Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This art...Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This article aims to un-derscore the promising role of emerging imaging aspects that may facilitate the earlier diagnosis of PC,thereby improving its management and prognosis.展开更多
As a highly invasive carcinoma,esophageal cancer(EC)was the eighth most prevalent malignancy and the sixth leading cause of cancer-related death worldwide in 2020.Esophageal squamous cell carcinoma(ESCC)is the major h...As a highly invasive carcinoma,esophageal cancer(EC)was the eighth most prevalent malignancy and the sixth leading cause of cancer-related death worldwide in 2020.Esophageal squamous cell carcinoma(ESCC)is the major histological subtype of EC,and its incidence and mortality rates are decreasing globally.Due to the lack of specific early symptoms,ESCC patients are usually diagnosed with advanced-stage disease with a poor prognosis,and the incidence and mortality rates are still high in many countries,especially in China.Therefore,enormous challenges still exist in the management of ESCC,and novel strategies are urgently needed to further decrease the incidence and mortality rates of ESCC.Although the key molecular mechanisms underlying ESCC pathogenesis have not been fully elucidated,certain promising biomarkers are being investigated to facilitate clinical decision-making.With the advent and advancement of highthroughput technologies,such as genomics,proteomics and metabolomics,valuable biomarkers with high sensitivity,specificity and stability could be identified for ESCC.Herein,we aimed to determine the epidemiological features of ESCC in different regions of the world,especially in China,and focused on novel molecular biomarkers associated with ESCC screening,early diagnosis and prognosis prediction.展开更多
BACKGROUND The liver imaging reporting and data system(LI-RADS)diagnostic table has 15 cells and is too complex.The diagnostic performance of LI-RADS for hepatocellular carcinoma(HCC)is not satisfactory on gadoxetic a...BACKGROUND The liver imaging reporting and data system(LI-RADS)diagnostic table has 15 cells and is too complex.The diagnostic performance of LI-RADS for hepatocellular carcinoma(HCC)is not satisfactory on gadoxetic acid-enhanced magnetic resonance imaging(EOB-MRI).AIM To evaluate the ability of the simplified LI-RADS(sLI-RADS)to diagnose HCC on EOB-MRI.METHODS A total of 331 patients with 356 hepatic observations were retrospectively analysed.The diagnostic performance of sLI-RADS A-D using a single threshold was evaluated and compared with LI-RADS v2018 to determine the optimal sLIRADS.The algorithms of sLI-RADS A-D are as follows:The single threshold for sLI-RADS A and B was 10 mm,that is,classified observations≥10mm using an algorithm of 10-19 mm observations(sLI-RADS A)and≥20 mm observations(sLI-RADS B)in the diagnosis table of LI-RADS v2018,respectively,while the classification algorithm remained unchanged for observations<10 mm;the single threshold for sLI-RADS C and D was 20 mm,that is,for<20 mm observations,the algorithms for<10 mm observations(sLI-RADS C)and 10-19 mm observations(sLI-RADS D)were used,respectively,while the algorithm remained unchanged for observations≥20 mm.With hepatobiliary phase(HBP)hypointensity as a major feature(MF),the final sLI-RADS(F-sLI-RADS)was formed according to the optimal sLI-RADS,and its diagnostic performance was evaluated.The times needed to classify the observations according to F-sLIRADS and LI-RADS v2018 were compared.RESULTS The optimal sLI-RADS was sLI-RADS D(with a single threshold of 20 mm),because its sensitivity was greater than that of LI-RADS v2018(89.8%vs 87.0%,P=0.031),and its specificity was not lower(89.4%vs 90.1%,P>0.999).With HBP hypointensity as an MF,the sensitivity of F-sLI-RADS was greater than that of LI-RADS v2018(93.0%vs 87.0%,P<0.001)and sLI-RADS D(93.0%vs 89.8%,P=0.016),without a lower specificity(86.5%vs 90.1%,P=0.062;86.5%vs 89.4%,P=0.125).Compared with that of LI-RADS v2018,the time to classify lesions according to FsLI-RADS was shorter(51±21 s vs 73±24 s,P<0.001).CONCLUSION The use of sLI-RADS with HBP hypointensity as an MF may improve the sensitivity of HCC diagnosis and reduce lesion classification time.展开更多
BACKGROUND Autoimmune pancreatitis(AIP)is a rare form of autoimmune-mediated pancrea-titis,which is easily misdiagnosed as pancreatic cancer and thus treated surgi-cally.We studied the diagnosis and treatment of a pat...BACKGROUND Autoimmune pancreatitis(AIP)is a rare form of autoimmune-mediated pancrea-titis,which is easily misdiagnosed as pancreatic cancer and thus treated surgi-cally.We studied the diagnosis and treatment of a patient with type 1 AIP recent-ly admitted to our hospital,and reviewed the literature to provide a reference for clinical diagnosis of AIP.CASE SUMMARY The chief complaint was yellowing of the body,eyes and urine for 21 d.The pa-tient's clinical presentation was obstructive jaundice and imaging suggested pan-creatic swelling.It was difficult to distinguish between inflammation and tumor.Serum immunoglobulin G4(IgG4)was markedly elevated.IgG4 is an important serological marker for type 1 AIP.The patient was diagnosed with AIP,IgG4-related cholangitis,acute cholecystitis and hepatic impairment.After applying hormonal therapy,the patient's symptoms improved significantly.At the same time,imaging suggested that pancreatic swelling subsided,and liver function and other biochemical indicators decreased.The treatment was effective.CONCLUSION In patients with pancreatic swelling,the possibility of AIP should be considered.展开更多
Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first diagnosis.If detected,early neoplastic lesions are ideal for surgery...Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first diagnosis.If detected,early neoplastic lesions are ideal for surgery,offering the best prognosis.Preneoplastic lesions of the pancreas include pancreatic intraepithelial neoplasia and mucinous cystic neoplasms,with intraductal papillary mucinous neoplasms being the most commonly diagnosed.Our study focused on predicting PC by identifying early signs using noninvasive techniques and artificial intelligence(AI).A systematic English literature search was conducted on the PubMed electronic database and other sources.We obtained a total of 97 studies on the subject of pancreatic neoplasms.The final number of articles included in our study was 44,34 of which focused on the use of AI algorithms in the early diagnosis and prediction of pancreatic lesions.AI algorithms can facilitate diagnosis by analyzing massive amounts of data in a short period of time.Correlations can be made through AI algorithms by expanding image and electronic medical records databases,which can later be used as part of a screening program for the general population.AI-based screening models should involve a combination of biomarkers and medical and imaging data from different sources.This requires large numbers of resources,collaboration between medical practitioners,and investment in medical infrastructures.展开更多
