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Pancreatic Neoplasms: HELP
Articles by Vinciane Rebours
Based on 45 articles published since 2010
(Why 45 articles?)
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Between 2010 and 2020, V. Rebours wrote the following 45 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer. 2019

Lorenzo, Diane / Rebours, Vinciane / Maire, Frédérique / Palazzo, Maxime / Gonzalez, Jean-Michel / Vullierme, Marie-Pierre / Aubert, Alain / Hammel, Pascal / Lévy, Philippe / de Mestier, Louis. ·Pancreatology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, and Paris Diderot University, Paris 75013, France. diane.lorenzo@aphp.fr. · Pancreatology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, and Paris Diderot University, Paris 75013, France. · Departement of Gastroenterology, Aix Marseille university - APHM - Hôpital Nord, Marseille 13000, France. · Radiology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, and Paris Diderot University, Paris 92110, France. · Oncology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, and Paris Diderot University, Paris 92110, France. ·World J Gastroenterol · Pubmed #31558858.

ABSTRACT: Managing familial pancreatic cancer (FPC) is challenging for gastroenterologists, surgeons and oncologists. High-risk individuals (HRI) for pancreatic cancer (PC) (FPC or with germline mutations) are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%. Screening is mainly based on annual magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS). The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions (pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia). In the literature, target lesions are identified in 2%-5% of HRI who undergo screening. EUS appears to provide better identification of small solid lesions (0%-46% of HRI) and chronic-pancreatitis-like parenchymal changes (14%-77% of HRI), while MRI is probably the best modality to identify small cystic lesions (13%-49% of HRI). There are no specific studies in HRI on the use of contrast-enhanced harmonic EUS. EUS can also be used to obtain tissue samples. Nevertheless, there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to treat. The cost-effectiveness of screening is also unclear. Certain new EUS-related techniques, such as searching for DNA abnormalities or protein markers in pancreatic fluid, appear to be promising.

2 Review Pancreatic ductal adenocarcinoma in BRCA2 mutation carriers. 2016

de Mestier, Louis / Danset, Jean-Baptiste / Neuzillet, Cindy / Rebours, Vinciane / Cros, Jérôme / Soufir, Nadem / Hammel, Pascal. ·Department of Gastroenterology and PancreatologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France. · Department of Hepato-GastroenterologyEuropean Georges-Pompidou Hospital, APHP, Paris, France. · Department of Digestive OncologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France. · Department of PathologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France. · Department of GeneticsBichat Hospital, Paris 7 University, APHP, Clichy, France. · Department of Digestive OncologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France pascal.hammel@aphp.fr. ·Endocr Relat Cancer · Pubmed #27511924.

ABSTRACT: Germline BRCA2 mutations are the first known cause of inherited (familial) pancreatic ductal adenocarcinoma (PDAC). This tumor is the third most frequent cancer in carriers of germline BRCA2 mutations, as it occurs in around 10% of BRCA2 families. PDAC is known as one of the most highly lethal cancers, mainly because of its chemoresistance and frequently late diagnosis. Based on recent developments in molecular biology, a subgroup of BRCA2-associated PDAC has been created, allowing screening, early surgical treatment and personalized systemic treatment. BRCA2 germline mutation carriers who have ≥1 first-degree relative, or ≥2 blood relatives with PDAC, should undergo screening and regular follow-up based on magnetic resonance imaging and endoscopic ultrasound. The goal of screening is to detect early invasive PDAC and advanced precancerous lesions suitable for a stepwise surgical complete (R0) resection. Increasing evidence on the molecular role of the BRCA2 protein in the homologous recombination of DNA damages suggest that BRCA2-related PDAC are sensitive to agents causing DNA cross-linking damage, such as platinum salts, and treatments targeting rescue DNA repair pathways, such as poly(ADP-ribose) polymerase inhibitors that are currently under investigation.

3 Review [Auto-immune pancreatitis: rational, diagnosis and differential diagnosis]. 2012

Rebours, Vinciane. ·Service de gastroentérologie-pancréatologie, pôle des maladies de l'appareil digestif, hôpital Beaujon, AP-HP, Inserm U773, 100, boulevard du général-Leclerc, 92118 Clichy cedex, France. vinciane.rebours@bjn.aphp.fr ·Ann Pathol · Pubmed #23127946.

ABSTRACT: -- No abstract --

4 Review An overview of hereditary pancreatitis. 2012

Rebours, Vinciane / Lévy, Philippe / Ruszniewski, Philippe. ·Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie - Pancréatologie, Hôpital Beaujon, AP-HP, Université Denis Diderot-Paris VII, Clichy, France. vinciane.rebours@bjn.aphp.fr ·Dig Liver Dis · Pubmed #21907651.

ABSTRACT: Hereditary pancreatitis is a rare cause of chronic pancreatitis. The prevalence was evaluated to 0.3/100000 in Western Countries. Genetic disorders are due to mutations of the PRSS1 gene on the long arm of the chromosome 7, encoding for the cationic trypsinogen. The inheritance pattern is autosomal dominant with an incomplete penetrance (80%). Since 1996, more than 30 mutations were found. The three more common mutations are R122H, N29I and A16V. First symptoms begin since childhood, mainly before 10 years old. Main symptoms are pancreatic pain and acute pancreatitis (>70%). CP morphological changes as pancreatic calcifications are diagnosed at a median age of 22-25 years. Exocrine and endocrine pancreatic insufficiency occurred in 34% and 26% at a median age of 29 and 38 years. No clinical differences exist according to the mutation type. No excess of mortality in hereditary pancreatitis population compared to general population was found, despite a real risk of cancer. The cumulative risks of pancreatic cancer at 50, 60 and, 75 years are 10%, 18.7% and, 53.5%, respectively. The relative risk of cancer increases in smokers and is evaluated to 8.55. Hereditary pancreatitis diagnosis permits to propose an adapted management in expert centres.

5 Article Consumption of nuts and seeds and pancreatic ductal adenocarcinoma risk in the European Prospective Investigation into Cancer and Nutrition. 2020

Obón-Santacana, Mireia / Luján-Barroso, Leila / Freisling, Heinz / Naudin, Sabine / Boutron-Ruault, Marie-Christine / Mancini, Francesca Romana / Rebours, Vinciane / Kühn, Tilman / Katzke, Verena / Boeing, Heiner / Tjønneland, Anne / Olsen, Anja / Overvad, Kim / Lasheras, Cristina / Rodríguez-Barranco, Miguel / Amiano, Pilar / Santiuste, Carmen / Ardanaz, Eva / Khaw, Kay-Thee / Wareham, Nicholas J / Schmidt, Julie A / Aune, Dagfinn / Trichopoulou, Antonia / Thriskos, Paschalis / Peppa, Eleni / Masala, Giovanna / Grioni, Sara / Tumino, Rosario / Panico, Salvatore / Bueno-de-Mesquita, Bas / Sciannameo, Veronica / Vermeulen, Roel / Sonestedt, Emily / Sund, Malin / Weiderpass, Elisabete / Skeie, Guri / González, Carlos A / Riboli, Elio / Duell, Eric J. ·Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain. · Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. · Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. · Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain. · Department of Nursing of Public Health, Mental Health and Maternity and Child Health School of Nursing, Universitat de Barcelona, Barcelona, Spain. · Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, Lyon, France. · CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. · Gustave Roussy, Villejuif, France. · Pancreatology Department, Beaujon Hospital, DHU Unity, AP-HP, Clichy, and Paris-Diderot University, Paris, France. · Inserm UMR1149, DHU Unity, and Paris-Diderot University, Paris, France. · Division of Cancer Epidemiology, German Cancer Reserach Center (DKFZ), Heidelberg, Germany. · Department of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-Rehbrücke, Nuthetal, Germany. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Department of Public Health, University of Copenhagen, Copenhagen, Denmark. · Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. · Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain. · Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, Spain. · Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain. · Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. · Navarra Public Health Institute, Pamplona, Spain. · IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. · MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. · Department of Nutrition, Bjørknes University College, Oslo, Norway. · Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. · Hellenic Health Foundation, Athens, Greece. · Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy. · Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy. · Cancer Registry and Histopathology Department, "Civic - M. P. Arezzo" Hospital, ASP Ragusa, Ragusa, Italy. · Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. · Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. · Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom. · Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Unit of Epidemiology, Regional Health Service ASL TO3, Turin, Italy. · Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands. · Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden. · Department of Surgical and Preoperative Sciences, Umeå University, Umeå, Sweden. · Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. · International Agency for Research on Cancer, Lyon, France. · Department of Community Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway. ·Int J Cancer · Pubmed #31107546.

