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Pancreatic Neoplasms: HELP
Articles by Andrada Seicean
Based on 20 articles published since 2008
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Between 2008 and 2019, A. Seicean wrote the following 20 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline - March 2017. 2017

Polkowski, Marcin / Jenssen, Christian / Kaye, Philip / Carrara, Silvia / Deprez, Pierre / Gines, Angels / Fernández-Esparrach, Gloria / Eisendrath, Pierre / Aithal, Guruprasad P / Arcidiacono, Paolo / Barthet, Marc / Bastos, Pedro / Fornelli, Adele / Napoleon, Bertrand / Iglesias-Garcia, Julio / Seicean, Andrada / Larghi, Alberto / Hassan, Cesare / van Hooft, Jeanin E / Dumonceau, Jean-Marc. ·Department of Gastroenterology, Hepatology, and Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland. · Department of Gastroenterological Oncology, The M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland. · Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Academic Teaching Hospital of the Medical University of Brandenburg, Germany. · Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, UK. · Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Italy. · Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. · Endoscopy Unit, Department of Gastroenterology, ICMDM, IDIBAPS, CIBEREHD, Hospital Clínic, Barcelona, Spain. · Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Hôpital Erasme & Hôpital Saint-Pierre, Brussels, Belgium. · Pancreato-Biliary Endoscopy and Endosonography Division, San Raffaele University, Milan, Italy. · Service de Gastroentérologie, Hôpital NORD AP-HM, Aix-Marseille-Université, Marseille, France. · Gastroenterology Department Instituto Português de Oncologia do Porto, Porto, Portugal. · Anatomic Pathology Unit, AUSL of Bologna, Maggiore Hospital, Bologna, Italy. · Department of Gastroenterology, Ramsay Générale de Santé, Private Hospital Jean Mermoz, Lyon, France. · Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. · Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. · Digestive Endoscopy Unit, Catholic University, Rome, Italy. · Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. · Gedyt Endoscopy Center, Buenos Aires, Argentina. ·Endoscopy · Pubmed #28898917.

ABSTRACT: For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation). ESGE suggests neutralizing residual negative pressure in the needle before withdrawing the needle from the target lesion (moderate quality evidence, weak recommendation).ESGE does not recommend for or against using the needle stylet for EUS-guided sampling of solid masses and LNs with FNA needles (high quality evidence, strong recommendation) and suggests using the needle stylet for EUS-guided sampling with FNB needles (low quality evidence, weak recommendation).ESGE suggests fanning the needle throughout the lesion when sampling solid masses and LNs (moderate quality evidence, weak recommendation).ESGE equally recommends EUS-guided sampling with or without on-site cytologic evaluation (moderate quality evidence, strong recommendation). When on-site cytologic evaluation is unavailable, ESGE suggests performance of three to four needle passes with an FNA needle or two to three passes with an FNB needle (low quality evidence, weak recommendation).For diagnostic sampling of pancreatic cystic lesions without a solid component, ESGE suggests emptying the cyst with a single pass of a 22G or 19G needle (low quality evidence, weak recommendation). For pancreatic cystic lesions with a solid component, ESGE suggests sampling of the solid component using the same technique as in the case of other solid lesions (low quality evidence, weak recommendation).ESGE does not recommend antibiotic prophylaxis for EUS-guided sampling of solid masses or LNs (low quality evidence, strong recommendation), and suggests antibiotic prophylaxis with fluoroquinolones or beta-lactam antibiotics for EUS-guided sampling of cystic lesions (low quality evidence, weak recommendation). ESGE suggests that evaluation of tissue obtained by EUS-guided sampling should include histologic preparations (e. g., cell blocks and/or formalin-fixed and paraffin-embedded tissue fragments) and should not be limited to smear cytology (low quality evidence, weak recommendation).

2 Review Maximizing the endosonography: The role of contrast harmonics, elastography and confocal endomicroscopy. 2017

Seicean, Andrada / Mosteanu, Ofelia / Seicean, Radu. ·Andrada Seicean, Ofelia Mosteanu, Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, University of Medicine and Pharmacy "Iuliu Hatieganu", 400162 Cluj-Napoca, Romania. ·World J Gastroenterol · Pubmed #28104978.

