Article
Gastroenterology & Hepatology
Efrat Zamir, Dana Zelnik Yovel, Erez Scapa, Mati Shnell, Nir Bar, Iddo Bar Yishay, Tomer Ziv-Baran, Fadi Younis, Adam Phillips, Nir Lubezky, Oren Shibolet, Dana Ben-Ami Shor
Summary: Glucose levels in pancreatic cystic fluid are more accurate than CEA for the diagnosis of mucinous cysts. Glucometry assessment of glucose levels shows excellent correlation with laboratory measurements and may serve as a useful diagnostic test.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2022)
Article
Surgery
Myrte Gorris, Frederike Dijk, Arantza Farina, Johannes B. Halfwerk, Gerrit K. Hooijer, Selma J. Lekkerkerker, Rogier P. Voermans, Mattheus C. Wielenga, Marc G. Besselink, Jeanin E. van Hooft
Summary: This study assessed the value of combined CEA and glucose testing in pancreatic cyst fluid, and found that this method has high specificity and sensitivity for differentiating mucinous from non-mucinous pancreatic cystic neoplasms.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Surgery
Jose Larino Noia, Rafael Mejuto, Ines Oria, Daniel De la Iglesia-Garcia, Augusto Villaverde, Alba Voces, Juan Pizzala, Julio Iglesias-Garcia, Dalila Urgiles, Mariano Marcolongo, Oscar Mazza, Enrique Dominguez-Munoz
Summary: On-site glucometry from samples obtained by EUS-FNA shows high sensitivity and specificity in distinguishing mucinous from non-mucinous CPL, with excellent correlation with laboratory glucose values.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Review
Gastroenterology & Hepatology
Sandra Faias, Marilia Cravo, Paula Chaves, Luisa Pereira
Summary: Glucose level in pancreatic cystic fluid performs better than carcinoembryonic antigen (CEA) for accurately diagnosing mucinous cysts, with higher sensitivity and fewer false-negative results. Glucose could potentially become a useful first-line test to exclude mucinous cysts, especially in small cysts with limited fluid volume. Larger studies are needed to confirm glucose as the preferred test for mucinous cyst diagnosis.
GASTROINTESTINAL ENDOSCOPY
(2021)
Review
Gastroenterology & Hepatology
Babu P. Mohan, Deepak Madhu, Shahab R. Khan, Lena L. Kassab, Suresh Ponnada, Saurabh Chandan, Antonio Facciorusso, Stefano F. Crino, Luca Barresi, Stephanie McDonough, Douglas G. Adler
Summary: The study demonstrates that intracystic glucose levels in fluid samples collected by endoscopic ultrasound guided fine-needle aspiration can accurately differentiate mucinous pancreatic cysts from nonmucinous cysts, with a cut-off of 50mg/dL showing the best performance.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Imadh Khan, Muhammad Baig, Thrisha Bandepalle, Srinivas R. Puli
Summary: The meta-analysis suggests that cyst fluid CEA level at a cutoff of 192 ng/mL is highly specific in diagnosing mucinous cystic lesions with reasonable sensitivity.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Gastroenterology & Hepatology
Zachary L. Smith, Sagarika Satyavada, Roberto Simons-Linares, Shaffer R. S. Mok, Belen Martinez Moreno, Jose Ramon Aparicio, Prabhleen Chahal
Summary: This study compared the performance of glucose and CEA concentrations in differentiating MNPC. The results showed that intracystic glucose concentration is superior to CEA concentration, and glucose has the advantages of low cost and ease of implementation.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Review
Gastroenterology & Hepatology
Linda S. Lee
Summary: Incidental pancreatic cysts are common and require risk assessment to determine the need for endoscopic ultrasound or surgical resection. Various cyst fluid markers help distinguish different types of cysts.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Surgery
Francesco Caiazza, Patricia C. Conroy, Sam L. Ivry, Tyler York, Joseph Lin, Sophia Hernandez, Thomas J. Hoffmann, Stephen S. Francis, Walter G. Park, Michele T. Yip-Schneider, C. Max Schmidt, Randall Brand, Charles S. Craik, Kimberly Kirkwood
Summary: This study compared the performance of gastricsin, glucose, and CEA as biomarkers for the classification of mucinous pancreatic cystic lesions. The results showed that gastricsin and glucose performed similarly to CEA, but required much smaller sample volumes.