ABSTRACT: Four epidemiologic studies have assessed the association between nut intake and pancreatic cancer risk with contradictory results. The present study aims to investigate the relation between nut intake (including seeds) and pancreatic ductal adenocarcinoma (PDAC) risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards models were used to estimate hazards ratio (HR) and 95% confidence intervals (95% CI) for nut intake and PDAC risk. Information on intake of nuts was obtained from the EPIC country-specific dietary questionnaires. After a mean follow-up of 14 years, 476,160 participants were eligible for the present study and included 1,283 PDAC cases. No association was observed between consumption of nuts and PDAC risk (highest intake vs nonconsumers: HR, 0.89; 95% CI, 0.72-1.10; p-trend = 0.70). Furthermore, no evidence for effect-measure modification was observed when different subgroups were analyzed. Overall, in EPIC, the highest intake of nuts was not statistically significantly associated with PDAC risk.

6 Article Natural history of SPINK1 germline mutation related-pancreatitis. 2019

Muller, Nelly / Sarantitis, Ioannis / Rouanet, Marie / de Mestier, Louis / Halloran, Christopher / Greenhalf, William / Férec, Claude / Masson, Emmanuelle / Ruszniewski, Philippe / Lévy, Philippe / Neoptolemos, John / Buscail, Louis / Rebours, Vinciane. ·Department of Gastroenterology and Pancreatology, Beaujon Hospital, APHP, Clichy, and Paris-Diderot University, Paris, France. · Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Royal Liverpool University Hospital, Liverpool, England United Kingdom. · Department of Gastroenterology and Pancreatology, INSERM U1037, University of Toulouse 3, CHU Rangueil, Toulouse, France. · UMR1078 Génétique, Génomique Fonctionnelle et Biotechnologies, INSERM, EFS - Bretagne, Université de Brest, CHRU Brest, Brest, France. · Department of General Surgery and transplantation, University of Heidelberg, Heidelberg, Germany. · Department of Gastroenterology and Pancreatology, Beaujon Hospital, APHP, Clichy, and Paris-Diderot University, Paris, France. Electronic address: vinciane.rebours@aphp.fr. ·EBioMedicine · Pubmed #31628023.

ABSTRACT: BACKGROUND: The aim was to describe genetic, clinical and morphological features in a large, multicentre European cohort of patients with SPINK1 related pancreatitis, in comparison with patients with idiopathic pancreatitis (IP). METHODS: All SPINK1 mutation carriers with pancreatic symptoms from two French and one English centers were included. Patients with IP were included in a control group. Genetic, clinical, radiological and biochemical data were collected. FINDINGS: 209 and 302 patients were included in the SPINK1 and control groups (median follow-up: 8.3 years (3.7-17.4) vs 5.3 (2.5-8.8)). The median age at onset of symptoms was 20.1 years (17.5-22.8) in the SPINK1 group versus 41.2 (35.2-45.2). The age of exocrine pancreatic insufficiency (EPI) onset in the SPINK1 group was 49.5 (44.5-54.6) years vs. 65.2 (62.1-68.3), p < 0.001. SPINK1 patients with EPI were 5.3%, 14.7%, 28.3% and 52.4% at 20, 30, 40 and 50 years. Diabetes occurred 37.7 (33.3-42.1) years following the onset of symptoms in the SPINK1 group vs. 30.6 (17.3-43.8) (p = 0.002). SPINK1 patients with diabetes were 7.8%, 13.4%, 26.3% and 43.4% at 30, 40, 50 and 60 years. Seven patients (3.3%) developed pancreatic cancer in the SPINK1 group (versus 3 (0.99%), p = 0.1), at a median age of 60 vs 66 years. The cancer risk was 0.8% before 50 years, 11.9%, 27.7%, 51.8% at 60, 70 and 80 years and was 12 times higher than in controls (Cox HR 12.0 (3.0-47.8), p < 0.001). INTERPRETATION: SPINK1 related pancreatitis is associated with earlier onset and pancreatic insufficiencies. p.N34S SPINK1 may well be associated with cancer.

7 Article Healthy lifestyle and the risk of pancreatic cancer in the EPIC study. 2019

Naudin, Sabine / Viallon, Vivian / Hashim, Dana / Freisling, Heinz / Jenab, Mazda / Weiderpass, Elisabete / Perrier, Flavie / McKenzie, Fiona / Bueno-de-Mesquita, H Bas / Olsen, Anja / Tjønneland, Anne / Dahm, Christina C / Overvad, Kim / Mancini, Francesca R / Rebours, Vinciane / Boutron-Ruault, Marie-Christine / Katzke, Verena / Kaaks, Rudolf / Bergmann, Manuela / Boeing, Heiner / Peppa, Eleni / Karakatsani, Anna / Trichopoulou, Antonia / Pala, Valeria / Masala, Giovana / Panico, Salvatore / Tumino, Rosario / Sacerdote, Carlotta / May, Anne M / van Gils, Carla H / Rylander, Charlotta / Borch, Kristin Benjaminsen / Chirlaque López, María Dolores / Sánchez, Maria-Jose / Ardanaz, Eva / Quirós, José Ramón / Amiano Exezarreta, Pilar / Sund, Malin / Drake, Isabel / Regnér, Sara / Travis, Ruth C / Wareham, Nick / Aune, Dagfinn / Riboli, Elio / Gunter, Marc J / Duell, Eric J / Brennan, Paul / Ferrari, Pietro. ·Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, World Health Organization, 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. · Department of Hematology and Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Nutritional Epidemiology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France. · Director Office, International Agency for Research on Cancer, World Health Organization, Lyon, France. · Environment and Radiation section, Agency for Research on Cancer, World Health Organization, Lyon, France. · Departement for Determinants of Chronic Diseases (Former), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepathology, University Medical Center, Utrecht, The Netherlands. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. · Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · CESP, Faculté de médecine (USVQ), Université Paris-Sud, INSERM, Université Paris-Saclay, Villejuif, France. · Inserm UMR1018, Institut Gustave Roussy, Villejuif, France. · Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, France. · Inserm UMR1149, DHU Unit, Paris-Diderot University, Paris, France. · Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany. · Hellenic Health Foundation, Athens, Greece. · Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, ATTIKON University Hospital of Athens, Haidari, Greece. · School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. · Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. · Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy. · Department of Clinical and Experimental Medecine, University Federico II, Naples, Italy. · Cancer Registry and Histopathology Department, Civic M.P.Arezzo Hospital, Ragusa, Italy. · Unit of Cancer Epidemiology, Città della Salute e della Scienza University, Hospital and Center for Cancer Prevention (CPO), Turin, Italy. · Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. · Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. · Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain. · Spanish Consortium for Research and Public Health (CIBERESP), Madrid, Spain. · Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria, Universidad de Granada, Granada, Spain. · Navarra Public Health Institute, Pamplona, Spain. · IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Public Health Directorate, Asturias, Spain. · Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain. · Department of Surgical and Preoperative Sciences, Umeå University, Umeå, Sweden. · Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. · Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom. · MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. · Department of Nutrition, Bjørknes University College, Oslo, Norway. · Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. · Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. · Genetic Epidemiology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France. · Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, World Health Organization, 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. ferrarip@iarc.fr. ·Eur J Epidemiol · Pubmed #31564045.

ABSTRACT: Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the Healthy Lifestyle Index (HLI) and PC risk was examined. Within the European Prospective Investigation into Cancer and Nutrition cohort, 1113 incident PC (57% women) were diagnosed from 400,577 participants followed-up for 15 years (median). HLI scores combined smoking, alcohol intake, dietary exposure, physical activity and, in turn, overall and central adiposity using BMI (HLI

8 Article Familial pancreatic adenocarcinoma: A retrospective analysis of germline genetic testing in a French multicentre cohort. 2019

Schwartz, Mathias / Korenbaum, Clement / Benfoda, Meriem / Mary, Mickael / Colas, Chrystelle / Coulet, Florence / Parrin, Melissa / Jonveaux, Philippe / Ingster, Olivier / Granier, Sandra / De Mestier, Louis / Cros, Jerome / Riffault, Angelique / Muller, Marie / Levy, Philippe / Rebours, Vinciane / Greenhalf, William / Soufir, Nadem / Hammel, Pascal. ·Service d'Oncologie Digestive, Hôpital Beaujon (AP-HP - Faculté Paris VII Denis Diderot), Clichy, France. · Service de Génétique, Hôpital Bichat (AP-HP), Paris, France. · Service de Génétique, Hôpital de la Pitié-Salpétrière (AP-HP), Paris, France. · Service de Génétique, Institut Curie, Paris, France. · Laboratoire de génétique médicale, Hôpitaux de Brabois, Nancy, France. · Service de génétique, CHU, Angers, France. · Service de Gastroentérologie-Pancréatologie, Hôpital Beaujon, Clichy, France. · Service de Pathologie, Hôpital Beaujon hôpital Beaujon, Clichy, France. · Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK. ·Clin Genet · Pubmed #31432501.