Pancreatic cancer(PC)is an aggressive and lethal neoplasm,ranking seventh in the world for cancer deaths,with an overall 5-year survival rate of below 10%.The knowledge about PC pathogenesis is rapidly expanding.New a...Pancreatic cancer(PC)is an aggressive and lethal neoplasm,ranking seventh in the world for cancer deaths,with an overall 5-year survival rate of below 10%.The knowledge about PC pathogenesis is rapidly expanding.New aspects of tumor biology,including its molecular and morphological heterogeneity,have been reported to explain the complicated“cross-talk”that occurs between the cancer cells and the tumor stroma or the nature of pancreatic ductal adenocarcinoma-associated neural remodeling.Nevertheless,currently,there are no specific and sensitive diagnosis options for PC.Vibrational spectroscopy(VS)shows a promising role in the development of early diagnosis technology.In this review,we summarize recent reports about improvements in spectroscopic methodologies,briefly explain and highlight the drawbacks of each of them,and discuss available solutions.The important aspects of spectroscopic data evaluation with multivariate analysis and a convolutional neural network methodology are depicted.We conclude by presenting a study design for systemic verification of the VS-based methods in the diagnosis of PC.展开更多
Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies and is developing into the 2nd leading cause of cancer-related death.Often,the clinical and radiological presentation of PDAC may be mirrore...Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies and is developing into the 2nd leading cause of cancer-related death.Often,the clinical and radiological presentation of PDAC may be mirrored by other inflammatory pancreatic masses,such as autoimmune pancreatitis(AIP)and massforming chronic pancreatitis(MFCP),making its diagnosis challenging.Differentiating AIP and MFCP from PDAC is vital due to significant therapeutic and prognostic implications.Current diagnostic criteria and tools allow the precise differentiation of benign from malignant masses;however,the diagnostic accuracy is imperfect.Major pancreatic resections have been performed in AIP cases under initial suspicion of PDAC after a diagnostic approach failed to provide an accurate diagnosis.It is not unusual that after a thorough diagnostic evaluation,the clinician is confronted with a pancreatic mass with uncertain diagnosis.In those cases,a re-evaluation must be entertained,preferably by an experienced multispecialty team including radiologists,pathologists,gastroenterologists,and surgeons,looking for disease-specific clinical,imaging,and histological hallmarks or collateral evidence that could favor a specific diagnosis.Our aim is to describe current diagnostic limitations that hinder our ability to reach an accurate diagnosis among AIP,PDAC,and MFCP and to highlight those disease-specific clinical,radiological,serological,and histological characteristics that could support the presence of any of these three disorders when facing a pancreatic mass with uncertain diagnosis after an initial diagnostic approach has been unsuccessful.展开更多
Artificial intelligence(AI)has been used in various fields of day-to-day life and its role in medicine is immense.Understanding of oncology has been improved with the introduction of AI which helps in diagnosis,treatm...Artificial intelligence(AI)has been used in various fields of day-to-day life and its role in medicine is immense.Understanding of oncology has been improved with the introduction of AI which helps in diagnosis,treatment planning,management,prognosis,and follow-up.It also helps to identify high-risk groups who can be subjected to timely screening for early detection of malignant conditions.It is more important in pancreatic cancer as it is one of the major causes of cancer-related deaths worldwide and there are no specific early features(clinical and radiological)for diagnosis.With improvement in imaging modalities(computed tomography,magnetic resonance imaging,endoscopic ultrasound),most often clinicians were being challenged with lesions that were difficult to diagnose with human competence.AI has been used in various other branches of medicine to differentiate such indeterminate lesions including the thyroid gland,breast,lungs,liver,adrenal gland,kidney,etc.In the case of pancreatic cancer,the role of AI has been explored and is still ongoing.This review article will focus on how AI can be used to diagnose pancreatic cancer early or differentiate it from benign pancreatic lesions,therefore,management can be planned at an earlier stage.展开更多
AIM: To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC). METHODS: A systematic review of relevant literatures in Pub...AIM: To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC). METHODS: A systematic review of relevant literatures in PubMed, Embase and Cochrane Library was performed. The sensitivity and specificity of diagnostic and staging studies, and HRs for prognosis predicting studies were pooled. The bivariate model was used for diagnostic studies and the random-effect model for prognostic studies. Heterogeneity between included studies was tested using χ 2 test, and subgroup analysis was performed to explain the heterogeneities. All of the calculations were performed using Stata version 11.0.RESULTS: A total of 39 studies were included. The pooled sensitivity of PET in diagnosing PC (30 studies, 1582 patients), evaluating N stating (4 studies, 101 patients) and liver metastasis (7 studies, 316 patients) were 0.91 (95%CI: 0.88-0.93), 0.64 (95%CI: 0.50-0.76), and 0.67 (95%CI: 0.52-0.79), respectively; and the corresponding specificity was 0.81 (95%CI: 0.75-0.85), 0.81 (95%CI: 0.25-0.85), and 0.96 (95%CI: 0.89-0.98), respectively. In prognosis analysis (6 studies, 198 patients), significant difference of overall survival was observed between high and low standardized uptake value groups (HR = 2.39, 95%CI: 1.57-3.63). Subgroup analysis showed that PET/CT was more sensitive than PET alone in evaluating liver metastasis of PC, 0.82 (95%CI: 0.48-0.98) and 0.67 (95%CI: 0.52-0.79), respectively. CONCLUSION: PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging of PC remains indeterminate.展开更多