JOURNAL OF SURGICAL RESEARCH
(2023)
Review
Medicine, General & Internal
Ronald C. Turner, Jared T. Melnychuk, Wei Chen, Daniel Jones, Somashekar G. Krishna
Summary: Early detection and diagnosis of precursor lesions for pancreatic malignancy is crucial. Current diagnostic tools for cystic precursor lesions, such as CEA levels and cytology, have limitations. Molecular analysis of cystic fluid can improve the diagnosis and risk stratification of pancreatic malignancy precursor lesions.
Article
Medicine, General & Internal
Yohei Shirakami, Takuji Iwashita, Shinya Uemura, Hisashi Imai, Katsutoshi Murase, Masahito Shimizu
Summary: This study investigated the use of miRNA in pancreatic cyst fluid as a marker for evaluating malignant alternation of IPMN. Six miRNAs were found to be significantly enriched in IPMC compared to IPMA. Further evaluation with larger cohorts is needed to confirm the efficacy of cyst fluid miRNA analysis for diagnosing malignant alteration of IPMN.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cell Biology
Newton A. C. S. Wong, Muhammad Abdalkoddus, Nadeem Al-Khafaji, Huw Roach, Reyad Abbadi
Summary: This article aims to confirm whether simple biliary cysts of the liver can be lined by mucinous epithelium and assess whether the presence of mucinous epithelium is associated with hepatobiliary neoplasia. The study found that at least one-third of surgically-managed simple biliary cysts of the liver had focal mucinous epithelium. Apart from the presence of ovarian-like stroma, mucinous epithelium appears to have no clinical significance.
Review
Oncology
Beata Jablonska, Pawel Szmigiel, Slawomir Mrowiec
Summary: Intraductal papillary mucinous neoplasms (IPMNs) are a type of pancreatic tumor, accounting for a small percentage of pancreatic neoplasms. They are categorized into different types with varying management strategies based on tumor characteristics and patient factors. There are several guidelines available for diagnosing and managing IPMNs.
WORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY
(2021)
Review
Gastroenterology & Hepatology
Tommaso Pollini, Volcan Adsay, Gabriele Capurso, Marco Dal Molin, Irene Esposito, Ralph Hruban, Claudio Luchini, Laura Maggino, Hanno Matthaei, Giovanni Marchegiani, Aldo Scarpa, Laura D. Wood, Claudio Bassi, Roberto Salvia, Mari Mino-Kenudson, Ajay V. Maker
Summary: Pancreatic intraductal papillary mucinous neoplasms (IPMNs) are precursors of invasive pancreatic ductal adenocarcinoma and their progression is influenced by the immune system. The immune composition of IPMNs changes during neoplastic progression, with low-grade lesions having a high proportion of effector T cells, while high-grade IPMNs and IPMNs with invasive carcinoma are characterized by a predominance of immunosuppressive elements.
LANCET GASTROENTEROLOGY & HEPATOLOGY
(2022)
Review
Medicine, General & Internal
Ritu. R. R. Singh, Harishankar Gopakumar, Neil. R. R. Sharma
Summary: The prevalence of pancreatic cysts is increasing due to the widespread use of cross-sectional imaging. Risk stratification of these lesions is not straightforward, and individual risk assessment as well as cyst size, distribution, and morphologic features can guide management decisions. Endoscopic ultrasound with fine-needle aspiration is often required to classify pancreatic cysts and assess malignant potential. Advances in endoscopic techniques can provide a definitive diagnosis, but carry higher risks of adverse events.
Article
Anesthesiology
Jami L. Saloman, Darwin L. Conwell, Evan Fogel, Santhi Swaroop Vege, Liang Li, Shuang Li, Dana K. Andersen, William E. Fisher, Christopher E. Forsmark, Phil A. Hart, Stephen J. Pandol, Walter G. Park, Anna Evans Phillips, Mark Topazian, Stephen K. Van den Eeden, Jose Serrano, Dhiraj Yadav
Summary: Pain is common and significantly reduces quality of life in patients with chronic pancreatitis. This study aimed to classify the pain types in these patients, finding that patients with multiple pain types have worse health and quality of life scores. Further research is needed to identify biomarkers associated with specific pain types and predict responses to interventions.