ABSTRACT: The rate of genetic diagnosis of French patients with familial pancreatic ductal adenocarcinoma (PDAC) is not known. We report germline genetic testing data from 133 index cases meeting criteria for familial pancreatic cancer (FPC) as well as 87 'FPC-like' index cases who did not fulfilled strict FPC definition but were evocative for a PDAC predisposition. The overall rate of genetic diagnosis (in BRCA1, BRCA2, CDKN2A, and ATM genes) was 8.3% in FPC patients and 4.6% in FPC-like patients, consistent with the literature in other populations. Genetic variants were also identified in FANCA and BAP1 genes, as well as in the CDKN2A p12 transcript. This pancreas-specific transcript is a known key player in driving pancreatic oncogenesis. This might be the first described case of a PDAC genetic predisposition due to a variant in this specific transcript.

9 Article GNAS but Not Extended RAS Mutations Spectrum are Associated with a Better Prognosis in Intraductal Pancreatic Mucinous Neoplasms. 2019

Gaujoux, Sébastien / Parvanescu, Alina / Cesaretti, Manuella / Silve, Caroline / Bieche, Ivan / Rebours, Vinciane / Lévy, Philippe / Sauvanet, Alain / Cros, Jérôme. ·Department of Hepato-Pancreato-Biliary Surgery - Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Hôpital Beaujon, Clichy, France. sebastien.gaujoux@aphp.fr. · Université Paris Descartes, Paris, France. sebastien.gaujoux@aphp.fr. · INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France. sebastien.gaujoux@aphp.fr. · Department of Hepato-Pancreato-Biliary Surgery - Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Hôpital Beaujon, Clichy, France. · Institut National de la Santé et de la Recherche Médicale - Centre de Recherche Biomédicale Bichat Beaujon (CRI)/INSERM U1149, Clichy, France. · Institut National de la Santé et de la Recherche Médicale-U986, Groupe Hospitalier Paris-Sud, Le Kremlin-Bicêtre, France. · Service de Génétique et Biologie Moléculaires, Hôpital Cochin, Paris, France. · Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore/Filière OSCAR, Le Kremlin-Bicêtre, France. · Unité de Pharmagogénomique, Institut Curie, Paris, France. · Department of Pancreatology-Gastroenterology, Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Hôpital Beaujon, Clichy, France. · Université Paris Diderot, Paris, France. · Department of Pathology, AP-HP, Hôpital Beaujon, Clichy, France. ·Ann Surg Oncol · Pubmed #31025231.

ABSTRACT: BACKGROUND: The management of intraductal papillary mucinous neoplasms (IPMNs) is mainly based on imaging features and clinical symptoms, and remains challenging. OBJECTIVE: The aim of this study was to assess GNAS, RAS family (KRAS, NRAS and HRAS), BRAF, and PIK3CA mutation status in resected IPMNs and correlate it with clinicopathological characteristics and patient survival. METHODS: Overall, 149 consecutive unselected patients who underwent pancreatectomy for IPMNs were included. After dissection from formalin-fixed and paraffin-embedded tumors, GNAS mutational screening was assessed by allelic discrimination using Taqman RESULTS: Gastric- and intestinal-type IPMNs were the most frequent lesions (52% and 41%, respectively). Intestinal-type IPMNs were more frequently associated high-grade dysplasia (49%) and were the only IPMNs associated with colloid-type carcinoma. All pancreatobiliary IPMNs were invasive lesions, located in the main pancreatic duct. GNAS-activating mutations were strongly associated with the intestinal phenotype (p < 10 CONCLUSION: In patients selected for surgery, GNAS mutation analysis and tumor phenotype can help to better predict patient prognosis. In the near future, a more precise mutational analysis of IPMNs might help to better tailor their management.

10 Article Appropriateness of pancreatic resection in high-risk individuals for familial pancreatic ductal adenocarcinoma: a patient-level meta-analysis and proposition of the Beaujon score. 2019

de Mestier, Louis / Muller, Marie / Cros, Jérôme / Vullierme, Marie-Pierre / Vernerey, Dewi / Maire, Frédérique / Dokmak, Safi / Rebours, Vinciane / Sauvanet, Alain / Lévy, Philippe / Hammel, Pascal. ·Department of Gastroenterology and Pancreatology, Beaujon Hospital (AP-HP) and University Paris Diderot, Clichy, France. · Department of Digestive Oncology and Genetic Counselling, Beaujon Hospital (AP-HP) and University Paris Diderot, Clichy, France. · Department of Pathology, Beaujon Hospital (AP-HP) and University Paris Diderot, Clichy, France. · Department of Radiology, Beaujon Hospital (AP-HP) and University Paris Diderot, Clichy, France. · Department of Methodology and Quality of Life in Oncology Unit, EA 3181, Minjoz University Hospital, Besançon, France. · Department of Hepatobiliary and Pancreatic Surgery, Beaujon Hospital (AP-HP) and University Paris Diderot, Clichy, France. ·United European Gastroenterol J · Pubmed #31019704.

ABSTRACT: Background: About 5% of pancreatic ductal adenocarcinomas are inherited due to a deleterious germline mutation detected in 20% or fewer families. Pancreatic screening in high-risk individuals is proposed to allow early surgical treatment of (pre)malignant lesions. The outcomes of pancreatic surgery in high-risk individuals have never been correctly explored. Objectives: To evaluate surgical appropriateness and search for associated factors in high-risk individuals. Methods: A patient-level meta-analysis was performed including studies published since 1999. Individual classification distinguished the highest risk imaging abnormality into low-risk or high-risk abnormality, and the highest pathological degree of malignancy of lesions into no/low malignant potential or potentially/frankly malignant. Surgical appropriateness was considered when potentially/frankly malignant lesions were resected. Results: Thirteen out of 24 studies were selected, which reported 90 high-risk individuals operated on. Low-risk/high-risk abnormalities were preoperatively detected in 46.7%/53.3% of operated high-risk individuals, respectively. Surgical appropriateness was consistent in 38 (42.2%) high-risk individuals, including 20 pancreatic ductal adenocarcinomas (22.2%). Identification of high-risk abnormalities was strongly associated with surgical appropriateness at multivariate analysis ( Conclusion: Overall, 42.2% of high-risk individuals underwent appropriate surgery. The proposed score might help selecting the best candidates among high-risk individuals for pancreatic resection.

11 Article Non-branched microcysts of the pancreas on MR imaging of patients with pancreatic tumors who had pancreatectomy may predict the presence of pancreatic intraepithelial neoplasia (PanIN): a preliminary study. 2019

Vullierme, Marie-Pierre / Menassa, Lina / Couvelard, Anne / Rebours, Vinciane / Maire, Frédérique / Ibrahim, Tony / Cros, Jerome / Ruszniewski, Philippe / Sauvanet, Alain / Levy, Philippe / Soyer, Philippe / Vilgrain, Valerie. ·Paris Diderot University, Sorbonne Paris Cité, INSERM U1149 CRB3, Paris, France. marie-pierre.vullierme@aphp.fr. · Imaging Department, Hotel-Dieu de France Hospital, Beirut, Lebanon. · Department of Pathology, Beaujon University Hospital, Clichy, France. · Department of Pancreatology, Beaujon University Hospital, Clichy, France. · Oncology Department, Clinical Research Units, Clinical Biostatistical Research Units, Saint Joseph University, Beirut, Lebanon. · Department of Hepato Pancreato Biliary Surgery, Beaujon University Hospital, Clichy, France. · Department of Radiology, Cochin University Hospital, Paris, France. · Paris Diderot University, Sorbonne Paris Cité, INSERM U1149 CRB3, Paris, France. ·Eur Radiol · Pubmed #30972547.

ABSTRACT: PURPOSE: To evaluate whether pancreatic parenchymal abnormalities on magnetic resonance imaging (MRI) are associated with pancreatic intraepithelial neoplasia (PanIN) on histology. MATERIALS AND METHODS: Retrospective study approved by institutional review board. One hundred patients (48 men, 52 women; mean age, 53.2 ± 16.29 [SD]) underwent MRI before pancreatectomy for pancreatic tumors analyzed by two independent observers blinded to histopathological results for the presence of non-communicating microcysts and pancreatic atrophy (global or focal) beside tumors. MRI findings were compared to histopathological findings of resected specimens. Interobserver agreement was calculated. The association between parenchymal abnormalities and presence of PanIN was assessed by uni- and multivariate analyses. RESULTS: PanIN was present in 65/100 patients (65%). The presence of microcysts on MRI had a sensitivity of 52.3% (34/65 [95%CI, 51.92-52.70%]), a specificity of 77.1% (27/35 [95%CI, 76.70-77.59]), and accuracy of 61% (61/100 95%CI [50.7-70.6]) for the diagnosis of PanIN while global atrophy had a sensitivity of 24.6% (16/6 [95%CI, 24.28-24.95]) and a specificity of 97.1% (34/35 [95%CI, 96.97-97.32%]). In multivariate analysis, the presence of microcysts (OR, 3.37 [95%CI, 1.3-8.76]) (p = 0.0127) and global atrophy (OR, 9.79 [95%CI, 1.21-79.129]) (p = 0.0324) were identified as independent predictors of the presence of PanIN. The combination of these two findings was observed in 10/65 PanIN patients and not in patients without PanIN (p = 0.013 with an OR of infinity [95%CI, 1.3-infinity]) and was not discriminant for PanIN-3 and lower grade (p = 0.22). Interobserver agreement for the presence of microcysts was excellent (kappa = 0.92), and for the presence of global atrophy, it was good (kappa = 0.73). CONCLUSION: The presence of non-communicating microcysts on pre-operative MRI can be a significant predictor of PanIN in patients with pancreatic tumors. KEY POINTS: • In patients with pancreatic tumors who had partial pancreatectomy, MR non-communicating pancreatic microcysts have a 52.3% sensitivity, a 77.1% specificity, and a 61% accuracy for the presence of PanIN with univariate and with an odds ratio of 3.37 with multivariate analyses. • The association of global atrophy and non-communicating microcysts increases the predictive risk of PanIN.