ABSTRACT: New technologies in endoscopic ultrasound (EUS) evaluation have been developed because of the need to improve the EUS and EUS-fine needle aspiration (EUS-FNA) diagnostic rate. This paper reviews the principle, indications, main literature results, limitations and future expectations for each of the methods presented. Contrast-enhanced harmonic EUS uses a low mechanical index and highlights slow-flow vascularization. This technique is useful for differentiating solid and cystic pancreatic lesions and assessing biliary neoplasms, submucosal neoplasms and lymph nodes. It is also useful for the discrimination of pancreatic masses based on their qualitative patterns; however, the quantitative assessment needs to be improved. The detection of small solid lesions is better, and the EUS-FNA guidance needs further research. The differentiation of cystic lesions of the pancreas and the identification of the associated malignancy features represent the main indications. Elastography is used to assess tissue hardness based on the measurement of elasticity. Despite its low negative predictive value, elastography might rule out the diagnosis of malignancy for pancreatic masses. Needle confocal laser endomicroscopy offers useful information about cystic lesions of the pancreas and is still under evaluation for use with solid pancreatic lesions of lymph nodes.

3 Review IL-6 roles - Molecular pathway and clinical implication in pancreatic cancer - A systemic review. 2017

Pop, Vlad-Vasile / Seicean, Andrada / Lupan, Iulia / Samasca, Gabriel / Burz, Claudia-Cristina. ·Iuliu Hatieganu University of Medicine and Pharmacy, Dept. Of Immunology and Allergology, Cluj-Napoca, Romania. · Iuliu Hatieganu University of Medicine and Pharmacy, Dept. Of Internal Medicine, Gastroenterology, Cluj-Napoca, Romania; Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. · Babes Bolyai University, Department of Molecular Biology, Cluj-Napoca, Romania. · Iuliu Hatieganu University of Medicine and Pharmacy, Dept. Of Immunology and Allergology, Cluj-Napoca, Romania; Emergency Hospital for Children, Cluj-Napoca, Romania. Electronic address: Gabriel.Samasca@umfcluj.ro. · Iuliu Hatieganu University of Medicine and Pharmacy, Dept. Of Immunology and Allergology, Cluj-Napoca, Romania; Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania. ·Immunol Lett · Pubmed #27876525.

ABSTRACT: Pancreatic cancer has attracted a great deal of attention owing to the poor outcome, increasing prevalence in the last years and delay diagnosis. Known as a complex disease, it involves genetic mutations, changes in tumour microenvironment and inflammatory component dominated by interleukin-6 and its activated pathways, like Janus Kinase-Signal Transducer and Activator of Translation3, Mitogen Activated Protein Kinase and Androgen receptor. The pro-inflammatory cytokine, plays a central role in oncogenesis, cancer progression, invasiveness, microenvironment changes, treatment resistance, prognosis and associated co morbidities like cachexia and depression. Fulfilling these roles IL-6 requires special attention to understand its complexity in PC development.

4 Review New targeted therapies in pancreatic cancer. 2015

Seicean, Andrada / Petrusel, Livia / Seicean, Radu. ·Andrada Seicean, Livia Petrusel, Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 4000192, Romania. ·World J Gastroenterol · Pubmed #26034349.

ABSTRACT: Patients with pancreatic cancer have a poor prognosis with a median survival of 4-6 mo and a 5-year survival of less than 5%. Despite therapy with gemcitabine, patient survival does not exceed 6 mo, likely due to natural resistance to gemcitabine. Therefore, it is hoped that more favorable results can be obtained by using guided immunotherapy against molecular targets. This review summarizes the new leading targeted therapies in pancreatic cancers, focusing on passive and specific immunotherapies. Passive immunotherapy may have a role for treatment in combination with radiochemotherapy, which otherwise destroys the immune system along with tumor cells. It includes mainly therapies targeting against kinases, including epidermal growth factor receptor, Ras/Raf/mitogen-activated protein kinase cascade, human epidermal growth factor receptor 2, insulin growth factor-1 receptor, phosphoinositide 3-kinase/Akt/mTOR and hepatocyte growth factor receptor. Therapies against DNA repair genes, histone deacetylases, microRNA, and pancreatic tumor tissue stromal elements (stromal extracellular matric and stromal pathways) are also discussed. Specific immunotherapies, such as vaccines (whole cell recombinant, peptide, and dendritic cell vaccines), adoptive cell therapy and immunotherapy targeting tumor stem cells, have the role of activating antitumor immune responses. In the future, treatments will likely include personalized medicine, tailored for numerous molecular therapeutic targets of multiple pathogenetic pathways.