Article
Gastroenterology & Hepatology
Dhiraj Yadav, Robert L. Askew, Tonya Palermo, Liang Li, Dana K. Andersen, Minxing Chen, William E. Fisher, Evan L. Fogel, Christopher E. Forsmark, Phil A. Hart, Mohamed O. Othman, Stephen J. Pandol, Walter G. Park, Mark D. Topazian, Stephen K. Van Den Eeden, Santhi Swaroop Vege, Yunlong Yang, Jose Serrano, Darwin L. Conwell
Summary: This study analyzed baseline data of 488 patients with chronic pancreatitis (CP) and 254 control subjects, and found that pain was significantly associated with impairments in physical and mental health. CP patients with severe pain had more decrements in each PROMIS domain and a higher prevalence of clinically significant depression, anxiety, sleep disturbance, and physical disability. Similar results were noted for constant pain.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Alessandro Paniccia, Patricio M. Polanco, Brian A. Boone, Abigail Wald, Kevin McGrath, Randall E. Brand, Asif Khalid, Nisa Kubiliun, Anne Marie O'Broin-Lennon, Walter G. Park, Jason Klapman, Benjamin Tharian, Sumant Inamdar, Kenneth Fasanella, John Nasr, Jennifer Chennat, Rohit Das, John DeWitt, Jeffrey J. Easler, Benjamin Bick, Harkirat Singh, Kimberly J. Fairley, Savreet Sarkaria, Tarek Sawas, Wasseem Skef, Adam Slivka, Anna Tavakkoli, Shyam Thakkar, Victoria Kim, Hendrikus Dutch Vanderveldt, Allyson Richardson, Michael B. Wallace, Bhaumik Brahmbhatt, Megan Engels, Charles Gabbert, Mohannad Dugum, Samer El-Dika, Yasser Bhat, Sanjay Ramrakhiani, Gennadiy Bakis, Daniil Rolshud, Gordon Millspaugh, Thomas Tielleman, Carl Schmidt, John Mansour, Wallis Marsh, Melanie Ongchin, Barbara Centeno, Sara E. Monaco, N. Paul Ohori, Sigfred Lajara, Elizabeth D. Thompson, Ralph H. Hruban, Phoenix D. Bell, Katelyn Smith, Jennifer B. Permuth, Christopher Vandenbussche, Wayne Ernst, Maria Grupillo, Cihan Kaya, Melissa Hogg, Jin He, Christopher L. Wolfgang, Kenneth K. Lee, Herbert Zeh, Amer Zureikat, Marina N. Nikiforova, Aatur D. Singhi
Summary: This study prospectively evaluated the use of next-generation sequencing (NGS) in the assessment of patients with pancreatic cysts. The results showed that PancreaSeq is a sensitive and specific method for evaluating different types of pancreatic cysts and advanced neoplasia arising from mucinous cysts, and it reveals the diversity of genomic alterations seen in pancreatic cysts and their clinical significance.
Article
Endocrinology & Metabolism
Christie Jeon, Phil A. Hart, Liang Li, Yunlong Yang, Eleanor Chang, Melena D. Bellin, William E. Fisher, Evan L. Fogel, Christopher E. Forsmark, Walter G. Park, Stephen K. Van den Eeden, Santhi Swaroop Vege, Jose Serrano, David C. Whitcomb, Dana K. Andersen, Darwin L. Conwell, Dhiraj Yadav, Mark O. Goodarzi
Summary: This study aimed to determine the independent risk factors for diabetes in patients with chronic pancreatitis. The results showed that features associated with the severity of pancreatitis and risk factors for type 2 diabetes were both associated with diabetes in patients with chronic pancreatitis. This study lays the groundwork for the future development of models integrating clinical and nonclinical data to identify patients with chronic pancreatitis at risk for diabetes and identifies modifiable risk factors (obesity, smoking) on which to focus for diabetes prevention.
