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ABSTRACT Background: The treatment of chronic pancreatitis does not consistently solve intestinal abnormalities, and despite the implementation of various therapeutic measures, patients often continue to experience persistent diarrhea. Therefore, it is imperative to recognize that diarrhea may stem from factors beyond pancreatic insufficiency, and intestinal inflammation emerges as a potential contributing factor. Objective: The aim of this study was to assess fecal lactoferrin and calprotectin levels as indicators of intestinal inflammation in patients with chronic pancreatitis experiencing persistent diarrhea. Methods: In this study, 23 male patients with chronic pancreatitis primarily attributed to alcohol consumption and presenting with diarrhea (classified as Bristol stool scale type 6 or 7), underwent a comprehensive evaluation of their clinical and nutritional status. Fecal lactoferrin and calprotectin levels were measured utilizing immunoassay techniques. Results: The average age of the participants was 54.8 years, 43.5% had diabetes, and 73.9% were smokers. Despite receiving enzyme replacement therapy and refraining from alcohol for over 4 years, all participants exhibited persistent diarrhea, accompanied by elevated calprotectin and lactoferrin levels indicative of ongoing intestinal inflammation. Conclusion: The findings of this study underscore that intestinal inflammation, as evidenced by elevated fecal biomarkers calprotectin and lactoferrin, may contribute to explaining the persistence of diarrhea in patients with chronic pancreatitis.
RESUMO Contexto: O tratamento da pancreatite crônica não resolve de forma consistente as anomalias intestinais e, apesar da implementação de várias medidas terapêuticas, os pacientes muitas vezes continuam a apresentar diarreia persistente. Portanto, é imperativo reconhecer que a diarreia pode resultar de fatores além da insuficiência pancreática, e a inflamação intestinal surge como um potencial fator contribuinte. Objetivo: O objetivo deste estudo foi avaliar os níveis fecais de lactoferrina e calprotectina como indicadores de inflamação intestinal em pacientes com pancreatite crônica com diarreia persistente. Métodos: Neste estudo, 23 pacientes do sexo masculino com pancreatite crônica atribuída principalmente ao consumo de álcool e apresentando diarreia (classificada na escala de fezes de Bristol tipo 6 ou 7), foram submetidos a uma avaliação abrangente de seu estado clínico e nutricional. Os níveis fecais de lactoferrina e calprotectina foram medidos utilizando técnicas de imunoensaio. Resultados: A idade média dos participantes foi de 54,8 anos, 43,5% tinham diabetes e 73,9% eram fumantes. Apesar de receber terapia de reposição enzimática e abster-se de álcool por mais de 4 anos, todos os participantes apresentaram diarreia persistente, acompanhada por níveis elevados de calprotectina e lactoferrina, indicativos de inflamação intestinal contínua. Conclusão: Os achados deste estudo ressaltam que a inflamação intestinal, evidenciada pelos biomarcadores fecais elevados calprotectina e lactoferrina, pode contribuir para explicar a persistência da diarreia em pacientes com pancreatite crônica.
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Pancreatic exocrine insufficiency (PEI) refers to insufficient or non-synchronous secretion of trypsin caused by various reasons, resulting in dyspepsia and other symptoms. Intestinal microbiota is a large number of microbiota on the surface of intestinal mucosa. Its main functions include intestinal immune function, forming intestinal biological barrier and participating in the regulation of nutrition and metabolism. Due to aging, some elderly people often have unexplained chronic pancreatic insufficiency, which is often characterized by unexplained weight loss and malnutrition. Several studies have shown that the composition of intestinal microbiota changes significantly with age. This article focuses on aging and its related PEI and then reviews its possible effects on intestinal microbiota, in order to provide a reference basis for individualized prevention and treatment strategies according to the changes of pancreatic exocrine function and microbiota in the elderly.
