanism remains elusive.This study aims to explore the role of exosomes derived from normal pancreatic ductal epithelial cells involved in PC progression.Methods:PC cells and pancreatic stellate cells(PSCs)were treated with exosomes isolated from pancreatic ductal epithelial cells.Cell proliferation was assessed by CCK8 assays.Cell migration and invasion were assessed by Transwell assays.PC and matched adjacent non-tumor tissue specimens were obtained from 46 patients pathologically diagnosed with PC at Peking University First Hospital from 2013 to 2017.Tissue miR-485-3p and p21-activated kinase-1(PAK1)expression was examined by real-time polymerase chain reaction(RT-PCR),and the relationship of the two was analyzed using Pearman’s product-moment correlation.The clinical significance of miR-485-3p was analyzed using the Chi-square test,Wilcoxon rank-sum test,and Fisher exact probability,respectively.The binding of miR-485-3p to PAK15’-untranslated region(5’-UTR)was examined by luciferase assay.PC cells were xenografted into nude mice as a PC metastasis model.Results:Exosomes from pancreatic ductal epithelial cells suppressed PC cell migration and invasion as well as the secretion and migration of PSCs.MiR-485-3p was enriched in the exosomes of pancreatic ductal epithelial cells but deficient in those of PC cells and PSCs,in accordance with the lower level in PSCs and PC cells than that in pancreatic ductal cells.And the mature miR-485-3p could be delivered into these cells by the exosomes secreted by normal pancreatic duct cells,to inhibit PC cell migration and invasion.Clinical data analysis showed that miR-485-3p was significantly decreased in PC tissues(P<0.05)and was negatively associated with lymphovascular invasion(P=0.044).As a direct target of miR-485-3p,PAK1 was found to exert an inhibitory effect on PC cells,and there was a significantly negative correlation between the expression levels of miR-485-3p and PAK1(r=-0.6525,P<0.0001)in PC tissues.Moreover,miR-485-3p could suppress PC metastasisin vivo by targeting p21-activated kinase-1.Conclusions:Exosomal miR-485-3p delivered by normal pancreatic ductal epithelial cells into PC cells inhibits PC metastasis by directly targeting PAK1.The restoration of miR-485-3p by exosomes or some other vehicle might be a novel approach for PC treatment. | Mingzhe Li Jiaxin Zhou Zhengkui Zhang Jisong Li Feng Wang Ling Ma Xiaodong Tian Zebin Mao Yinmo Yang | 2022 | Chinese Medical Journal2022，135，19： | 0 |
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