Article
Surgery
Francesco Caiazza, Patricia C. Conroy, Sam L. Ivry, Tyler York, Joseph Lin, Sophia Hernandez, Thomas J. Hoffmann, Stephen S. Francis, Walter G. Park, Michele T. Yip-Schneider, C. Max Schmidt, Randall Brand, Charles S. Craik, Kimberly Kirkwood
Summary: This study compared the performance of gastricsin, glucose, and CEA as biomarkers for the classification of mucinous pancreatic cystic lesions. The results showed that gastricsin and glucose performed similarly to CEA, but required much smaller sample volumes.
JOURNAL OF SURGICAL RESEARCH
(2023)
Article
Cell Biology
T. Jessie Ge, Vasiliki Nataly Rahimzadeh, Kevin Mintz, Walter G. Park, Nicole Martinez-Martin, Joseph C. Liao, Seung-min Park
SCIENCE TRANSLATIONAL MEDICINE
(2023)
Article
Surgery
Marina N. Nikiforova, Abigail I. Wald, Daniel M. Spagnolo, Melissa A. Melan, Maria Grupillo, Yi-Tak Lai, Randall E. Brand, Anne Marie O'Broin-Lennon, Kevin Mcgrath, Walter G. Park, Patrick R. Pfau, Patricio M. Polanco, Nisa Kubiliun, John Dewitt, Jeffrey J. Easler, Aamir Dam, Shaffer R. Mok, Michael B. Wallace, Vivek Kumbhari, Brian A. Boone, Wallis Marsh, Shyam Thakkar, Kimberly J. Fairley, Elham Afghani, Yasser Bhat, Sanjay Ramrakhiani, John Nasr, Wasseem Skef, Nikhil R. Thiruvengadam, Asif Khalid, Kenneth Fasanella, Jennifer Chennat, Rohit Das, Harkirat Singh, Savreet Sarkaria, Adam Slivka, Charles Gabbert, Tarek Sawas, Thomas Tielleman, Hendrikus Dutch Vanderveldt, Anna Tavakkoli, Lynette M. Smith, Katelyn Smith, Phoenix D. Bell, Ralph H. Hruban, Alessandro Paniccia, Amer Zureikat, Kenneth K. Lee, Melanie Ongchin, Herbert Zeh, Rebecca Minter, Jin He, Yuri E. Nikiforov, Aatur D. Singhi
Summary: We developed a combined DNA/RNA sequencing platform to improve the evaluation of pancreatic cysts. The newly created genomic classifier system accurately predicted cystic precursor neoplasms and advanced neoplasia, while also increasing the sensitivity of current pancreatic cyst guidelines.
Article
Oncology
Marta Sans, Yuki Makino, Jimin Min, Kimal I. Rajapakshe, Michele Yip-Schneider, C. Max Schmidt, Mark W. Hurd, Jared K. Burks, Javier A. Gomez, Fredrik I. Thege, Johannes F. Fahrmann, Robert A. Wolff, Michael P. Kim, Paola A. Guerrero, Anirban Maitra
Summary: Intraductal papillary mucinous neoplasms (IPMN) of the pancreas with gastric foveolar-type epithelium and low-grade mucinous neoplasms are linked to high-grade dysplasia and cancer. The study identified the transcription factor NKX6-2 as a key driver of gastric cell identity in low-grade IPMNs. Understanding the molecular features of IPMN development and differentiation is critical for preventing cancer progression.
Article
Gastroenterology & Hepatology
Bomi Lee, Elaina K. Jones, Murli Manohar, Liang Li, Dhiraj Yadav, Darwin L. Conwell, Phil A. Hart, Santhi Swaroop Vege, Evan L. Fogel, Jose Serrano, Dana Andersen, Melena D. Bellin, Mark D. Topazian, Stephen K. Van Den Eeden, Stephen J. Pandol, Chris E. Forsmark, William E. Fisher, Walter G. Park, Sohail Z. Husain, Aida Habtezion
Summary: This study examined the potential use of serum immune profiling as biomarkers for pancreatitis. The analysis of 92 immune markers identified 33 markers that could differentiate pancreatitis patients from healthy individuals. IL17 signaling was found to play a crucial role in chronic pancreatitis, and was associated with smoking, alcohol, and diabetes status.