5 Review Endoscopic ultrasound guided radiofrequency ablation in pancreas. 2014

Seicean, Andrada / Tefas, Cristian / Ungureanu, Bogdan / Săftoiu, Adrian. · ·Hepatogastroenterology · Pubmed #25436368.

ABSTRACT: Radiofrequency ablation of the pancreas represents a more effective tumor-destruction method compared to other ablation techniques. The endoscopic ultrasound guided radiofrequency ablation is indicated for locally advanced, non-metastatic pancreatic adenocarcinoma, without the need of general anesthesia and fast recovery. The main limitations are the encasement of the mesenteric vessels or of the common bile duct in the head pancreatic tumours. The technique is feasible, effective and relatively safe in porcine models, with minimal evidence of fat necrosis in intra-pancreatic and/or extra-pancreatic adipose tissue. It has been successfully applied on insulinomas and pancreatic adenocarcinoma in humans, with few complications, such as duodenal bleeding or mild abdominal pain. Other side effects as biliary fistula, pancreatic fistula or acute pancreatitis seen in intraoperative settings of radiofrequency ablation, have not been reported in endoscopic ultrasound guided radiofrequency ablation.

6 Review Celiac plexus neurolysis in pancreatic cancer: the endoscopic ultrasound approach. 2014

Seicean, Andrada. ·Andrada Seicean, Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, University of Medicine and Pharmacy "Iuliu Hatieganu", 400162 Cluj-Napoca, Romania. ·World J Gastroenterol · Pubmed #24415863.

ABSTRACT: Pain in pancreatic cancer is often a major problem of treatment. Administration of opioids is frequently limited by side effects or insufficient analgesia. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) represents an alternative for the palliative treatment of visceral pain in patients with pancreatic cancer. This review focuses on the indications, technique, outcomes of EUS-CPN and predictors of pain relief. EUS-CPN should be considered as the adjunct method to standard pain management. It moderately reduces pain in pancreatic cancer, without eliminating it. Nearly all patients need to continue opioid use, often at a constant dose. The effect on quality of life is controversial and survival is not influenced. The approach could be done in the central position of the celiac axis, which is easy to perform, or in the bilateral position of the celiac axis, with similar results in terms of pain alleviation. The EUS-CPN with multiple intraganglia injection approach seems to have better results, although extended studies are still needed. Further trials are required to enable more confident conclusions regarding timing, quantity of alcohol injected and the method of choice. Severe complications have rarely been reported, and great care should be taken in choosing the site of alcohol injection.

7 Article Pancreatic gangliocytic paraganglioma - CEUS appearance. 2017

Furcea, Luminita / Mois, Emil / Al Hajjar, Nadim / Seicean, Andrada / Badea, Radu / Graur, Florin. ·Iuliu Hațieganu University of Medicine and Pharmacy; Prof. Dr. O.Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. · Iuliu Hațieganu University of Medicine and Pharmacy; Prof. Dr. O.Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.na_hajjar@yahoo.com. · Iuliu Hațieganu University of Medicine and Pharmacy;Prof. Dr. O.Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. ·J Gastrointestin Liver Dis · Pubmed #29253044.

ABSTRACT: -- No abstract --

8 Article Role of computer tomography and endoscopic ultrasonography in assessing portal and superior mesenteric vessels invasion in cephalo-pancreatic adenocarcinoma. 2017

Bodea, Raluca / Seicean, Andrada / Vasile, Tudor / Calinici, Tudor / Ciuca, Irina / Al Hajjar, Nadim / Iancu, Cornel / Iordache, Constantin. · ·Ann Ital Chir · Pubmed #29051395.