AIM: To evaluate the utility of carbohydrate antigen19-9(CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.METHODS: We searched the literature for studies reporting the sensitivity, s...AIM: To evaluate the utility of carbohydrate antigen19-9(CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.METHODS: We searched the literature for studies reporting the sensitivity, specificity, and other accuracy measures of serum CA19-9 levels for differentiating pancreatic carcinoma and chronic pancreatitis.Pooled analysis was performed using random-effects models, and receiver operating characteristic(ROC) curves were generated.Study quality was assessed using Standards for Reporting Diagnostic Accuracy and Quality Assessment for Studies of Diagnostic Accuracy tools.RESULTS: A total of 34 studies involving 3125 patients with pancreatic carcinoma and 2061 patients with chronic pancreatitis were included.Pooled analysis of the ability of CA19-9 level to differentiate pancreatic carcinoma and chronic pancreatitis showed the following effect estimates: sensitivity, 0.81(95%CI: 0.80-0.83); specificity, 0.81(95%CI: 0.79-0.82); positive likelihood ratio, 4.08(95%CI: 3.39-4.91); negative likelihood ratio, 0.24(95%CI: 0.21-0.28); and diagnostic odds ratio, 19.31(95%CI: 14.40-25.90).The area under the ROC curve was 0.88.No significant publication bias was detected.CONCLUSION: Elevated CA19-9 by itself is insufficient for differentiating pancreatic carcinoma and chronic pancreatitis, however, it increases suspicion of pancreatic carcinoma and may complement other clinical findings to improve diagnostic accuracy.展开更多
BACKGROUND Mucinous cystic neoplasm(MCN)of the pancreas is characterized by mucinproducing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation.Early diagnosis and treatment of MC...BACKGROUND Mucinous cystic neoplasm(MCN)of the pancreas is characterized by mucinproducing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation.Early diagnosis and treatment of MCN are particularly important.AIM To investigate the clinical characteristics of and management strategies for pancreatic mucinous cystadenoma(MCA)and mucinous cystadenocarcinoma(MCC).METHODS The clinical and pathological data of 82 patients with pancreatic MCA and MCC who underwent surgical resection at our department between April 2015 and March 2019 were retrospectively analyzed.RESULTS Of the 82 patients included in this study,70 had MCA and 12 had MCC.Tumor size of MCC was larger than that of MCA(P=0.049).Age and serum levels of tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,and CA12-5 were significantly higher in MCC than in MCA patients(P=0.005,0.026,and 0.037,respectively).MCA tumor size was positively correlated with serum CA19-9 levels(r=0.389,P=0.001).Compared with MCC,MCA had a higher minimally invasive surgery rate(P=0.014).In the MCA group,the rate of major complications was 5.7%and that of clinically relevant pancreatic fistula was 8.6%;the corresponding rates in the MCC group were 16.7%and 16.7%,respectively.CONCLUSION Tumor size,age,and serum CEA,CA19-9,and CA12-5 levels may contribute to management of patients with MCN.Surgical resection is the primary treatment modality for MCC and MCA.展开更多
Objective: To evaluate the value of MR dynamic Gadolinium-enhanced fast multiplanar spoiled gradi- ent-echo (FMPSPGR) and spin-echo (SE) T1- weighted fat-suppressed techniques in the diagnosis of pancreatic carcinoma....Objective: To evaluate the value of MR dynamic Gadolinium-enhanced fast multiplanar spoiled gradi- ent-echo (FMPSPGR) and spin-echo (SE) T1- weighted fat-suppressed techniques in the diagnosis of pancreatic carcinoma. Methods: Eighteen cases of pancreatic carcinoma veri- fied by surgical and pathologic results were examined by MR, and the MR sequences included SE T1WI, FSE T2WI, SE T1-weighted fat-suppressed and dy- namic Gadolinium-enhanced FMPSPGR. Results: Of 18 pancreatic carcinomas, 10, 6, and 2 tumors showed respectively hypo-intensity, iso-inten- sity and hyper-intensity on SE T1WI, meanwhile, 8, 6, and 4 tumors displayed hyper-intensity, iso-inten- sity and hypo-intensity on FSE T2WI in comparison with the normal pancreatic tissue. All of the tumors showed hypo-intensity on SE T1-weighted fat-sup- pressed and also obvious non-enhancement or slight enhancement on MR dynamic Gadolinium-enhanced FMPSPGR images during the arterial dominant phase scanning. Conclusion: SE T1-weighted fat-suppressed and MR dynamic Gadolinium-enhanced FMPSPGR sequences could evidently improve the sensitivity and specificity in the diagnosis of pancreatic carcinoma.展开更多
Several advances in genetics, diagnosis and palliation of pancreatic cancer (PC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. PC is relatively common as it ...Several advances in genetics, diagnosis and palliation of pancreatic cancer (PC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. PC is relatively common as it is the fourth leading cause of cancer related mortality. Most patients present with obstructive jaundice, epigastric or back pain, weight loss and anorexia. Despite improvements in diagnostic modalities, the majority of cases are still detected in advanced stages. The only curative treatment for PC remains surgical resection. No more than 20% of patients are candidates for surgery at the time of diagnosis and survival remains quite poor as adjuvant therapies are not very effective. A small percentage of patients with borderline non-resectable PC might benefit from neo-adjuvant chemoradiation therapy enabling them to undergo resection; however, randomized controlled studies are needed to prove the benefits of this strategy. Patients with unresectable PC benefit from palliative interventions such as biliary decompression and celiac plexus block. Further clinical trials to evaluate new chemo and radiation protocols as well as identification of genetic markers for PC are needed to improve the overall survival of patients affected by PC, as the current overall 5-year survival rate of patients affected by PC is still less than 5%. The aim of this article is to review the most recent high quality literature on this topic.展开更多