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Objective:To examine the expression of core clock genes in the peripheral blood mononuclear cells (PBMCs) and the level of circadian disturbance-related proteins in the serum of chronic pancreatitis (CP) patients with pancreatic exocrine insufficiency (PEI), and explore their potential diagnostic value in clinical practice.Methods:The peripheral blood samples and related clinical data from 68 patients diagnosed with CP in Shanghai General Hospital from Jan 2015 to Jan 2022 were collected. Peripheral blood samples from 30 healthy individuals were used for control. The M-ANNHEIM classification system was used to stratify the clinical stages of patients with CP. The mRNA expression of the core clock genes, including Clock, Bmal1, Per1/2/3 and Cry1/2 in PBMCs was analyzed using realtime qPCR, and the expression of circadian disturbance-related proteins like TrkB, CD 36 and Rbp in serum was measured with ELISA. The receiver operating characteristic curve(ROC) and the area under curve (AUC) was used to test the efficiency for diagnozing PEI. Results:The mRNA expression of Per1 in CP patients was significantly decreased (0.76 vs 1, P<0.05), and the AUC for diagnozing PEI was 0.744 (95% CI 0.628-0.860), with a cut-off value of 0.72; and the sensitivity and specificity was 84.8% and 57.1%, respectively. The protein abundance of serum CD 36 was significantly increased in CP patients (33.85±19.74ng/ml vs 24.71±11.53 ng/ml, P<0.05); the AUC for diagnozing PEI was 0.834 (95% CI 0.735-0.932), with a cut-off value of 29.75 pg/ml; and the sensitivity and specificity was 74.3% and 84.8%, respectively. The expression of CD 36 was increased with the increase of CP clinical stage, and there were statistically significant differences between either two stages (all P value <0.05). The mRNA expression of Per1 in patients with CP in Stage Ⅰ was significantly higher than that in patients with CP in Stage Ⅱ or Ⅲ, and the differences were statistically significant ( P<0.05), but no statistical difference was found between Stage Ⅱ and Stage Ⅲ. Conclusions:The decreased expression of Per1 mRNA in PBMCs and increased level of CD 36 in serum are significantly related to the occurrence of PEI in CP, suggesting that they may have potential value for diagnozing PEI and guiding the clinical practice.
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The evaluation of pancreatic function includes the evaluation of endocrine function and exocrine function.Insufficiency of pancreatic endocrine function can lead to pancreatic related diabetes.The pancreatic endocrine function is often evaluated by fasting blood glucose, two hours postprandial blood glucose, and glycosylated hemoglobin.Pancreatic exocrine dysfunction can lead to abdominal pain, abdominal distension, fatty diarrhea, malnutrition, weight loss and other manifestations.Pancreatic exocrine dysfunction is often atypical, and it is difficult to accurately evaluate pancreatic exocrine function, so the evaluation of pancreatic exocrine function is particularly important.There are indirect and direct methods to evaluate pancreatic exocrine function.At present, the most commonly used direct detection method is the detection of pancreatic function under intravenous anesthesia endoscope.Fecal elastase-1 is a commonly used indirect detection method at present.
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Dyspepsia is the one of the most common clinical manifestations of digestive system diseases and has various and complex causes， among which pancreatic tumor is a relatively uncommon cause and is easily neglected in clinical practice. The dual factors of tumor and dyspepsia may cause a significant reduction in the quality of life of patients. At present， there is still a lack of standardized diagnosis and treatment strategies for dyspepsia associated with pancreatic tumors， and this article reviews the diagnosis and treatment of this disease.
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Dyspepsia due to pancreatic exocrine insufficiency is a common complication after pancreatectomy； however， due to the lack of simple， efficient， and unified diagnostic methods， standardized treatment standards， and awareness of this disease among surgeons， it is difficult to get adequate diagnosis and treatment. Therefore， this article summarizes the research advances in the definition and pathogenesis of pancreatic exocrine insufficiency， the incidence rate of pancreatic exocrine insufficiency after different surgical procedures， and current diagnostic methods and treatment strategies， in order to provide a reference for further improving the diagnosis and treatment of pancreatic exocrine insufficiency after pancreatectomy.