ABSTRACT: AIM: The aim of this study is to evaluate the information given by contrast-enhanced computer tomography (CECT) and ultrasound endoscopy (EUS) regarding vascular involvement of cephalo-pancreatic cancer, data compared with intraoperative findings. MATERIAL AND METHODS: We choose to analyze the most often interested vessels by tumor development, such as superior mesenteric artery (SMA), superior mesenteric vein (SMV) and portal vein (PV). The patients included in the study (n=425) had a cephalo-pancreatic tumor diagnosed in our Institute and a positive histology for pancreatic adenocarcinoma. The exclusion criteria were: tumors in sites other than the head of the pancreas (including metastases); tumor involvement of common hepatic artery, celiac trunk, inferior cava vein or aorta; CECT or EUS diagnosis performed in another center; and a delay of more than 35 days between the diagnostic imaging and surgery. RESULTS: In diagnosing SMA invasion CECT had an accuracy of 84,92% and EUS had an accuracy of 87,39%. In diagnosing PV and SMV involvement, CECT had an accuracy of 84,83% and EUS had an accuracy of 92,17%. The accuracy of the two combined examinations in diagnosing vascular invasion was 93%. CONCLUSONS: Both types of examination have showed good accuracies in diagnosing vascular invasion separately. A combination of the two may be used when the CECT result is uncertain as it provides a higher chance of a correct diagnosis. KEY WORDS: Pancreatic cancer, Resectability criteria, Vascular invasion.

9 Article Harmonic Contrast-Enhanced Endoscopic Ultrasonography for the Guidance of Fine-Needle Aspiration in Solid Pancreatic Masses. 2017

Seicean, Andrada / Badea, Radu / Moldovan-Pop, Anca / Vultur, Simona / Botan, Emil Claudiu / Zaharie, Teodor / Săftoiu, Adrian / Mocan, Teodora / Iancu, Cornel / Graur, Florin / Sparchez, Zeno / Seicean, Radu. ·Regional Institute of Gastroenterology and Hepatology, University of Medicine and Pharmacy Cluj-Napoca, Romania. · Research Centre of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania. · First Surgical Clinic, University of Medicine and Pharmacy Cluj-Napoca, Romania. ·Ultraschall Med · Pubmed #26274382.

ABSTRACT:

10 Article Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer. 2016

Seicean, Andrada / Gheorghiu, Marcel / Zaharia, Teodor / Calinici, Tudor / Samarghitan, Andrada / Marcus, Bogdan / Cainap, Simona / Seicean, Radu. ·Iuliu Hatieganu University of Medicine and Pharmacy, Prof. dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. · Prof. dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. marcel.gheorghiu@gmail.com. · Prof. dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. · Iuliu Hatieganu University of Medicine and Pharmacy, Department of Biostatistics, Cluj-Napoca, Romania. · Iuliu Hatieganu University of Medicine and Pharmacy, 2nd Pediatrics Clinic, Cluj-Napoca, Romania. · Iuliu Hatieganu University of Medicine and Pharmacy, 1st Surgical Clinic, Cluj-Napoca, Romania. ·J Gastrointestin Liver Dis · Pubmed #27308653.

ABSTRACT: BACKGROUND AND AIM: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. METHOD: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. RESULTS: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. CONCLUSIONS: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results.

11 Article Quantitative contrast-enhanced harmonic EUS in differential diagnosis of focal pancreatic masses (with videos). 2015

Săftoiu, Adrian / Vilmann, Peter / Dietrich, Christoph F / Iglesias-Garcia, Julio / Hocke, Michael / Seicean, Andrada / Ignee, Andre / Hassan, Hazem / Streba, Costin Teodor / Ioncică, Ana Maria / Gheonea, Dan Ionuţ / Ciurea, Tudorel. ·Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy, Craiova, Romania; Endoscopy Department, Copenhagen University Hospital, Herlev, Denmark. · Endoscopy Department, Copenhagen University Hospital, Herlev, Denmark. · Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Medical D 2, Caritas-Krankenhaus Bad, Mergentheim, Germany. · Gastroenterology Department, University Hospital Santiago de Compostela, Coruña, Spain. · Internal Medicine II, Hospital Meiningen, Meiningen, Germany. · Regional Institute of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Iuliu Haţieganu" Cluj-Napoca, Romania. · Medical D 2, Caritas-Krankenhaus Bad, Mergentheim, Germany. · Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy, Craiova, Romania. ·Gastrointest Endosc · Pubmed #25792386.