Article
Radiology, Nuclear Medicine & Medical Imaging
Temel Tirkes, Dhiraj L. Yadav, Darwin L. R. Conwell, Paul R. Territo, Xuandong A. Zhao, Scott A. K. Persohn, Anil K. K. Dasyam, Zarine K. K. Shah, Sudhakar K. Venkatesh, Naoki N. Takahashi, Ashley Wachsman, Liang Li, Yan J. Li, Stephen J. G. Pandol, Walter G. Park, Santhi Swaroop A. Vege, Phil A. Hart, Mark K. Topazian, Dana K. L. Andersen, Evan L. Fogel
Summary: This study aimed to determine the diagnostic performance of MRI features in differentiating chronic pancreatitis (CP) from controls. The results showed that semi-quantitative parameters of the pancreatic parenchyma, including T1 score, enhancement ratio, pancreas volume, diameter, and multi-parametric models combining these parameters, were helpful in the diagnosis of CP.
ABDOMINAL RADIOLOGY
(2023)
Article
Gastroenterology & Hepatology
Brian C. C. Jacobson, Amit Bhatt, Katarina B. B. Greer, Linda S. S. Lee, Walter G. G. Park, Bryan G. G. Sauer, Vanessa M. M. Shami
Summary: Subepithelial lesions (SEL) of the GI tract can be benign or potentially malignant and can occur anywhere along the GI tract. This clinical guideline suggests endoscopic ultrasound (EUS) with tissue acquisition for diagnosis of solid nonlipomatous SEL and EUS fine-needle biopsy or aspiration for sampling solid SEL. The guideline also recommends resection of gastric GIST >2 cm and all nongastric GIST due to their malignant potential.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2023)
Letter
Dermatology
Justine G. Schneider, Matthew Gallardo, Kristopher Fisher, Benjamin H. Kaffenberger, Abraham M. Korman
INTERNATIONAL JOURNAL OF DERMATOLOGY
(2023)
Meeting Abstract
Gastroenterology & Hepatology
Mohamed Othman, Jens Kort, Jun Yu, Vikesh Singh, Christopher Forsmark, Luis Lara, Walter Park, Zuoyi Zhang, Dhiraj Yadav
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Phil A. Hart, Georgios Papachristou, Walter G. Park, Anne-Marie Dyer, Vernon M. Chinchilli, Elham Afghani, Venkata S. Akshintala, Dana K. Andersen, James L. Buxbaum, Darwin L. Conwell, Kathleen M. Dungan, Jeffrey J. Easler, Evan L. Fogel, Carla J. Greenbaum, Rita R. Kalyani, Murray Korc, Richard Kozarek, Maren R. Laughlin, Peter J. Lee, Jennifer L. Maranki, Stephen J. Pandol, Anna Evans Phillips, Jose Serrano, Vikesh K. Singh, Cate Speake, Temel Tirkes, Frederico G. S. Toledo, Guru Trikudanathan, Santhi Swaroop Vege, Ming Wang, Cemal Yazici, Atif Zaheer, Christopher E. Forsmark, Melena D. Bellin, Dhiraj Yadav
Summary: Diabetes mellitus after acute pancreatitis is increasingly recognized as an important late and chronic complication. The DREAM study aims to address the challenges in determining the incidence rate and understanding the underlying mechanisms of diabetes after acute pancreatitis. This article summarizes the literature on the epidemiology of diabetes after acute pancreatitis and provides an overview of the DREAM study.
Article
Gastroenterology & Hepatology
Temel Tirkes, Vernon M. Chinchilli, Ulas Bagci, Jason G. Parker, Xuandong Zhao, Anil K. Dasyam, Nicholas Feranec, Joseph R. Grajo, Zarine K. Shah, Peter D. Poullos, Benjamin Spilseth, Atif Zaheer, Karen L. Xie, Ashley M. Wachsman, Martha Campbell-Thompson, Darwin L. Conwell, Evan L. Fogel, Christopher E. Forsmark, Phil A. Hart, Stephen J. Pandol, Walter G. Park, Richard E. Pratley, Cemal Yazici, Maren R. Laughlin, Dana K. Andersen, Jose Serrano, Melena D. Bellin, Dhiraj Yadav
Summary: The core component of the DREAM study aims to use advanced MRI techniques to predict diabetes mellitus after acute pancreatitis. Longitudinal MRI observations will allow for a better understanding of the natural history of post-AP DM. The study will also correlate MRI parameters with metabolic, genetic, and immunological phenotypes to develop a quantitative composite risk score.