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Dyspepsia is a common group of clinical symptoms and can be classified into organic and functional dyspepsia. Patients with chronic pancreatitis （CP） often have the symptoms of dyspepsia such as fatty diarrhea， abdominal distention， and abdominal pain， and most patients have pancreatic exocrine insufficiency （PEI）， which belongs to organic dyspepsia. In clinical practice， the diagnosis of PEI and dyspepsia requires a comprehensive assessment of clinical manifestations， nutritional status， and pancreatic exocrine function， and an individualized treatment regimen should be developed based on such factors. However， some patients with normal exocrine function may have the symptoms of dyspepsia， and the diagnosis and treatment of such patients are still difficulties in clinical practice. This article reviews the advances in the diagnosis and treatment of dyspepsia in CP patients.
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Various pancreatic diseases can cause dyspepsia due to pancreatic exocrine insufficiency （PEI） caused by pancreatic parenchymal injury and/or pancreatic duct obstruction， which further leads to impaired digestive function and a series of severe clinical outcomes such as malnutrition， weight loss， and shortened survival time. Therefore， pancreatic disease-related dyspepsia should be taken seriously in clinical practice to improve its diagnosis and treatment rates， so as to improve the quality of life of patients with pancreatic diseases and prolong overall survival time.
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La fibrosis quística (FQ) es un trastorno hereditario, de las glándulas de secreción exocrina, considerada la causa más frecuente de insuficiencia pancreática exocrina (IPE) en la infancia. Esta revisión resume el panorama del tratamiento de reposición enzimática en la IPE asociada a la FQ, las formulaciones disponibles, su dosificación y modo de administración, así como las limitaciones y desafíos actuales y las posibles áreas del desarrollo futuro
Cystic fibrosis (CF) is an inherited disorder of the exocrine secretion glands, considered the most frequent cause of exocrine pancreatic insufficiency (EPI) in childhood. This review summarizes the landscape of enzyme replacement therapy in PEI associated with CF, the available formulations, their dosage and mode of administration, as well as the current limitations and challenges and potential areas for future development.
Subject(s)
Cystic Fibrosis , Exocrine Pancreatic Insufficiency , Enzyme Replacement TherapyABSTRACT
Introduction: Fetal biometric parameters are very often utilized for calculating gestational age. The pancreas is a gland with dual functions in our body – exocrine and endocrine, with the latter component being very often discussed in the context of diabetes mellitus. Through evaluation of variations in morphometry in relation to different gestational ages, the research intends to draw attention to various associated developmental correlations that were not mentioned in previous studies. MaterialsandMethods: The current research was carried out on 30 fetuses after obtaining due approval from Institute’s Ethical Committee. Fetuses were divided into different gestational age groups and morphometric parameters such as crown‑rump length, crown heel length, head circumference, abdomen circumference, chest circumference, hand length, and Foot Length (FL) were noted by measuring with nylon thread in centimetres. Fetal pancreases were removed after stepwise dissection and pancreatic weight along with length and thickness was measured by Vernier calipers. All the parameters were then compared within different gestational age groups. Results: All the parameters and the age group of fetuses were positively correlated and showed statistical significance.Conclusion: The study would add substantial knowledge in the areas of pancreatic regeneration, surgical pancreatectomy, and treatment protocols for diabetes mellitus and pancreatic cancer. Through evaluation of variations in morphometry in relation to different gestational ages, the research intends to draw attention to various associated developmental correlations
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Background : Exocrine pancreatic insufficiency (EPI), characterized by reduced secretion or activity of pancreatic enzymes, causes improper absorption of food, excessive fat excretion in the stool, and malnourishment. Methods : In this observational, real-world evidence study, patients with one or more of the following condition were enrolled: abdominal pain, acidity, diarrhea, nausea, or dyspepsia (as per ROME III criteria). Patients had either been diagnosed with gallstones, hypertriglyceridemia, alcohol consumption or undergone abdominal surgery. Patients were prescribed capsule EnzigestTM10000 (pancreatin minimicrospheres) for one month.The severity and frequency of various gastric symptoms was measured at day 0 and day 30. Results : 540 patients were enrolled with a mean age of 51.6 years. Enzigest significantly reduced the severity of functional dyspepsia by 88.67% (p<0.001) as per Rome III Criteria. There is significant improvement in frequency of symptoms (83.80%), abdominal pain severit(81.58%), epigastric pain (83.09%), nausea (84.35%) and vomiting by 89.62% (all P<0.001). The overall improvement in symptoms was significant (p<0.001). Enzigest was well tolerated.Conclusion : Enzigest improved abdominal pain, dyspepsia, and acidity in patients with exocrine pancreatic insufficiency due to alcohol consumption, gallstones, hypertriglyceridemia, diuretic (Furosemide or Thiazide) or abdominal surgery. Enzigest containing pancreatin minimicrospheres can be an easy therapeutic option to counteract EPI.