12 Article Comparison of Temozolomide-Capecitabine to 5-Fluorouracile-Dacarbazine in 247 Patients with Advanced Digestive Neuroendocrine Tumors Using Propensity Score Analyses. 2019

de Mestier, Louis / Walter, Thomas / Brixi, Hedia / Evrard, Camille / Legoux, Jean-Louis / de Boissieu, Paul / Hentic, Olivia / Cros, Jérôme / Hammel, Pascal / Tougeron, David / Lombard-Bohas, Catherine / Rebours, Vinciane / Ruszniewski, Philippe / Cadiot, Guillaume. ·Department of Pancreatology and Gatroenterology, ENETS Centre of Excellence, Hopital Beaujon, and Paris Diderot University, Clichy, France, louis.demestier@aphp.fr. · Department of Digestive Oncology, ENETS Centre of Excellence, Edouard Herriot Hospital, Lyon, France. · Department of Hepato-Gastroenterology and Digestive Oncology and Reims-Champagne-Ardennes University, Reims, France. · Department of Medical Oncology, Poitiers University Hospital, Poitiers, France. · Department of Hepato-Gatroenterology, La Source Hospital, Orlėans, France. · Department of Epidemiology and Public Health, Le Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France. · Department of Pancreatology and Gatroenterology, ENETS Centre of Excellence, Hopital Beaujon, and Paris Diderot University, Clichy, France. · Department of Pathology, ENETS Centre of Excellence, Hopital Beaujon, and Paris Diderot University, Clichy, France. · Department of Digestive Oncology, ENETS Centre of Excellence, Hopital Beaujon, and Paris 7 University, Clichy, France. · Department of Gastroenterology, Poitiers University Hospital, Poitiers, France. ·Neuroendocrinology · Pubmed #30759445.

ABSTRACT: INTRODUCTION: Although chemotherapy combining 5-fluorouracil (5FU)-dacarbazine (DTIC) or temozolomide (TEM)-capecitabine (CAP) is extensively used in patients with neuroendocrine tumors (NET), they were never compared. We compared their tolerance and efficacy in advanced NET. METHODS: We evaluated the records of consecutive patients with pancreatic or small-intestine advanced NET who received 5FU-DTIC or TEM-CAP between July 2004 and December 2017 in 5 French centers. Tolerance, tumor response and progression-free survival (PFS) were compared. Factors associated with PFS were analyzed using Cox multivariate regression model. To reduce the confounding bias of the nonrandomized design, PFS was compared using propensity score analyses. RESULTS: Ninety-four (5FU-DTIC) patients and 153 (TEM-CAP) patients were included. Pancreatic NET represented 82.3% of cases and 17.1, 61.8 and 10.9% of patients had G1, G2 or G3 NET respectively. Progression at baseline was reported in 92.7% of patients with available data. Grades 3-4 adverse events occurred in 24.7 and 8.5% of TEM-CAP and 5FU-DTIC patients respectively (p = 0.002). The overall response rate was 38.3 and 39.2% respectively (p = 0.596). Median PFS on raw analysis was similar to 5FU-DTIC and TEM-CAP (13.9 vs. 18.3 months, respectively p = 0.86). TEM-CAP was associated with an increased risk of progression on the raw multivariate analysis (hazard ratio [HR] 1.90, 95% CI [1.32-2.73], p = 0.001) and when adjusted on propensity score (HR 1.65, 95% CI [1.18-2.31], p = 0.004). CONCLUSION: PFS may be longer with 5FU-DTIC than TEM-CAP in patients with advanced NET. Although patients often prefer oral chemotherapy, 5FU-DTIC is a relevant alternative. A randomized comparison is needed to confirm these results.

13 Article CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation. 2019

Honda, Kazufumi / Katzke, Verena A / Hüsing, Anika / Okaya, Shinobu / Shoji, Hirokazu / Onidani, Kaoru / Olsen, Anja / Tjønneland, Anne / Overvad, Kim / Weiderpass, Elisabete / Vineis, Paolo / Muller, David / Tsilidis, Kostas / Palli, Domenico / Pala, Valeria / Tumino, Rosario / Naccarati, Alessio / Panico, Salvatore / Aleksandrova, Krasimira / Boeing, Heiner / Bueno-de-Mesquita, H Bas / Peeters, Petra H / Trichopoulou, Antonia / Lagiou, Pagona / Khaw, Kay-Tee / Wareham, Nick / Travis, Ruth C / Merino, Susana / Duell, Eric J / Rodríguez-Barranco, Miguel / Chirlaque, María Dolores / Barricarte, Aurelio / Rebours, Vinciane / Boutron-Ruault, Marie-Chiristine / Romana Mancini, Francesca / Brennan, Paul / Scelo, Ghislaine / Manjer, Jonas / Sund, Malin / Öhlund, Daniel / Canzian, Federico / Kaaks, Rudolf. ·Department of Biomarker for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan. · Japan Agency for Medical Research and Development (AMED) CREST, Tokyo, Japan. · Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan. · Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark. · Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. · Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. · Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom. · Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece. · Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy. · Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. · Cancer Registry and Histopathology Unit, "Civic - M.P. Arezzo" Hospital, Ragusa, Italy. · Department of Molecular and Genetic Epidemiology, IIGM - Italian Institute for Genomic Medicine, Torino, Italy. · Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. · Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. · Department of Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. · Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands. · MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom. · Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, School of Medicine, WHO Collaborating Center for Nutrition and Health. · Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. · Cancer Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom. · MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · Public Health Directorate, Asturias, Spain, Acknowledgment of funds: Regional Government of Asturias. · PanC4 Consortium, Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. · Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. · CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain. · Department of Epidemiology, Murcia Regional Health Council, CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Ronda de Levante, Murcia, Spain. · Navarra Public Health Institute, Pamplona, Spain. · IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Pancreatology Unit, Beaujon Hospital, Clichy, France. · INSERM - UMR 1149, University Paris 7, Paris, France. · CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France. · Lifestyle, Genes and Health: Integrative Trans-Generational Epidemiology, Gustave Roussy, Villejuif, France. · Section of Genetics, International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France. · Department of Surgery, Skåne University Hospital, Lund University, Lund, Sweden. · Department of Surgical and Preoperative Sciences, Umeå University, Umeå, Sweden. · Department of Radiation Sciences and Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden. · Genomic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. ·Int J Cancer · Pubmed #30259989.

ABSTRACT: Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform ("ApoA2-ATQ/AT"), alone and in combination with carbohydrate antigen 19-9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for >6-18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within >6-18 months (C = 0.74 vs. 0.71 for CA19-9 alone, p = 0.022) and ≤ 18 months (C = 0.75 vs. 0.74, p = 0.022). At 98% specificity, and for lag times of ≤6, >6-18 or ≤ 18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging.