ABSTRACT: BACKGROUND: The role of EUS with contrast agents can be expanded through the use of time-intensity curve (TIC) analysis and computer-aided interpretation. OBJECTIVE: To validate the use of parameters derived from TIC analysis in an artificial neural network (ANN) classification model designed to diagnose pancreatic carcinoma (PC) and chronic pancreatitis (CP). SETTING: Prospective, multicenter, observational trial-endoscopy units from Romania, Denmark, Germany, and Spain. PATIENTS: A total of 167 consecutive patients with PC or CP. INTERVENTIONS: Contrast-enhanced harmonic EUS (CEH-EUS) and EUS-guided FNA (EUS-FNA), TIC analysis, and ANN processing. MAIN OUTCOME MEASUREMENTS: Sensitivity, specificity, positive and negative predictive values (PPV, NPV) for EUS-FNA, CEH-EUS, and the ANN. RESULTS: After excluding all of the recordings that did not meet the technical and procedural criteria, 112 cases of PC and 55 cases of CP were included. EUS-FNA was performed in 129 patients, and the diagnosis was confirmed by surgery (n = 15) or follow-up (n = 23) in the remaining cases. Its sensitivity and specificity were 84.82% and 100%, respectively, whereas the PPV and NPV were 100% and 76.63%, respectively. The sensitivity of real-time quantitative assessment of CEH-EUS was 87.5%, specificity 92.72%, PPV 96.07%, and NPV 78.46%. Peak enhancement, wash-in area under the curve, wash-in rate, and the wash-in perfusion index were significantly different between the groups. No significant differences were found between rise time, mean transit time, and time to peak. For the ANN, sensitivity was 94.64%, specificity 94.44%, PPV 97.24%, and NPV 89.47%. LIMITATIONS: Only PC and CP lesions were included. CONCLUSION: Parameters obtained through TIC analysis can differentiate between PC and CP cases and can be used in an automated computer-aided diagnostic system with good diagnostic results. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01315548.).

12 Article Proteomic identification of potential prognostic biomarkers in resectable pancreatic ductal adenocarcinoma. 2014

Iuga, Cristina / Seicean, Andrada / Iancu, Cornel / Buiga, Rareş / Sappa, Praveen K / Völker, Uwe / Hammer, Elke. ·Department of Pharmaceutical Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy "Iuliu Haţieganu", Cluj-Napoca, Romania; Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany. ·Proteomics · Pubmed #24459066.

ABSTRACT: Pancreatic cancer is a devastating disease with a mortality rate almost identical with its incidence. In this context, the investigation of the pancreatic cancer proteome has gained considerable attention because profiles of proteins may be able to identify disease states and progression more accurately. Therefore, our objective was to investigate the changes in the proteome of patients suffering from pancreatic ductal adenocarcinoma (PDAC) by a comprehensive quantitative approach. Comparative proteomic profiling by label-free LC-MS/MS analysis of nine matched pairs of tumor and nontumor pancreas samples was used to identify differences in protein levels characteristic for PDAC. In this analysis, 488 proteins were quantified by at least two peptides of which 99 proteins displayed altered levels in PDAC (p < 0.01, fold change >1.3). Screening of data revealed a number of molecules that had already been related to PDAC such as galectin-1 (LEG1), major vault protein, adenylyl cyclase-associated protein 1 (CAP1), but also a potential new prognostic biomarker prolargin (PRELP). The Kaplan-Meier survival analysis revealed a significant correlation of protein abundance of PRELP with postoperative survival of patients with PDAC. For selected proteins the findings were verified by targeted proteomics (SRM), validated by immunohistochemistry and Western blotting and their value as candidate biomarkers is discussed.