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La pancreatitis crónica (PC) es una enfermedad de incidencia creciente en la población pediátrica, aunque desconocida, y conlleva una importante comorbilidad. La clínica inicial suele ser la propia de un episodio de pancreatitis aguda pero la importancia recae en el desarrollo, al cabo de meses o años, de insuficiencia pancreática. Para su diagnóstico será necesario tener un alto índice de sospecha clínica y realizar pruebas de imagen que demuestren cambios propios de la PC. El manejo de esta entidad deberá ser multidisciplinar y consistirá en controlar de forma adecuada el dolor e iniciar tratamiento sustitutivo cuando se constate la presencia de insuficiencia pancreática exocrina y endocrina. El caso que se reporta a continuación es un buen ejemplo de un caso de PC con presencia de insuficiencia exocrina y endocrina. Se documenta el proceso diagnóstico de la PC, en cuanto a pruebas de imagen y pruebas que demuestren la presencia de insuficiencia pancreática. Se exponen también las diferentes pruebas que se realizan para llegar a la etiología del cuadro. Se intenta reflejar el manejo que se debe llevar a cabo en estos pacientes y el seguimiento estricto que requieren.
Chronic pancreatitis (CP) is a disease with increasing incidence, though unknown, in the last years in the pediatric population which entails important comorbidities. The initial symptomatology is similar to the clinical scenario of acute pancreatitis, but its importance relies on the development, in months to years, of pancreatic insufficiency. For its diagnosis a high clinical suspicion and typical image findings are necessary. The management of this entity is held by a multidisciplinary team and the main goal is to assure an optimal pain control and start substitutive treatment once the pancreatic insufficiency is diagnosed. The clinical case that follows is a good example of CP with stablished pancreatic exocrine and endocrine insufficiency. It documents the diagnostic process of CP, regarding the imaging tools used and other laboratory test that manifested the pancreatic insufficiency. We expose the different etiologic tests that were performed in order to get to the etiologic diagnosis. It intends to reflect on the management needed for these patients and the strict follow-up that must be done.
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Chronic pancreatitis (CP) during pregnancy is rare but complicated in clinic, and its pathophysiology, clinical manifestations, diagnosis and treatment are special, which may seriously harm the health of mother and fetus if not properly treated. During pregnancy, physiological changes such as insulin resistance, mechanical pressure caused by the enlarged uterus and increased secretion of estrogen and progesterone will affect patients with CP. CP may increase the risk of pregnancy⁃related complications and adverse perinatal outcomes. The management of pregnant patients with CP mainly includes the improvement of lifestyle, symptomatic treatment and obstetric management. This article mainly reviewed the pancreatic physiology, clinical manifestations and management of pregnant patients with CP.
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There are currently various pancreatic exocrine function tests with different indicators for detection, and there is still a lack of unified standard. This article summarizes the pancreatic exocrine function tests which are widely used or hold promise for application in clinical practice, briefly introduces the procedures of each test, and reviews their clinical practicability and advances, so as to provide a reference for the clinical application and research ideas of pancreatic exocrine function tests.