14 Article Dietary folate intake and pancreatic cancer risk: Results from the European prospective investigation into cancer and nutrition. 2019

Park, Jin Young / Bueno-de-Mesquita, H Bas / Ferrari, Pietro / Weiderpass, Elisabete / de Batlle, Jordi / Tjønneland, Anne / Kyro, Cecilie / Rebours, Vinciane / Boutron-Ruault, Marie-Christine / Mancini, Francesca Romana / Katzke, Verena / Kühn, Tilman / Boeing, Heiner / Trichopoulou, Antonia / La Vecchia, Carlo / Kritikou, Maria / Masala, Giovanna / Pala, Valeria / Tumino, Rosario / Panico, Salvatore / Peeters, Petra H / Skeie, Guri / Merino, Susana / Duell, Eric J / Rodríguez-Barranco, Miguel / Dorronsoro, Miren / Chirlaque, Maria-Dolores / Ardanaz, Eva / Gylling, Björn / Schneede, Jörn / Ericson, Ulrika / Sternby, Hanna / Khaw, Kay-Tee / Bradbury, Kathryn E / Huybrechts, Inge / Aune, Dagfinn / Vineis, Paolo / Slimani, Nadia. ·International Agency for Research on Cancer, Lyon, France. · National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. · School of Public Health, Imperial College London, London, United Kingdom. · Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. · Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain. · Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Pancreatology Unit, Beaujon Hospital, Clichy, France. · INSERM-UMR 1149, University Paris 7, France. · CESP, INSERM U1018, University of Paris-Sud, UVSQ, Université Paris-Saclay, France. · Gustave Roussy, Villejuif, France. · German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany. · Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Germany. · Hellenic Health Foundation, Athens, Greece. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. · Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network-ISPRO, Florence, Italy. · Epidemiology and Prevention Unit, IRCCS Foundation National Cancer Institute, Milan, Italy. · Cancer Registry and Histopathology Department, 'Civic-M.P. Arezzo' Hospital, ASP Ragusa, Italy. · Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. · Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht. · Public Health Directorate, Asturias, Spain. · Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. · Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. · CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. · Dirección de Salud Pública y Adicciones, Gobierno Vasco, Vitoria, Spain. · Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain. · Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. · Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. · Navarra Public Health Institute, Pamplona, Spain. · IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. · Department of Clinical Pharmacology, Pharmacology and Clinical Neurosciences, Umeå University, Umeå, Sweden. · Diabetes and Cardiovascular disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Sweden. · Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Sweden. · Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom. · Bjørknes University College, Oslo, Norway. · IIGM Foundation, Turin, Italy. ·Int J Cancer · Pubmed #30178496.

ABSTRACT: Pancreatic cancer (PC) has an exceptionally low survival rate and primary prevention strategies are limited. Folate plays an important role in one-carbon metabolism and has been associated with the risk of several cancers, but not consistently with PC risk. We aimed to investigate the association between dietary folate intake and PC risk, using the standardised folate database across 10 European countries. A total of 477,206 participants were followed up for 11 years, during which 865 incident primary PC cases were recorded. Folate intake was energy-adjusted using the residual method. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. In multivariable analyses stratified by age, sex, study centre and adjusted for energy intake, smoking status, BMI, educational level, diabetes status, supplement use and dietary fibre intake, we found no significant association between folate intake and PC risk: the HR of PC risk for those in the highest quartile of folate intake (≥353 μg/day) compared to the lowest (<241 μg/day) was 0.81 (95% CI: 0.51, 1.31; p

15 Article Circulating plasma phospholipid fatty acids and risk of pancreatic cancer in a large European cohort. 2018

Matejcic, M / Lesueur, F / Biessy, C / Renault, A L / Mebirouk, N / Yammine, S / Keski-Rahkonen, P / Li, K / Hémon, B / Weiderpass, E / Rebours, V / Boutron-Ruault, M C / Carbonnel, F / Kaaks, R / Katzke, V / Kuhn, T / Boeing, H / Trichopoulou, A / Palli, D / Agnoli, C / Panico, S / Tumino, R / Sacerdote, C / Quirós, J R / Duell, E J / Porta, M / Sánchez, M J / Chirlaque, M D / Barricarte, A / Amiano, P / Ye, W / Peeters, P H / Khaw, K T / Perez-Cornago, A / Key, T J / Bueno-de-Mesquita, H B / Riboli, E / Vineis, P / Romieu, I / Gunter, M J / Chajès, V. ·International Agency for Research on Cancer, Lyon, France. · Genetic Epidemiology of Cancer team, Inserm, U900, Paris, France. · Institut Curie, Paris, France. · PSL University, Paris, France. · Mines ParisTech, Fontainebleau, France. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway. · Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Public Health Division of Gipuzkoa, BioDonostia Research institute, San Sebastian, Spain. · Department of Gastroenterology and Pancreatology, Beaujon Hospital, University Paris 7, Clichy, France. · INSERM, Centre for Research in Epidemiology and Population Health, U1018, Health across Generations Team, Institut Gustave Roussy, Villejuif, France. · Université Paris Sud, UMRS, Villejuif, France. · Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France. · Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. · Hellenic Health Foundation, Athens, Greece. · WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. · Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy. · Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Clinical Medicine and Surgery Department, Università degli Studi di Napoli Federico II, Naples, Italy. · Cancer Registry and Histopathology Department, ASP, "Civic - M.P. Arezzo" Hospital, Ragusa, Italy. · Unit of Cancer Epidemiology, Citta' della Salute e della Scienza Hospital, University of Turin and Centre for Cancer Prevention (CPO), Turin, Italy. · EPIC Asturias, Public Health Directorate, Asturias, Spain. · Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. · Hospital del Mar Research Institute - IMIM, CIBER Epidemiología y Salud Pública (CIBERESP) and Universitat Autònoma de Barcelona, Barcelona, Spain. · Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. · CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain. · Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. · Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. · Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. · Navarra Public Health Institute, Pamplona, Spain. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · The Medical Biobank at Umeå University, Umeå, Sweden. · Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom. · University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · MRC-PHE Center for Environment and Health, School of Public Health, Imperial College, London, United Kingdom. ·Int J Cancer · Pubmed #30110135.

ABSTRACT: There are both limited and conflicting data on the role of dietary fat and specific fatty acids in the development of pancreatic cancer. In this study, we investigated the association between plasma phospholipid fatty acids and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The fatty acid composition was measured by gas chromatography in plasma samples collected at recruitment from375 incident pancreatic cancer cases and375 matched controls. Associations of specific fatty acids with pancreatic cancer risk were evaluated using multivariable conditional logistic regression models with adjustment for established pancreatic cancer risk factors. Statistically significant inverse associations were found between pancreatic cancer incidence and levels of heptadecanoic acid (OR

16 Article Biomarkers for the risk of thrombosis in pancreatic adenocarcinoma are related to cancer process. 2018

Faille, Dorothée / Bourrienne, Marie-Charlotte / de Raucourt, Emmanuelle / de Chaisemartin, Luc / Granger, Vanessa / Lacroix, Romaric / Panicot-Dubois, Laurence / Hammel, Pascal / Lévy, Philippe / Ruszniewski, Philippe / Ajzenberg, Nadine / Rebours, Vinciane. ·Department of Hematology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. · Laboratory for Vascular Translational Science (LVTS), INSERM U1148, University of Paris Diderot, Sorbonne Paris Cité, Paris, France. · Department of Hematology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France. · Department of Immunology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. · Inflammation, Chemokines and Immunopathology, INSERM UMR 996, Paris-Sud University, Châtenay-Malabry, France. · Vascular Research Centre of Marseille (VRCM), INSERM UMR 1076, Aix-Marseille University, Marseille, France. · Haematology and Vascular Biology Laboratory, Conception Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France. · Digestive Oncology Unit, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France. · Centre de Recherche sur l'Inflammation (CRI), INSERM UMR 1149, University of Paris Diderot, Sorbonne Paris Cité, Paris, France. · Department of Pancreatology and Gastroenterology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France. ·Oncotarget · Pubmed #29899870.

ABSTRACT: Background: Venous thrombo-embolic events (VTE) frequently occur in patients with pancreatic ductal adenocarcinoma (PDAC) and contribute to high morbidity and mortality. Objectives: To determine whether VTE biomarkers are related to cancer, inflammation or precancerous states and to assess their relevance to predict VTE in PDAC. Patients and Methods: We compared VTE biomarkers in patients with PDAC ( Results: Factor VIII, D-dimers, von Willebrand factor, free tissue factor pathway inhibitor and microvesicle-tissue factor (MV-TF) activity were higher in PDAC patients compared to patients with IPMN or chronic pancreatitis. PDAC patients with metastasis presented higher D-dimers and MV-TF activity compared to patients with localized lesions, but elevation of D-dimers was dependent on tumor size. In multivariate analysis, elevated D-dimers (≥2.16 µg/mL) or MV-TF activity (≥2.37 pg/mL) were significant risk factors for VTE in PDAC patients, after adjustment for age and sex (HR 4.9 [1.0-23.1] or HR 10.5 [1.5-72.4], mean [interquartile range], respectively). Cumulative probability of VTE at 6 months was higher in patients with elevated D-dimers (56.3% vs 15.6%, Conclusions: VTE biomarkers including D-dimers and MV-TF activity are not related to inflammation but rather to cancer process and dissemination. D-dimers and MV-TF activity are associated to future VTE in PDAC patients and could help identify patients who could benefit from thromboprophylaxis.