Pancreatic carcinoma has a poor prognosis and early detection is essential for potentially curative resection. Despite the wide array of diagnostic tools, preoperative detection of small pancreatic carcinomas remains ...Pancreatic carcinoma has a poor prognosis and early detection is essential for potentially curative resection. Despite the wide array of diagnostic tools, preoperative detection of small pancreatic carcinomas remains difficult. We report a case of small pancreatic carcinoma of the head of pancreas with indeterminate findings on US, ERCP, MRI and EUS which was successfully diagnosed via fusion CT-PET. This case illustrates the utility of CT-PET in the diagnosis of patients with small pancreatic carcinoma with equivocal findings on conventional diagnostic modalities.展开更多
BACKGROUND Pancreatic metastases account for only a small proportion of all pancreatic malignancies.Isolated pancreatic metastasis from renal cell cancer(isPM-RCC)is extremely rare and may be difficult to differentiat...BACKGROUND Pancreatic metastases account for only a small proportion of all pancreatic malignancies.Isolated pancreatic metastasis from renal cell cancer(isPM-RCC)is extremely rare and may be difficult to differentiate from more common primary neoplasms.A history of nephrectomy is crucial for the diagnosis.CASE SUMMARY We report the case of a 64-year-old Asian man who was diagnosed with a mass in the pancreatic head using computed tomography.He had no related symptoms,and his medical history was unremarkable,except for unilateral nephrectomy performed to remove a“benign”tumor 19 years ago.All preoperative imaging findings suggested a diagnosis of pancreatic neuroendocrine tumor.However,ultrasound-guided biopsy revealed features of clear cell renal cell carcinoma(ccRCC).Re-examination of the specimen resected 19 years ago confirmed that he had a ccRCC.The pancreatic mass was resected and pathological examination confirmed isPM-RCC.CONCLUSION Misdiagnosis of isPM-RCC is common because of its rarity and the long interval from resection of the primary tumor and manifestation of the metastasis.The history of the previous surgery may be the only clue.展开更多
BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most ...BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.展开更多
Objective:To study the epidemiological features of pancreatic cystadenoma and cystadenocarcinoma in China during the last 10 years and to analyze the diagnosis and treatment.Methods:Reports on pancreatic cystadenoma a...Objective:To study the epidemiological features of pancreatic cystadenoma and cystadenocarcinoma in China during the last 10 years and to analyze the diagnosis and treatment.Methods:Reports on pancreatic cystadenoma and cystadenocarcinoma published from 2000 to 2009 were retrieved from various databases,such as WANFANG data,VIP web and China National Knowledge Infrastructure(CNKI).The epidemiological features of pancreatic cystadenoma and cystadenocarcinoma and its diagnosis and treatment were analyzed.Results:Totally 1 865 patients with pancreatic cystadenoma and cystadenocarcinoma were reported in China during the last 10 years.The male to female ratio was approximately 1:2.1.The accurate ages were reported in 1 536 cases,the average age of them was 50.8 years,whose average age from 40 to 60 years old accounted 75.9% of the patients.65.3% of the cases were located in East China and Central China.Abdominal pain was the main clinical manifestation and was found in 54.9% of the patients.Pancreatoduodenectomy and resection of body and tail of the pancreas were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.Conclusion:Pancreatic cystadenoma and cystadenocarcinoma were mainly found in older women in East and Central China.Preoperative diagnosis is difficult.Pancreatoduodenectomy and resection of pancreatic body and tail were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.展开更多
Hepatocellular carcinoma(HCC)is a common malignant tumor.At present,early diagnosis of HCC is dif-ficult and therapeutic methods are limited.Radiomics can achieve accurate quantitative evaluation of the lesions withou...Hepatocellular carcinoma(HCC)is a common malignant tumor.At present,early diagnosis of HCC is dif-ficult and therapeutic methods are limited.Radiomics can achieve accurate quantitative evaluation of the lesions without invasion,and has important value in the diagnosis and treatment of HCC.Radiomics fea-tures can predict the development of cancer in patients,serve as the basis for risk stratification of HCC patients,and help clinicians distinguish similar diseases,thus improving the diagnostic accuracy.Further-more,the prediction of the treatment outcomes helps determine the treatment plan.Radiomics is also helpful in predicting the HCC recurrence,disease-free survival and overall survival.This review summa-rized the role of radiomics in the diagnosis,treatment and prognosis of HCC.展开更多
Introduction:Among all malignant tumors of the digestive system,pancreatic carcinoma exhibits the highest mortality rate.Currently,prevention and effective treatment are urgent issues that need to be addressed.Methods...Introduction:Among all malignant tumors of the digestive system,pancreatic carcinoma exhibits the highest mortality rate.Currently,prevention and effective treatment are urgent issues that need to be addressed.Methods:The study focused on meiotic nuclear divisions 1(MND1),integrating data from the Gene Expression Profiling Interactive Analysis(GEPIA)database with prognostic survival analysis.Simultaneously,experiments at cellular level were employed to demonstrate the effect of MND1 on the proliferation and migration of PC.The small-molecule inhibitor of MND1 was used to suppress the migration of PC cells by knocking down MND1 using small interfering RNA(siRNA)in Patu-8988 and Panc1 cell lines.Results:The results of Cell Counting Kit-8 indicated that the suppression of MND1 resulted in a decrease in cell proliferation.Wound healing and Transwell assays revealed that MND1 knockdown reduced cell migration and invasion.Flow cytometry revealed that inhibiting MND1 hindered the cell cycle.Furthermore,MND1 could stimulate the proliferation,migration,and invasion of Patu-8988 and Panc1 cells by increasing the expression of MND1.Notably,MND1 had a positive effect on H2AFX expression in PC cells.Elevated MND1 expression suggests the low overall survival rate of individuals diagnosed with PC.Conclusion:These findings suggest that MND1 has the potential to be a gene with the ability to accurately diagnose and treat PC.展开更多
文摘Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This article aims to un-derscore the promising role of emerging imaging aspects that may facilitate the earlier diagnosis of PC,thereby improving its management and prognosis.