13 Article Pain palliation by endoscopic ultrasound-guided celiac plexus neurolysis in patients with unresectable pancreatic cancer. 2013

Seicean, Andrada / Cainap, Calin / Gulei, Iulia / Tantau, Marcel / Seicean, Radu. ·3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Regional Institute of Gastroenterology and Hepatology, Croitorilor street 19-21, 400162 Cluj-Napoca, Romania. andradaseicean@yahoo.com ·J Gastrointestin Liver Dis · Pubmed #23539392.

ABSTRACT: BACKGROUND: Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) represents an alternative approach to pain palliation in patients with advanced pancreatic cancer. AIM: to evaluate the safety and initial efficacy of EUS-CPN in patients with painful unresectable pancreatic cancer. METHODS: Patients with inoperable body-tail pancreatic adenocarcinoma without prior chemotherapy and pain requiring opioid analgesia were included prospectively in this cohort study in a tertiary medical center. Central EUS-CPN was performed and the brief pain inventory and the Functional Assessment of Cancer Therapy measurement were applied before and 2 weeks after the procedure. RESULTS: Thirty-two patients underwent the procedure in one session without complications. Follow-up revealed overall pain relief in 24 patients (75%) and significant improvement in pain scores. Ratings of pain interfering with general activity, walking, work, mood, enjoyment of life, relations with others, and sleep improved significantly. Physical, functional, and emotional well-being improved significantly, except for acceptance of illness and enjoyment of life. CONCLUSION: Central EUS-CPN was an efficient and safe method for palliative pain management in our patients with inoperable pancreatic body-tail adenocarcinoma. The pain alleviation improved the patients' functional status, sleep, and quality of life, although other variables could also be involved, but acceptance of the illness and enjoyment of life did not change after treatment.

14 Article Contrast enhanced ultrasound and computer tomography diagnosis of solid and mixed pancreatic tumors - analysis of confounders. 2012

Vasile, Tudor Andrei / Feier, Diana / Socaciu, Mihai / Anton, Ofelia Maria / Seicean, Andrada / Iancu, Cornel / Zaharie, Toader / Badea, Radu. ·Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj-Napoca, Romania. ·J Gastrointestin Liver Dis · Pubmed #23012670.

ABSTRACT: AIMS. The aim of this study was to evaluate the leading causes of discrepancies between imaging studies [contrast enhanced ultrasound (CEUS) and contrast enhanced computer tomography (CECT)] diagnosis and histology in patients presenting to a tertiary referral center with previously detected pancreatic masses by standard abdominal ultrasound. METHODS. We performed a prospective longitudinal observational study on 76 patients with pancreatic masses: 57 (75%) patients with solid pancreatic tumors and 19 (25%) patients with cystic and mixed pancreatic masses. For each tumor the CEUS and CECT features were analyzed and compared with the final histological diagnosis. RESULTS. Testing the performance of CEUS and CECT in evaluating the benign or malignant etiology of pancreatic masses, we obtained a probability of 82% for CEUS and of 83% for CECT, for a randomly selected individual from the pancreatic tumor group to have an imaging result indicating suspicion for malignancy. We obtained discordances with the histopathological diagnosis in 25 (32.89%) patients for CEUS and in 23 (30.26%) patients for CECT. In multiple regression analysis, two variables independently influenced the discordance between the two imaging methods and histological conclusion: enhancement pattern and tumor nature (solid vs. cystic). CONCLUSIONS.CEUS and CECT showed a good diagnostic performance in differentiating benign from malignant pancreatic tumors. Enhancement pattern and tumor nature (solid vs. cystic) are independent confounders between imaging and histological diagnosis.

15 Article Added value of intravenous contrast-enhanced ultrasound for characterization of cystic pancreatic masses: a prospective study on 37 patients. 2012

Vasile, Tudor Andrei / Socaciu, Mihai / Stan Iuga, Roxana / Seicean, Andrada / Iancu, Cornel / al Hajjar, Nadim / Zaharie, Toader / Badea, Radu. ·Radiology Department, Regional Institute of Hepatology and Gastroenterology Octavian Fodor, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania. ·Med Ultrason · Pubmed #22675710.