17 Article Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study. 2018

Naudin, Sabine / Li, Kuanrong / Jaouen, Tristan / Assi, Nada / Kyrø, Cecilie / Tjønneland, Anne / Overvad, Kim / Boutron-Ruault, Marie-Christine / Rebours, Vinciane / Védié, Anne-Laure / Boeing, Heiner / Kaaks, Rudolf / Katzke, Verena / Bamia, Christina / Naska, Androniki / Trichopoulou, Antonia / Berrino, Franco / Tagliabue, Giovanna / Palli, Domenico / Panico, Salvatore / Tumino, Rosario / Sacerdote, Carlotta / Peeters, Petra H / Bueno-de-Mesquita, H B As / Weiderpass, Elisabete / Gram, Inger Torhild / Skeie, Guri / Chirlaque, Maria-Dolores / Rodríguez-Barranco, Miguel / Barricarte, Aurelio / Quirós, Jose Ramón / Dorronsoro, Miren / Johansson, Ingegerd / Sund, Malin / Sternby, Hanna / Bradbury, Kathryn E / Wareham, Nick / Riboli, Elio / Gunter, Marc / Brennan, Paul / Duell, Eric J / Ferrari, Pietro. ·Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer, Lyon, France. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. · CESP, INSERM U1018, University of Paris-Sud, UVSQ, University of Paris-Saclay, Villejuif, France. · Institut Gustave Roussy, Villejuif, France. · Pancreatology Unit, Beaujon Hospital, Clichy, France. · INSERM U1149, University Paris 7, Paris, France. · Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Potsdam, Germany. · Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Hellenic Health Foundation, Athens, Greece. · Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, WHO Collaborating Center for Nutrition and Health, National and Kapodistrian University of Athens, Athens, Greece. · Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Lombardy Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. · Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy. · Cancer Registry and Histopathology Department, Civic M.P.Arezzo Hospital, Ragusa, Italy, Ragusa, Italy. · Unit of Cancer Epidemiology, Hospital and Center for Cancer Prevention (CPO), Città della Salute e della Scienza University, Turin, Italy. · Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. · Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala, Malaysia, Lumpur. · Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. · Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. · CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. · Department of Health and Social Sciences, University of Murcia, Murcia, Spain. · Biosanitary Investigation Institute (IBS) of Granada, University Hospital and University of Granada, Granada, Spain. · Navarra Public Health Institute, Pamplona, Spain. · Navarra Institute for Health Research (IdiSNA), Pamplona, Spain. · Public Health Directorate, Asturias, Spain. · Subdirección de Salud Pública de Gipuzkoa, Gobierno Vasco, San Sebastian, Spain. · Department of Odontology, Cariology, Umeå University, Umeå, Sweden. · Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden. · Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Malmö, Sweden. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom. · School of Public Health, Imperial College London, London, United Kingdom. · Nutrition and Epidemiology Group, International Agency for Research on Cancer, Lyon, France. · Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France. · Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-Idibell), Barcelona, Spain. ·Int J Cancer · Pubmed #29524225.

ABSTRACT: Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In our study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake.

18 Article None 2018

Dayot, Stéphanie / Speisky, Daniela / Couvelard, Anne / Bourgoin, Pierre / Gratio, Valérie / Cros, Jérôme / Rebours, Vinciane / Sauvanet, Alain / Bedossa, Pierre / Paradis, Valérie / Ruszniewski, Philippe / Couvineau, Alain / Voisin, Thierry. ·INSERM UMR1149 Centre de Recherche sur l'Inflammation (CRI), Université Paris-Diderot, Sorbonne Paris Cité, DHU UNITY, Faculté de Médecine Xavier Bichat, Huchard, 75018 Paris, France. · Département de Pathologie Beaujon-Bichat, AP-HP, Hôpital Bichat, Huchard, 75018 Paris, France. · Département de Pathologie Beaujon-Bichat, AP-HP, Hôpital Beaujon, 92118 Clichy, France. · Service de Pancréatologie-Gastroentérologie PMAD, Pôle des Maladies de l'Appareil Digestif, AP-HP, Hôpital Beaujon, 92118 Clichy, France. ·Oncotarget · Pubmed #29467942.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is still the poorest prognostic tumor of the digestive system. We investigated the antitumoral role of orexin-A and almorexant in PDAC. We analyzed the orexin receptor type 1 (OX1R) expression by immunohistochemistry in human normal pancreas, PDAC and its precursor dysplastic intraepithelial lesions. We used PDAC-derived cell lines and fresh tissue slices to study the apoptotic role of hypocretin-1/orexin-A and almorexant

19 Article Plasma microRNAs as biomarkers of pancreatic cancer risk in a prospective cohort study. 2017

Duell, Eric J / Lujan-Barroso, Leila / Sala, Núria / Deitz McElyea, Samantha / Overvad, Kim / Tjonneland, Anne / Olsen, Anja / Weiderpass, Elisabete / Busund, Lill-Tove / Moi, Line / Muller, David / Vineis, Paolo / Aune, Dagfinn / Matullo, Giuseppe / Naccarati, Alessio / Panico, Salvatore / Tagliabue, Giovanna / Tumino, Rosario / Palli, Domenico / Kaaks, Rudolf / Katzke, Verena A / Boeing, Heiner / Bueno-de-Mesquita, H B As / Peeters, Petra H / Trichopoulou, Antonia / Lagiou, Pagona / Kotanidou, Anastasia / Travis, Ruth C / Wareham, Nick / Khaw, Kay-Tee / Ramon Quiros, Jose / Rodríguez-Barranco, Miguel / Dorronsoro, Miren / Chirlaque, María-Dolores / Ardanaz, Eva / Severi, Gianluca / Boutron-Ruault, Marie-Christine / Rebours, Vinciane / Brennan, Paul / Gunter, Marc / Scelo, Ghislaine / Cote, Greg / Sherman, Stuart / Korc, Murray. ·Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. · Department of Medicine, Indiana University School of Medicine, Indianapolis, IN. · Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. · Department of Medical Biology, UiT The Arctic University of Norway, Tromso, Norway. · School of Public Health, Epidemiology & Biostatistics, Imperial College London, London, United Kingdom. · Human Genetics Foundation (HuGeF), Turin, Italy. · Department of Medical Sciences, University of Turin, Turin, Italy. · Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. · Lombardy Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. · Cancer Registry and Histopathology Unit, "Civic - M.P, Arezzo" Hospital, ASP, Ragusa, Italy. · Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy. · Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. · Dt. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Dt. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom. · Dt. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Dept of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. · MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom. · Hellenic Health Foundation, Athens, Greece. · WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece. · Department of Epidemiology, Harvard School of Public Health, Boston, MA. · Department of Critical Care Medicine & Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom. · Public Health Directorate, Asturias, Spain. · Andalusian School of Public Health, Research Insititute Biosanitary Granada, University Hospital Granada/University of Granada, Granada. · CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain. · Basque Regional Health Department, San Sebatian, Spain. · Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain. · Navarra Public Health Institute, Pamplona, Spain. · IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France. · Gustave Roussy, Villejuif, France. · Beaujon Hospital, Pancreatology Unit, Clichy, France. · INSERM, University Paris, France. · International Agency for Research on Cancer (IARC), Lyon, France. · Medical University of South Carolina, Charleston, SC. · Departments of Medicine and Biochemistry & Molecular Biology, Indiana University School of Medicine, Indianapolis, IN. · Pancreatic Cancer Signature Center, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN. ·Int J Cancer · Pubmed #28542740.

ABSTRACT: Noninvasive biomarkers for early pancreatic ductal adenocarcinoma (PDAC) diagnosis and disease risk stratification are greatly needed. We conducted a nested case-control study within the Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate prediagnostic microRNAs (miRs) as biomarkers of subsequent PDAC risk. A panel of eight miRs (miR-10a, -10b, -21-3p, -21-5p, -30c, -106b, -155 and -212) based on previous evidence from our group was evaluated in 225 microscopically confirmed PDAC cases and 225 controls matched on center, sex, fasting status and age/date/time of blood collection. MiR levels in prediagnostic plasma samples were determined by quantitative RT-PCR. Logistic regression was used to model levels and PDAC risk, adjusting for covariates and to estimate area under the receiver operating characteristic curves (AUC). Plasma miR-10b, -21-5p, -30c and -106b levels were significantly higher in cases diagnosed within 2 years of blood collection compared to matched controls (all p-values <0.04). Based on adjusted logistic regression models, levels for six miRs (miR-10a, -10b, -21-5p, -30c, -155 and -212) overall, and for four miRs (-10a, -10b, -21-5p and -30c) at shorter follow-up time between blood collection and diagnosis (≤5 yr, ≤2 yr), were statistically significantly associated with risk. A score based on the panel showed a linear dose-response trend with risk (p-value = 0.0006). For shorter follow-up (≤5 yr), AUC for the score was 0.73, and for individual miRs ranged from 0.73 (miR-212) to 0.79 (miR-21-5p).