基金Supported by Xi’an Municipal Health Commission of China,No.2022qn07 and No.2023ms11.
文摘As a highly invasive carcinoma,esophageal cancer(EC)was the eighth most prevalent malignancy and the sixth leading cause of cancer-related death worldwide in 2020.Esophageal squamous cell carcinoma(ESCC)is the major histological subtype of EC,and its incidence and mortality rates are decreasing globally.Due to the lack of specific early symptoms,ESCC patients are usually diagnosed with advanced-stage disease with a poor prognosis,and the incidence and mortality rates are still high in many countries,especially in China.Therefore,enormous challenges still exist in the management of ESCC,and novel strategies are urgently needed to further decrease the incidence and mortality rates of ESCC.Although the key molecular mechanisms underlying ESCC pathogenesis have not been fully elucidated,certain promising biomarkers are being investigated to facilitate clinical decision-making.With the advent and advancement of highthroughput technologies,such as genomics,proteomics and metabolomics,valuable biomarkers with high sensitivity,specificity and stability could be identified for ESCC.Herein,we aimed to determine the epidemiological features of ESCC in different regions of the world,especially in China,and focused on novel molecular biomarkers associated with ESCC screening,early diagnosis and prognosis prediction.
基金by The Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-074C.
文摘BACKGROUND The liver imaging reporting and data system(LI-RADS)diagnostic table has 15 cells and is too complex.The diagnostic performance of LI-RADS for hepatocellular carcinoma(HCC)is not satisfactory on gadoxetic acid-enhanced magnetic resonance imaging(EOB-MRI).AIM To evaluate the ability of the simplified LI-RADS(sLI-RADS)to diagnose HCC on EOB-MRI.METHODS A total of 331 patients with 356 hepatic observations were retrospectively analysed.The diagnostic performance of sLI-RADS A-D using a single threshold was evaluated and compared with LI-RADS v2018 to determine the optimal sLIRADS.The algorithms of sLI-RADS A-D are as follows:The single threshold for sLI-RADS A and B was 10 mm,that is,classified observations≥10mm using an algorithm of 10-19 mm observations(sLI-RADS A)and≥20 mm observations(sLI-RADS B)in the diagnosis table of LI-RADS v2018,respectively,while the classification algorithm remained unchanged for observations<10 mm;the single threshold for sLI-RADS C and D was 20 mm,that is,for<20 mm observations,the algorithms for<10 mm observations(sLI-RADS C)and 10-19 mm observations(sLI-RADS D)were used,respectively,while the algorithm remained unchanged for observations≥20 mm.With hepatobiliary phase(HBP)hypointensity as a major feature(MF),the final sLI-RADS(F-sLI-RADS)was formed according to the optimal sLI-RADS,and its diagnostic performance was evaluated.The times needed to classify the observations according to F-sLIRADS and LI-RADS v2018 were compared.RESULTS The optimal sLI-RADS was sLI-RADS D(with a single threshold of 20 mm),because its sensitivity was greater than that of LI-RADS v2018(89.8%vs 87.0%,P=0.031),and its specificity was not lower(89.4%vs 90.1%,P>0.999).With HBP hypointensity as an MF,the sensitivity of F-sLI-RADS was greater than that of LI-RADS v2018(93.0%vs 87.0%,P<0.001)and sLI-RADS D(93.0%vs 89.8%,P=0.016),without a lower specificity(86.5%vs 90.1%,P=0.062;86.5%vs 89.4%,P=0.125).Compared with that of LI-RADS v2018,the time to classify lesions according to FsLI-RADS was shorter(51±21 s vs 73±24 s,P<0.001).CONCLUSION The use of sLI-RADS with HBP hypointensity as an MF may improve the sensitivity of HCC diagnosis and reduce lesion classification time.
文摘BACKGROUND Autoimmune pancreatitis(AIP)is a rare form of autoimmune-mediated pancrea-titis,which is easily misdiagnosed as pancreatic cancer and thus treated surgi-cally.We studied the diagnosis and treatment of a patient with type 1 AIP recent-ly admitted to our hospital,and reviewed the literature to provide a reference for clinical diagnosis of AIP.CASE SUMMARY The chief complaint was yellowing of the body,eyes and urine for 21 d.The pa-tient's clinical presentation was obstructive jaundice and imaging suggested pan-creatic swelling.It was difficult to distinguish between inflammation and tumor.Serum immunoglobulin G4(IgG4)was markedly elevated.IgG4 is an important serological marker for type 1 AIP.The patient was diagnosed with AIP,IgG4-related cholangitis,acute cholecystitis and hepatic impairment.After applying hormonal therapy,the patient's symptoms improved significantly.At the same time,imaging suggested that pancreatic swelling subsided,and liver function and other biochemical indicators decreased.The treatment was effective.CONCLUSION In patients with pancreatic swelling,the possibility of AIP should be considered.