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La Fibrosis Quística es una enfermedad genética que se caracteriza por el aumento de la densidad de las secreciones de los tejidos exocrinos, pudiendo afectar a múltiples órganos y sistemas dependiendo del genotipo de la enfermedad, el cual es variable. Uno de los sistemas que puede estar afectado es el gastrointestinal, manifestándose con varios signos y síntomas que pueden contribuir con la sospecha clínica de Fibrosis Quística. Es importante realizar precozmente el diagnóstico para llevar a cabo un manejo oportuno y tener un mejor pronóstico de la enfermedad. El diagnóstico deï¬nitivo se realiza con el test de sudor. Actualmente se está realizando un proyecto piloto de tamizaje neonatal para todos los recién nacidos de las regiones Metropolitana y de Valparaíso, incluyendo al Hospital Dr. Gustavo Fricke, con el ï¬n de diagnosticar Fibrosis Quística precozmente
Cystic Fibrosis is a genetic disease characterized by an increase in secretion density of the exocrine tissues, which can aï¬ect multiple organs and systems, depending on the illness´s genotype which is variable. One of the systems that may be aï¬ected is gastrointestinal, showing various signs and symptoms which may contribute to the clinical suspicion of cystic ï¬brosis. An early diagnosis is important for timely management and a better prognosis. The deï¬nitive diagnosis is done by the sweat test. A pilot neonatal screening for early cystic ï¬brosis diagnosis is being carried out in the Metropolitan and Valparaíso regions, including Gustavo Fricke Hospital.
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Abstract The aim of this study was to describe histologically and histochemically the pancreas of three adult Hydrochoerus isthmius, attacked by feral dog in Buenavista, Córdoba, Colombia. A complete necropsy was performed and pancreatic fragments were collected and stored in 10% buffered formalin and Bouin liquid. Then, they were dehydrated, diaphanized and embedded in paraffin, stained with Hematoxylin & Eosin, P.A.S., Gomori trichrome, Grimelius and Masson Fontana modified. The H. isthmius pancreas presented a duodenal mesenteric pattern. The exocrine portion was described as a composite tubuloacinar gland. The endocrine portion of the pancreas was constituted by pancreatic islets of Langerhans and a diffuse neuroendocrine system. The histological and histochemical techniques used allowed us to identify the exocrine and endocrine portion of the organ. It is suggested to complement this study with some special techniques for the identification of specific endocrine cells, such as Beta, Alpha, Delta, Epsilon, PP or Gamma.
Resumen El objetivo del presente estudio fue describir histológica e histoquímicamente el páncreas de tres individuos adultos de Hydrochoerus isthmius atacados por perros ferales en Buenavista, Córdoba, Colombia. Se realizó una necropsia completa y se recolectaron fragmentos pancreáticos, los cuales se almacenaron en formol tamponado al 10 % y líquido Bouin. Luego, fueron deshidratados, diafanizados y embebidos en parafina; teñidos con hematoxilina y eosina, P.A.S., tricrómico Gomori, Grimelius y Masson Fontana modificado. El páncreas de H. isthmius presentó un patrón mesentérico duodenal. La porción exocrina fue descrita como una glándula tubuloacinar compuesta. La porción endocrina del páncreas estaba constituida por islotes pancreáticos o Langerhans, y un sistema neuroendocrino difuso. En ese contexto, las técnicas histológicas e histoquímicas utilizadas permitieron identificar la porción exocrina y endocrina del órgano. Se sugiere complementar este estudio con algunas técnicas especiales para la identificación de células endocrinas específicas, como Beta, Alpha, Delta, Epsilon, PP o Gamma.
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Resumen Introducción: la pancreatitis crónica (PC) es una inflamación progresiva del páncreas que puede llevar a su destrucción e insuficiencia irreversibles. Es una patología desafiante para el médico, debido a que establecer su diagnóstico puede tomar meses e incluso años, el seguimiento de pacientes suele ser problemático y el conocimiento sobre la clínica y epidemiología en Colombia es incompleto. Este estudio pretende hacer una descripción de pacientes con PC en un centro de referencia en gastroenterología de Cali, Colombia. Metodología: estudio de corte transversal de pacientes adultos con PC confirmada por criterios clínicos y radiológicos entre 2011 y 2017. Resultados: se incluyeron 36 pacientes con PC. La mayoría fueron hombres (72,2%) y la media de edad fue 56 (+ 15,1) años. El dolor abdominal crónico fue la presentación clínica más común (83,3%). Cerca de un cuarto de pacientes presentaba diabetes mellitus (22,2%). Se consideró etiología idiopática en 58,3%, alcohólica en el 11,0% y biliar en el 11,0%. La tomografía axial computarizada (TAC), resonancia magnética (RMN) y colangiopancreatografía por RMN fueron los métodos diagnósticos más usados (60,5%), con los que en su mayoría se visualizó atrofia (53,1%), dilatación de conductos (49,0%) y calcificaciones del páncreas (34,7%). Conclusión: los síntomas inespecíficos de la PC en fases iniciales y su largo curso clínico favorecen al subdiagnóstico de esta patología. Los resultados presentados pueden contribuir a la futura creación de escalas clínicas locales que orienten estudios radiológicos y genéticos tempranos, con el fin de lograr un diagnóstico oportuno y mejorar la calidad de vida de estos pacientes.