20 Article Helicobacter pylori infection, chronic corpus atrophic gastritis and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: A nested case-control study. 2017

Huang, Jiaqi / Zagai, Ulrika / Hallmans, Göran / Nyrén, Olof / Engstrand, Lars / Stolzenberg-Solomon, Rachael / Duell, Eric J / Overvad, Kim / Katzke, Verena A / Kaaks, Rudolf / Jenab, Mazda / Park, Jin Young / Murillo, Raul / Trichopoulou, Antonia / Lagiou, Pagona / Bamia, Christina / Bradbury, Kathryn E / Riboli, Elio / Aune, Dagfinn / Tsilidis, Konstantinos K / Capellá, Gabriel / Agudo, Antonio / Krogh, Vittorio / Palli, Domenico / Panico, Salvatore / Weiderpass, Elisabete / Tjønneland, Anne / Olsen, Anja / Martínez, Begoña / Redondo-Sanchez, Daniel / Chirlaque, Maria-Dolores / Hm Peeters, Petra / Regnér, Sara / Lindkvist, Björn / Naccarati, Alessio / Ardanaz, Eva / Larrañaga, Nerea / Boutron-Ruault, Marie-Christine / Rebours, Vinciane / Barré, Amélie / Bueno-de-Mesquita, H B As / Ye, Weimin. ·Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden. · Department of Public Health and Clinical Nutrition, Umeå University, Umeå, Sweden. · Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden. · Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. · Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. · Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. · Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Prevention and Implementation Group, Section of Early Detection and Prevention, Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France. · Hellenic Health Foundation, Athens, Greece. · WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. · Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. · Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. · Translational Research Laboratory, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain. · Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain. · Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. · Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy. · Dipartimento di medicina clinica e chirurgia Federico II, Naples, Italy. · Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. · Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, Granada, Spain. · CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. · Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. · Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. · Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. · Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. · Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Malmö, Sweden. · Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. · Molecular and Genetic Epidemiology Unit, Human Genetics Foundation, Turin, Italy. · Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain. · Hormones and Women's Health Team, INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Villejuif, F-94805, France. · Université Paris Sud, UMRS 1018, Villejuif, F-94805, France. · Institut Gustave Roussy, Villejuif, F-94805, France. · Department of Gastroenterology and Pancreatology, Beaujon Hospital, University Paris 7, Clichy, France. · Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France. · Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. · Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom. · Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · The Medical Biobank at Umeå University, Umeå, Sweden. ·Int J Cancer · Pubmed #28032715.

ABSTRACT: The association between H. pylori infection and pancreatic cancer risk remains controversial. We conducted a nested case-control study with 448 pancreatic cancer cases and their individually matched control subjects, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to determine whether there was an altered pancreatic cancer risk associated with H. pylori infection and chronic corpus atrophic gastritis. Conditional logistic regression models were applied to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for matching factors and other potential confounders. Our results showed that pancreatic cancer risk was neither associated with H. pylori seropositivity (OR = 0.96; 95% CI: 0.70, 1.31) nor CagA seropositivity (OR = 1.07; 95% CI: 0.77, 1.48). We also did not find any excess risk among individuals seropositive for H. pylori but seronegative for CagA, compared with the group seronegative for both antibodies (OR = 0.94; 95% CI: 0.63, 1.38). However, we found that chronic corpus atrophic gastritis was non-significantly associated with an increased pancreatic cancer risk (OR = 1.35; 95% CI: 0.77, 2.37), and although based on small numbers, the excess risk was particularly marked among individuals seronegative for both H. pylori and CagA (OR = 5.66; 95% CI: 1.59, 20.19, p value for interaction < 0.01). Our findings provided evidence supporting the null association between H. pylori infection and pancreatic cancer risk in western European populations. However, the suggested association between chronic corpus atrophic gastritis and pancreatic cancer risk warrants independent verification in future studies, and, if confirmed, further studies on the underlying mechanisms.

21 Article Low progression of intraductal papillary mucinous neoplasms with worrisome features and high-risk stigmata undergoing non-operative management: a mid-term follow-up analysis. 2017

Crippa, Stefano / Bassi, Claudio / Salvia, Roberto / Malleo, Giuseppe / Marchegiani, Giovanni / Rebours, Vinciane / Levy, Philippe / Partelli, Stefano / Suleiman, Shadeah L / Banks, Peter A / Ahmed, Nazir / Chari, Suresh T / Fernández-Del Castillo, Carlos / Falconi, Massimo. ·Division of Pancreatic Surgery, Università Politecnica delle Marche, Ancona, Italy. · Division of Pancreatic Surgery, Università Vita-Salute, San Raffaele Scientific Institute, Milan, Italy. · Unit of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Service de Gastroenterologie-Pancreatologie, Hopital Beaujon, APHP, Université Paris Diderot, DHU UNITY, Clichy, France. · Center for Pancreatic Disease, Brigham and Woman's Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota, USA. ·Gut · Pubmed #26743012.

ABSTRACT: OBJECTIVE: To evaluate mid-term outcomes and predictors of survival in non-operated patients with pancreatic intraductal papillary mucinous neoplasms (IPMNs) with worrisome features or high-risk stigmata as defined by International Consensus Guidelines for IPMN. Reasons for non-surgical options were physicians' recommendation, patient personal choice or comorbidities precluding surgery. METHODS: In this retrospective, multicentre analysis, IPMNs were classified as branch duct (BD) and main duct (MD), the latter including mixed IPMNs. Univariate and multivariate analysis for overall survival (OS) and disease-specific survival (DSS) were obtained. RESULTS: Of 281 patients identified, 159 (57%) had BD-IPMNs and 122 (43%) had MD-IPMNs; 50 (18%) had high-risk stigmata and 231 (82%) had worrisome features. Median follow-up was 51 months. The 5-year OS and DSS for the entire cohort were 81% and 89.9%. An invasive pancreatic malignancy developed in 34 patients (12%); 31 had invasive IPMNs (11%) and 3 had IPMN-distinct pancreatic ductal adenocarcinoma (1%). Independent predictors of poor DSS in the entire cohort were age >70 years, atypical/malignant cyst fluid cytology, jaundice and MD >15 mm. Compared with MD-IPMNs, BD-IPMNs had significantly better 5-year OS (86% vs 74.1%, p=0.002) and DSS (97% vs 81.2%, p<0.0001). Patients with worrisome features had better 5-year DSS compared with those with high-risk stigmata (96.2% vs 60.2%, p<0.0001). CONCLUSIONS: In elderly patients with IPMNs that have worrisome features, the 5-year DSS is 96%, suggesting that conservative management is appropriate. By contrast, presence of high-risk stigmata is associated with a 40% risk of IPMN-related death, reinforcing that surgical resection should be offered to fit patients.

22 Article MGMT expression predicts response to temozolomide in pancreatic neuroendocrine tumors. 2016

Cros, J / Hentic, O / Rebours, V / Zappa, M / Gille, N / Theou-Anton, N / Vernerey, D / Maire, F / Lévy, P / Bedossa, P / Paradis, V / Hammel, P / Ruszniewski, P / Couvelard, A. ·Department of PathologyAP-HP, DHU UNITY, Beaujon University Hospital, Clichy, France U1149 - University Paris DiderotParis, France. · Department of Gastroenterology and PancreatologyAP-HP, DHU UNITY, Beaujon University Hospital, Clichy, France. · U1149 - University Paris DiderotParis, France Department of Gastroenterology and PancreatologyAP-HP, DHU UNITY, Beaujon University Hospital, Clichy, France. · Department of RadiologyAP-HP, DHU UNITY, Beaujon Hospital, Clichy, France. · Department of PathologyAP-HP, DHU UNITY, Beaujon University Hospital, Clichy, France. · Department of Somatic GeneticAP-HP, DHU UNITY, Bichat University Hospital, Paris, France. · Methodology and Quality of Life in Oncology Unit (EA 3181)University Hospital of Besançon, Besançon, France. · U1149 - University Paris DiderotParis, France Department of Digestive OncologyAP-HP, DHU UNITY, Beaujon University Hospital, Clichy, France. · U1149 - University Paris DiderotParis, France Department of PathologyAP-HP, DHU UNITY, Bichat University Hospital, Paris, France anne.couvelard@bch.aphp.fr. ·Endocr Relat Cancer · Pubmed #27353036.