ABSTRACT: PATIENTS AND METHOD: Between December 2008 and November 2011, 37 patients with PCM discovered at ultrasound examination were prospectively followed. A qualitative and quantitative CEUS analysis was performed in order to differentiate etiologies of the PCM. In the quantitative analysis several parameters were followed: Peak Intensity (PI), Time to Peak (TTP), maximum ascending gradient (GRAD), Time to maximum gradient (TTG) and Area Under the Curve (AUC). Normalized ratios were also calculated. In all patients a definite cytological or histological diagnosis was obtained. RESULTS: Thirty-seven patients were studied: 12 with pancreatitis-associated pseudocyst and 25 with cystic tumors (10 serous cystic adenoma, 5 mucinous cystic adenoma, 6 cystadenocarcinomas, 2 solid pseudopapillary tumors and 2 intraductal papillary mucinous neoplasms). There was a significant difference of the nAUC and nTTP between pseudocyst and cystic tumors, p=0.03 and p=0.01, respectively. A normalized TTP value above 7 sec was suggestive for the diagnosis of pseudocysts with 79.16 % accuracy. There was a significant difference of nTTP and nTTG between the benign and malignant lesions. nTTP < 9 sec and nTTG < 8.5 sec rules out malignant cysts in almost 90% of cases. CONCLUSION: The CEUS is useful in the diagnosis of PCM. The quantitative analysis of the enhancement of the cystic wall may discriminate the different types of the PCM.

16 Article Molecular angiogenesis profile as a tool to discriminate chronic pancreatitis (CP) from pancreatic cancer (PC). 2011

Berindan-Neagoe, Ioana / Burz, Claudia / Balacescu, Ovidiu / Balacescu, Loredana / Seicean, Andrada / Cristea, Victor / Irimie, Alexandru. · ·Pancreas · Pubmed #21412121.

ABSTRACT: -- No abstract --

17 Article Quantitative contrast-enhanced harmonic endoscopic ultrasonography for the discrimination of solid pancreatic masses. 2010

Seicean, A / Badea, R / Stan-Iuga, R / Mocan, T / Gulei, I / Pascu, O. ·Third Medical Clinic, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca. andradaseicean@yahoo.com ·Ultraschall Med · Pubmed #21080306.

ABSTRACT: PURPOSE: Contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) for the assessment of microcirculation and the delineation of pancreatic tumors in order to characterize and stage them has only recently become available for commercial use, and few reports have been published. The purpose of the study was the qualitative and quantitative digital image analysis of pancreatic adenocarcinomas using conventional endoscopic ultrasonography (EUS) and CEH-EUS and the evaluation of whether contrast medium injection modified adenocarcinoma staging and patient management. MATERIALS AND METHODS: In each of 30 prospectively examined patients with suspected pancreatic solid lesions, CEH-EUS was performed using the same quantity of the contrast agent SonoVue and a low mechanical index (0.3 - 0.4), followed by EUS-FNA. The histology, based on EUS-FNA or surgery and 9 months of follow-up, was: pancreatic adenocarcinoma (n = 15), pseudotumoral chronic pancreatitis (n = 12), neuroendocrine tumor (n = 1), common bile duct tumor (n = 1), lymph node metastases of gastric cancer (n = 1). The quantitative analysis was based on histograms obtained from each CEH-EUS video recording. RESULTS: CEH-EUS showed a hypoenhanced pattern in 14 cases of adenocarcinoma and in 10 cases of chronic pancreatitis. The index of the contrast uptake ratio was significantly lower in adenocarcinoma than in mass-forming chronic pancreatitis. A cut-off uptake ratio index value of 0.17 for diagnosing adenocarcinoma corresponded to an AUC (CI 95%) of 0.86 (0.67 - 1.00) with a sensitivity of 80%, a specificity of 91.7%, a positive predictive value of 92.8%, and a negative predictive value of 78%. The size of the pancreatic mass was assessed significantly more effectively by CEH-EUS but adenocarcinoma staging was not modified. CONCLUSION: The majority of cases of both pancreatic adenocarcinoma and chronic pancreatitis were hypoenhanced and visual discrimination was not possible. This is the first study about CEH-EUS for the quantitative assessment of uptake after contrast injection which has shown that it can aid differentiation between benign and malignant masses but cannot replace EUS-FNA. Neither tumor stage nor therapeutic management have changed after contrast medium injection during CEH-EUS.