文摘Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first diagnosis.If detected,early neoplastic lesions are ideal for surgery,offering the best prognosis.Preneoplastic lesions of the pancreas include pancreatic intraepithelial neoplasia and mucinous cystic neoplasms,with intraductal papillary mucinous neoplasms being the most commonly diagnosed.Our study focused on predicting PC by identifying early signs using noninvasive techniques and artificial intelligence(AI).A systematic English literature search was conducted on the PubMed electronic database and other sources.We obtained a total of 97 studies on the subject of pancreatic neoplasms.The final number of articles included in our study was 44,34 of which focused on the use of AI algorithms in the early diagnosis and prediction of pancreatic lesions.AI algorithms can facilitate diagnosis by analyzing massive amounts of data in a short period of time.Correlations can be made through AI algorithms by expanding image and electronic medical records databases,which can later be used as part of a screening program for the general population.AI-based screening models should involve a combination of biomarkers and medical and imaging data from different sources.This requires large numbers of resources,collaboration between medical practitioners,and investment in medical infrastructures.
基金The National Science Centre,Poland Under The“OPUS 19”Project,No.UMO-2020/37/B/ST4/02990.
文摘Pancreatic cancer(PC)is an aggressive and lethal neoplasm,ranking seventh in the world for cancer deaths,with an overall 5-year survival rate of below 10%.The knowledge about PC pathogenesis is rapidly expanding.New aspects of tumor biology,including its molecular and morphological heterogeneity,have been reported to explain the complicated“cross-talk”that occurs between the cancer cells and the tumor stroma or the nature of pancreatic ductal adenocarcinoma-associated neural remodeling.Nevertheless,currently,there are no specific and sensitive diagnosis options for PC.Vibrational spectroscopy(VS)shows a promising role in the development of early diagnosis technology.In this review,we summarize recent reports about improvements in spectroscopic methodologies,briefly explain and highlight the drawbacks of each of them,and discuss available solutions.The important aspects of spectroscopic data evaluation with multivariate analysis and a convolutional neural network methodology are depicted.We conclude by presenting a study design for systemic verification of the VS-based methods in the diagnosis of PC.
文摘Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies and is developing into the 2nd leading cause of cancer-related death.Often,the clinical and radiological presentation of PDAC may be mirrored by other inflammatory pancreatic masses,such as autoimmune pancreatitis(AIP)and massforming chronic pancreatitis(MFCP),making its diagnosis challenging.Differentiating AIP and MFCP from PDAC is vital due to significant therapeutic and prognostic implications.Current diagnostic criteria and tools allow the precise differentiation of benign from malignant masses;however,the diagnostic accuracy is imperfect.Major pancreatic resections have been performed in AIP cases under initial suspicion of PDAC after a diagnostic approach failed to provide an accurate diagnosis.It is not unusual that after a thorough diagnostic evaluation,the clinician is confronted with a pancreatic mass with uncertain diagnosis.In those cases,a re-evaluation must be entertained,preferably by an experienced multispecialty team including radiologists,pathologists,gastroenterologists,and surgeons,looking for disease-specific clinical,imaging,and histological hallmarks or collateral evidence that could favor a specific diagnosis.Our aim is to describe current diagnostic limitations that hinder our ability to reach an accurate diagnosis among AIP,PDAC,and MFCP and to highlight those disease-specific clinical,radiological,serological,and histological characteristics that could support the presence of any of these three disorders when facing a pancreatic mass with uncertain diagnosis after an initial diagnostic approach has been unsuccessful.
文摘Artificial intelligence(AI)has been used in various fields of day-to-day life and its role in medicine is immense.Understanding of oncology has been improved with the introduction of AI which helps in diagnosis,treatment planning,management,prognosis,and follow-up.It also helps to identify high-risk groups who can be subjected to timely screening for early detection of malignant conditions.It is more important in pancreatic cancer as it is one of the major causes of cancer-related deaths worldwide and there are no specific early features(clinical and radiological)for diagnosis.With improvement in imaging modalities(computed tomography,magnetic resonance imaging,endoscopic ultrasound),most often clinicians were being challenged with lesions that were difficult to diagnose with human competence.AI has been used in various other branches of medicine to differentiate such indeterminate lesions including the thyroid gland,breast,lungs,liver,adrenal gland,kidney,etc.In the case of pancreatic cancer,the role of AI has been explored and is still ongoing.This review article will focus on how AI can be used to diagnose pancreatic cancer early or differentiate it from benign pancreatic lesions,therefore,management can be planned at an earlier stage.