ABSTRACT: Temozolomide (TEM) showed encouraging results in well-differentiated pancreatic neuroendocrine tumors (WDPNETs). Low O(6)-methylguanine-DNA methyltransferase (MGMT) expression and MGMT promoter methylation within tumors correlate with a better outcome under TEM-based chemotherapy in glioblastoma. We aimed to assess whether MGMT expression and MGMT promoter methylation could help predict the efficacy of TEM-based chemotherapy in patients with WDPNET. Consecutive patients with progressive WDPNET and/or liver involvement over 50% who received TEM between 2006 and 2012 were retrospectively studied. Tumor response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 guidelines. Nuclear expression of MGMT was assessed by immunochemistry (H-score, 0-300) and MGMT promoter methylation by pyrosequencing. Forty-three patients (21 men, 58years (27-84)) with grade 1 WDPNET (n=6) or 2 (n=36) were analyzed. Objective response, stable disease, and progression rates were seen in 17 patients (39.5%), 18 patients (41.9%), and 8 patients (18.6%), respectively. Low MGMT expression (≤50) was associated with radiological objective response (P=0.04) and better progression-free survival (PFS) (HR=0.35 (0.15-0.81), P=0.01). Disease control rate at 18months of treatment remained satisfying with an MGMT score up to 100 (74%) but dropped with a higher expression. High MGMT promoter methylation was associated with a low MGMT expression and longer PFS (HR=0.37 (0.29-1.08), P=0.05). Low MGMT score (≤50) appears to predict an objective tumor response, whereas an intermediate MGMT score (50-100) seems to be associated with prolonged stable disease.

23 Article Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). 2016

Jais, B / Rebours, V / Malleo, G / Salvia, R / Fontana, M / Maggino, L / Bassi, C / Manfredi, R / Moran, R / Lennon, A M / Zaheer, A / Wolfgang, C / Hruban, R / Marchegiani, G / Fernández Del Castillo, C / Brugge, W / Ha, Y / Kim, M H / Oh, D / Hirai, I / Kimura, W / Jang, J Y / Kim, S W / Jung, W / Kang, H / Song, S Y / Kang, C M / Lee, W J / Crippa, S / Falconi, M / Gomatos, I / Neoptolemos, J / Milanetto, A C / Sperti, C / Ricci, C / Casadei, R / Bissolati, M / Balzano, G / Frigerio, I / Girelli, R / Delhaye, M / Bernier, B / Wang, H / Jang, K T / Song, D H / Huggett, M T / Oppong, K W / Pererva, L / Kopchak, K V / Del Chiaro, M / Segersvard, R / Lee, L S / Conwell, D / Osvaldt, A / Campos, V / Aguero Garcete, G / Napoleon, B / Matsumoto, I / Shinzeki, M / Bolado, F / Fernandez, J M Urman / Keane, M G / Pereira, S P / Acuna, I Araujo / Vaquero, E C / Angiolini, M R / Zerbi, A / Tang, J / Leong, R W / Faccinetto, A / Morana, G / Petrone, M C / Arcidiacono, P G / Moon, J H / Choi, H J / Gill, R S / Pavey, D / Ouaïssi, M / Sastre, B / Spandre, M / De Angelis, C G / Rios-Vives, M A / Concepcion-Martin, M / Ikeura, T / Okazaki, K / Frulloni, L / Messina, O / Lévy, P. ·Department of Gastroenterology and Pancreatology, Beaujon Hospital, AP-HP, Clichy, France. · The Pancreas Institute, G.B. Rossi Hospital, University of Verona Hospital Trust, Verona, Italy. · Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · Departments of Surgery and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. · First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan. · Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. · Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. · Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea. · Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, Ancona-Torrette, Italy. · NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, Royal Liverpool University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. · Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Padua, Italy. · Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. · Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Italy. · Department of Gastroenterology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. · Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. · Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. · Department of Pathology, Gyeongsang National University School of Medicine, Jinju, Korea. · Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK. · National Institute of Surgery and Transplantology named after Shalimov, Kiev, Ukraine. · Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. · Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA. · Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. · Hôpital Privé Mermoz, Gastroentérologie, Lyon, France. · Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. · Gastroenterology Department, Hospital de Navarra, Pamplona, Spain. · Department of Gastroenterology and Hepatology, University College Hospital, London, UK. · Department of Gastroenterology, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain. · Department of Pancreatic Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy. · Gastroenterology and Liver Services, Concord Hospital, Sydney, New South Wales, Australia. · Radiological Department, General Hospital Cá Foncello, Treviso, Italy. · Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Milan, Italy. · Department of Internal Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University School of Medicine, Bucheon, Korea. · Department of Gastroenterology, Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia. · Department of Digestive Surgery, Timone Hospital, Marseille, France. · Gastrohepatology Department, San Giovanni Battista Molinette Hospital, University of Turin, Turin, Italy. · Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, Institut de Reçerca-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. · The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan. · Department of Medicine, Pancreas Center, University of Verona, Verona, Italy. ·Gut · Pubmed #26045140.

ABSTRACT: OBJECTIVES: Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. DESIGN: Retrospective multinational study including SCN diagnosed between 1990 and 2014. RESULTS: 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4-140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1). CONCLUSIONS: After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. TRIAL REGISTRATION NUMBER: IRB 00006477.

24 Article Can pancreatic neuroendocrine tumour biopsy accurately determine pathological characteristics? 2015

Rebours, Vinciane / Cordova, Jacqueline / Couvelard, Anne / Fabre, Monique / Palazzo, Laurent / Vullierme, Marie Pierre / Hentic, Olivia / Sauvanet, Alain / Aubert, Alain / Bedossa, Pierre / Ruszniewski, Philippe. ·Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France; Inserm U773-CRB3, Paris-Diderot University, Paris, France. Electronic address: vinciane.rebours@bjn.aphp.fr. · Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France. · Inserm U773-CRB3, Paris-Diderot University, Paris, France; Pathology Department, Bichat Hospital, AP-HP, Paris-Diderot University, France. · Pathology Department, Institut Gustave Roussy, Villejuif, France. · Endoscopy and Gastroenterology Department, Clinique du Trocadéro, Paris, France. · Radiology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France. · Pancreatic Surgery Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France. · Pathology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France. · Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France; Inserm U773-CRB3, Paris-Diderot University, Paris, France. ·Dig Liver Dis · Pubmed #26169284.

ABSTRACT: BACKGROUND: Assessment of the pathological characteristics of pancreatic neuroendocrine tumours is crucial for appropriate management. We compared preoperative pathological data with surgical specimens for accuracy. METHODS: Surgical patients with pancreatic neuroendocrine tumours who underwent preoperative endoscopic ultrasound-guided fine needle aspiration of the primary tumour or biopsy of liver metastasis were retrospectively included. Tumour differentiation and the Ki67 proliferation index on biopsies were compared with pancreatic specimens. RESULTS: Fifty-seven patients were included. A preoperative biopsy of the primary tumour or of a liver metastasis was obtained in 48 and 9 patients respectively. Tumour differentiation was high in 98%, and poor in 2% on biopsy and high in 100% of surgical specimens. Ki67 index values were 0 (0-19) and 2 (0-15) on biopsy and surgical specimens (p=0.01). Correlation between preoperative and surgical findings was stronger for liver (r=0.62, p=0.001) than for pancreas (r=0.23, p=0.11). Correlation for pancreas varied according to the tumour pattern: solid (r=0.24, p=0.16), mixed (r=0.91, p=0.0036) or cystic (r=0.04, p=0.89). Tumour grade was different between pancreatic biopsies and surgical specimens, for grade 1 (63% vs 37%) and grade 2 (28% vs 72%), p=0.0007. CONCLUSIONS: Tumour grade assessment is accurate in biopsies of liver metastases of pancreatic neuroendocrine tumours, while pancreatic fine-needle aspiration biopsies are less accurate.

25 Article Laparoscopic fenestration of pancreatic serous cystadenoma: Minimally invasive approach for symptomatic benign disease. 2015

Dokmak, Safi / Aussilhou, Béatrice / Rasoaherinomenjanahary, Fanjandrainy / Sauvanet, Alain / Vullierme, Marie-Pierre / Rebours, Vinciane / Lévy, Philippe. ·Safi Dokmak, Béatrice Aussilhou, Fanjandrainy Rasoaherinomenjanahary, Alain Sauvanet, Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, 92210 Clichy, France. ·World J Gastroenterol · Pubmed #26078583.

ABSTRACT: Serous cystadenoma (SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the literature. In this study, 3 female patients underwent laparoscopic fenestration for macrocystic SC (12-14 cm). Diagnosis was established via magnetic resonance imaging and endoscopic ultrasound, with intra-cystic dosage of tumors markers (ACE and CA19-9) in 2 patients. All patients were symptomatic and operated on 15-60 mo after diagnosis. Radiological evaluation showed constant cyst growth. Patients were informed about this new surgical modality that can avoid pancreatic resection. The mean operative time was 103 min (70-150 min) with one conversion. The post-operative course was marked by a grade A pancreatic fistula in one patient and was uneventful in the other two. The hospital stay was 3, 10, and 18 d, respectively. The diagnosis of macrocystic SC was histologically-confirmed in all cases. At the last follow-up (13-26 mo), all patients were symptom-free, and radiological evaluation showed complete disappearance of the cyst. Laparoscopic fenestration, as opposed to resection, should be considered for large symptomatic macrocystic SC, thereby avoiding pancreatic resection morbidity and mortality.

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