18 Article The added value of real-time harmonics contrast-enhanced endoscopic ultrasonography for the characterisation of pancreatic diseases in routine practice. 2010

Seicean, Andrada / Badea, Radu / Stan-Iuga, Roxana / Gulei, Iulia / Pop, Teodora / Pascu, Oliviu. ·3rd Medical Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, 19-21 Croitorilor Str., Cluj-Napoca, Romania. andradaseicean@yahoo.com ·J Gastrointestin Liver Dis · Pubmed #20361085.

ABSTRACT: Endoscopic ultrasonography is an imaging method used in the diagnosis of pancreatic diseases. The differentiation between inflammatory tumor-like masses and pancreatic adenocarcinoma still remains difficult. Contrast enhanced harmonic endoscopic ultrasonography (CEH-EUS) is a new technique, recently available in commercial use and less evaluated. It is used to characterize the microcirculation in pancreatic disorders--hypervascularized masses such as neuroendocrine tumors or hypovascularized masses such as adenocarcinomas--and to better visualize the necrotic areas in acute pancreatitis and the vascularisation of mural nodules and septa in pancreatic cystic lesions.

19 Article Th1 and Th2 profiles in patients with pancreatic cancer compared with chronic pancreatitis. 2009

Seicean, Andrada / Popa, Daniel / Mocan, Teodora / Cristea, Victor / Berindan-Neagoe, Ioana. · ·Pancreas · Pubmed #19550277.

ABSTRACT: -- No abstract --

20 Article Radial endoscopic ultrasonography in the preoperative staging of pancreatic cancer. 2008

Seicean, Andrada / Badea, Radu / Mocan, Teodora / Iancu, Cornel / Pop, Teodora / Seicean, Radu / Mo Scedil Teanu, Ofelia / B Abreve L Abreve, Ovidiu / Pascu, Oliviu. ·3rd Medical Clinic, Croitorilor Str., 19-21 400162 Cluj-Napoca, Romania. andradaseicean@yahoo.com ·J Gastrointestin Liver Dis · Pubmed #18836619.

ABSTRACT: BACKGROUND: Endoscopic ultrasonography (EUS) is a diagnostic method that aims to detect and stage tumors of the pancreas more accurately. It has a high predictive role regarding tumor resectability. AIM: The present paper aims to assess the diagnostic accuracy of radial EUS in the staging of pancreatic cancer as well as the role of EUS to predict tumor resectability. MATERIAL AND METHODS: 30 patients (22 males, 8 females, mean age 61 +/- 12 years) with pancreatic masses staged by both radial EUS and surgery (17 patients with intraoperative exploration and 13 with pathological examination of surgical specimens) and with histologically proved adenocarcinoma were included in the study. Surgical examination was indicated in patients with pancreatic masses evidenced by imaging methods other than EUS, without distant metastases proved preoperatively, and without taking into consideration the staging obtained by EUS. Resectability criteria for pancreatic tumors as assessed by EUS were invasion of superior mesenteric artery or invasion of celiac trunk. RESULTS: The accuracy of EUS T staging was 86.6%, that of N staging was 93.3% while that of the vascular invasion was 80%. The accuracy of EUS for predicting tumor stage had a direct impact on the assessment of tumor resectability (83.3%, CI 95%: 81.5- 85.2). It had a sensitivity of 100%, specificity of 75%, PPV of 91.6% and NPV of 100%. CONCLUSION: The radial EUS of the pancreas is an accurate method for tumor staging. For establishing tumor resectability, association with other imaging methods is advisable for arterial assessment.