基金Supported by Grant from The Natural Science Foundation of Guangxi Zhuang Autonomous Region of China, No. 0832113 and 2012GXNSFDA239001the Research Project of Guangxi Education Department, No. 201012MS062
文摘AIM: To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC). METHODS: A systematic review of relevant literatures in PubMed, Embase and Cochrane Library was performed. The sensitivity and specificity of diagnostic and staging studies, and HRs for prognosis predicting studies were pooled. The bivariate model was used for diagnostic studies and the random-effect model for prognostic studies. Heterogeneity between included studies was tested using χ 2 test, and subgroup analysis was performed to explain the heterogeneities. All of the calculations were performed using Stata version 11.0.RESULTS: A total of 39 studies were included. The pooled sensitivity of PET in diagnosing PC (30 studies, 1582 patients), evaluating N stating (4 studies, 101 patients) and liver metastasis (7 studies, 316 patients) were 0.91 (95%CI: 0.88-0.93), 0.64 (95%CI: 0.50-0.76), and 0.67 (95%CI: 0.52-0.79), respectively; and the corresponding specificity was 0.81 (95%CI: 0.75-0.85), 0.81 (95%CI: 0.25-0.85), and 0.96 (95%CI: 0.89-0.98), respectively. In prognosis analysis (6 studies, 198 patients), significant difference of overall survival was observed between high and low standardized uptake value groups (HR = 2.39, 95%CI: 1.57-3.63). Subgroup analysis showed that PET/CT was more sensitive than PET alone in evaluating liver metastasis of PC, 0.82 (95%CI: 0.48-0.98) and 0.67 (95%CI: 0.52-0.79), respectively. CONCLUSION: PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging of PC remains indeterminate.
文摘AIM: To evaluate the utility of carbohydrate antigen19-9(CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.METHODS: We searched the literature for studies reporting the sensitivity, specificity, and other accuracy measures of serum CA19-9 levels for differentiating pancreatic carcinoma and chronic pancreatitis.Pooled analysis was performed using random-effects models, and receiver operating characteristic(ROC) curves were generated.Study quality was assessed using Standards for Reporting Diagnostic Accuracy and Quality Assessment for Studies of Diagnostic Accuracy tools.RESULTS: A total of 34 studies involving 3125 patients with pancreatic carcinoma and 2061 patients with chronic pancreatitis were included.Pooled analysis of the ability of CA19-9 level to differentiate pancreatic carcinoma and chronic pancreatitis showed the following effect estimates: sensitivity, 0.81(95%CI: 0.80-0.83); specificity, 0.81(95%CI: 0.79-0.82); positive likelihood ratio, 4.08(95%CI: 3.39-4.91); negative likelihood ratio, 0.24(95%CI: 0.21-0.28); and diagnostic odds ratio, 19.31(95%CI: 14.40-25.90).The area under the ROC curve was 0.88.No significant publication bias was detected.CONCLUSION: Elevated CA19-9 by itself is insufficient for differentiating pancreatic carcinoma and chronic pancreatitis, however, it increases suspicion of pancreatic carcinoma and may complement other clinical findings to improve diagnostic accuracy.
文摘BACKGROUND Mucinous cystic neoplasm(MCN)of the pancreas is characterized by mucinproducing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation.Early diagnosis and treatment of MCN are particularly important.AIM To investigate the clinical characteristics of and management strategies for pancreatic mucinous cystadenoma(MCA)and mucinous cystadenocarcinoma(MCC).METHODS The clinical and pathological data of 82 patients with pancreatic MCA and MCC who underwent surgical resection at our department between April 2015 and March 2019 were retrospectively analyzed.RESULTS Of the 82 patients included in this study,70 had MCA and 12 had MCC.Tumor size of MCC was larger than that of MCA(P=0.049).Age and serum levels of tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,and CA12-5 were significantly higher in MCC than in MCA patients(P=0.005,0.026,and 0.037,respectively).MCA tumor size was positively correlated with serum CA19-9 levels(r=0.389,P=0.001).Compared with MCC,MCA had a higher minimally invasive surgery rate(P=0.014).In the MCA group,the rate of major complications was 5.7%and that of clinically relevant pancreatic fistula was 8.6%;the corresponding rates in the MCC group were 16.7%and 16.7%,respectively.CONCLUSION Tumor size,age,and serum CEA,CA19-9,and CA12-5 levels may contribute to management of patients with MCN.Surgical resection is the primary treatment modality for MCC and MCA.
文摘Objective: To evaluate the value of MR dynamic Gadolinium-enhanced fast multiplanar spoiled gradi- ent-echo (FMPSPGR) and spin-echo (SE) T1- weighted fat-suppressed techniques in the diagnosis of pancreatic carcinoma. Methods: Eighteen cases of pancreatic carcinoma veri- fied by surgical and pathologic results were examined by MR, and the MR sequences included SE T1WI, FSE T2WI, SE T1-weighted fat-suppressed and dy- namic Gadolinium-enhanced FMPSPGR. Results: Of 18 pancreatic carcinomas, 10, 6, and 2 tumors showed respectively hypo-intensity, iso-inten- sity and hyper-intensity on SE T1WI, meanwhile, 8, 6, and 4 tumors displayed hyper-intensity, iso-inten- sity and hypo-intensity on FSE T2WI in comparison with the normal pancreatic tissue. All of the tumors showed hypo-intensity on SE T1-weighted fat-sup- pressed and also obvious non-enhancement or slight enhancement on MR dynamic Gadolinium-enhanced FMPSPGR images during the arterial dominant phase scanning. Conclusion: SE T1-weighted fat-suppressed and MR dynamic Gadolinium-enhanced FMPSPGR sequences could evidently improve the sensitivity and specificity in the diagnosis of pancreatic carcinoma.
文摘Several advances in genetics, diagnosis and palliation of pancreatic cancer (PC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. PC is relatively common as it is the fourth leading cause of cancer related mortality. Most patients present with obstructive jaundice, epigastric or back pain, weight loss and anorexia. Despite improvements in diagnostic modalities, the majority of cases are still detected in advanced stages. The only curative treatment for PC remains surgical resection. No more than 20% of patients are candidates for surgery at the time of diagnosis and survival remains quite poor as adjuvant therapies are not very effective. A small percentage of patients with borderline non-resectable PC might benefit from neo-adjuvant chemoradiation therapy enabling them to undergo resection; however, randomized controlled studies are needed to prove the benefits of this strategy. Patients with unresectable PC benefit from palliative interventions such as biliary decompression and celiac plexus block. Further clinical trials to evaluate new chemo and radiation protocols as well as identification of genetic markers for PC are needed to improve the overall survival of patients affected by PC, as the current overall 5-year survival rate of patients affected by PC is still less than 5%. The aim of this article is to review the most recent high quality literature on this topic.
文摘Pancreatic carcinoma has a poor prognosis and early detection is essential for potentially curative resection. Despite the wide array of diagnostic tools, preoperative detection of small pancreatic carcinomas remains difficult. We report a case of small pancreatic carcinoma of the head of pancreas with indeterminate findings on US, ERCP, MRI and EUS which was successfully diagnosed via fusion CT-PET. This case illustrates the utility of CT-PET in the diagnosis of patients with small pancreatic carcinoma with equivocal findings on conventional diagnostic modalities.
文摘BACKGROUND Pancreatic metastases account for only a small proportion of all pancreatic malignancies.Isolated pancreatic metastasis from renal cell cancer(isPM-RCC)is extremely rare and may be difficult to differentiate from more common primary neoplasms.A history of nephrectomy is crucial for the diagnosis.CASE SUMMARY We report the case of a 64-year-old Asian man who was diagnosed with a mass in the pancreatic head using computed tomography.He had no related symptoms,and his medical history was unremarkable,except for unilateral nephrectomy performed to remove a“benign”tumor 19 years ago.All preoperative imaging findings suggested a diagnosis of pancreatic neuroendocrine tumor.However,ultrasound-guided biopsy revealed features of clear cell renal cell carcinoma(ccRCC).Re-examination of the specimen resected 19 years ago confirmed that he had a ccRCC.The pancreatic mass was resected and pathological examination confirmed isPM-RCC.CONCLUSION Misdiagnosis of isPM-RCC is common because of its rarity and the long interval from resection of the primary tumor and manifestation of the metastasis.The history of the previous surgery may be the only clue.
文摘BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.
文摘Objective:To study the epidemiological features of pancreatic cystadenoma and cystadenocarcinoma in China during the last 10 years and to analyze the diagnosis and treatment.Methods:Reports on pancreatic cystadenoma and cystadenocarcinoma published from 2000 to 2009 were retrieved from various databases,such as WANFANG data,VIP web and China National Knowledge Infrastructure(CNKI).The epidemiological features of pancreatic cystadenoma and cystadenocarcinoma and its diagnosis and treatment were analyzed.Results:Totally 1 865 patients with pancreatic cystadenoma and cystadenocarcinoma were reported in China during the last 10 years.The male to female ratio was approximately 1:2.1.The accurate ages were reported in 1 536 cases,the average age of them was 50.8 years,whose average age from 40 to 60 years old accounted 75.9% of the patients.65.3% of the cases were located in East China and Central China.Abdominal pain was the main clinical manifestation and was found in 54.9% of the patients.Pancreatoduodenectomy and resection of body and tail of the pancreas were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.Conclusion:Pancreatic cystadenoma and cystadenocarcinoma were mainly found in older women in East and Central China.Preoperative diagnosis is difficult.Pancreatoduodenectomy and resection of pancreatic body and tail were the main procedure for the treatment of pancreatic cystadenoma and cystadenocarcinoma.
基金supported by grants from the National Natural Science Foundation of China(82272396)Suzhou Medical and Health Science and Technology Innovation Project(SKY2022057).
文摘Hepatocellular carcinoma(HCC)is a common malignant tumor.At present,early diagnosis of HCC is dif-ficult and therapeutic methods are limited.Radiomics can achieve accurate quantitative evaluation of the lesions without invasion,and has important value in the diagnosis and treatment of HCC.Radiomics fea-tures can predict the development of cancer in patients,serve as the basis for risk stratification of HCC patients,and help clinicians distinguish similar diseases,thus improving the diagnostic accuracy.Further-more,the prediction of the treatment outcomes helps determine the treatment plan.Radiomics is also helpful in predicting the HCC recurrence,disease-free survival and overall survival.This review summa-rized the role of radiomics in the diagnosis,treatment and prognosis of HCC.
基金supported by grants from National Innovation Program for College Students(202210367076)Graduate Student Research Innovation Program of Bengbu Medical College(Byycxz22016)the National Natural Science Foundation of China(82072585),and the Key Research Project of Bengbu Medical College(No.2020byzd029).
文摘Introduction:Among all malignant tumors of the digestive system,pancreatic carcinoma exhibits the highest mortality rate.Currently,prevention and effective treatment are urgent issues that need to be addressed.Methods:The study focused on meiotic nuclear divisions 1(MND1),integrating data from the Gene Expression Profiling Interactive Analysis(GEPIA)database with prognostic survival analysis.Simultaneously,experiments at cellular level were employed to demonstrate the effect of MND1 on the proliferation and migration of PC.The small-molecule inhibitor of MND1 was used to suppress the migration of PC cells by knocking down MND1 using small interfering RNA(siRNA)in Patu-8988 and Panc1 cell lines.Results:The results of Cell Counting Kit-8 indicated that the suppression of MND1 resulted in a decrease in cell proliferation.Wound healing and Transwell assays revealed that MND1 knockdown reduced cell migration and invasion.Flow cytometry revealed that inhibiting MND1 hindered the cell cycle.Furthermore,MND1 could stimulate the proliferation,migration,and invasion of Patu-8988 and Panc1 cells by increasing the expression of MND1.Notably,MND1 had a positive effect on H2AFX expression in PC cells.Elevated MND1 expression suggests the low overall survival rate of individuals diagnosed with PC.Conclusion:These findings suggest that MND1 has the potential to be a gene with the ability to accurately diagnose and treat PC.