Abstract Introduction: Chronic pancreatitis (CP) is a progressive inflammation of the pancreas that can lead to irreversible damage and failure. This condition poses great challenges to physicians since its diagnosis can take months or even years. Patient follow-up is often problematic and knowledge about its clinical presentation and epidemiology in Colombia is scarce. This study aims to describe patients with CP treated at a gastroenterology reference center in Cali, Colombia. Methodology: Cross-sectional study in adult patients with CP confirmed based on clinical and radiological criteria between 2011 and 2017. Results: 36 patients with CP were included. The majority were men (72.2%), and the mean age was 56 (+15.1) years. Chronic abdominal pain was the most common clinical presentation (83.3%). About a quarter of patients had diabetes mellitus (22.2%). Etiology was idiopathic in 58.3%, alcoholic in 11.0%, and biliary in 11.0%. Computed tomography (CT), magnetic resonance imaging (MRI), and MRI cholangiopancreatography were the most commonly used diagnostic methods (60.5%), showing mostly atrophy (53.1%), duct dilation (49.0%), and pancreatic calcifications (34.7%). Conclusion: Nonspecific symptoms of CP in early stages and its long clinical course favor the underdiagnosis of this condition. The results presented may contribute to the future creation of local clinical scales that guide early radiological and genetic studies to achieve a timely diagnosis and improve the quality of life of these patients.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Abdominal Pain , Epidemiology , Pancreatitis, Chronic , Patients , Magnetic Resonance Spectroscopy , Tomography , Diagnosis , Forecasting , HospitalsABSTRACT
Objective:To investigate the expression and diagnostic value of microRNA-335-5p (miR-335-5p) and Human Vascular endothelial growth factor receptor 1 (VEGFR-1, FLT1) in serum exosomal bodies of patients with triple negative breast cancer (TNBC) .Methods:Gene Expression Omnibus database (GEO) analysis was performed and differentially expressed miRNA in breast cancer tissues was screened. From Jan. 2016 to Nov. 2017, the peripheral blood samples of 56 TNBC patients in People’s Hospital Affiliated to Ningbo University were collected, and the exosomes were isolated and identified. FLT1 was selected as the target gene of miR-335-5p by using bioinformatics analysis. Expression levels of miR-335-5p and FLT1 in serum exosome were detected by qRT-PCR. The relationship between miR-335-5p and clinicopathological parameters of TNBC patients was analyzed. The diagnostic value of miR-335-5p was evaluated by receiver operating characteristic (ROC) , and the survival prognosis of miR-335-5p and FLT1 was analyzed by Kaplan Meier survival curve.Results:The expression of miR-335-5p in the serum exosome of TNBC patients was lower than that of the control group, while the expression of FLT1 in the serum exosome was higher than that of the control group ( P<0.05) . The expression of miR-335-5p was related to tissue grade ( χ2=22.02, P<0.000 1) , degree of differentiation ( χ2=20.67, P<0.000 1) and lymph node metastasis ( χ2=4.667, P=0.030 8) in patients with TNBC ( P<0.05) . The area under ROC diagnosed by miR-335-5p was 0.809 8 (95% CI: 0.726 3-0.893 2, P<0.000 1) . Kaplan-Meier survival analysis showed that the overall survival time of patients with low expression of miR-335-5p was significantly shorter than that of patients with high expression of miR-335-5p ( P=0.004 5) . The high expression of its target gene FLT1 was associated with low survival rate ( P=0.048 0) . Conclusion:Serum exosomal miR-335-5p can be used as an important index to predict the prognosis of TNBF and is expected to play a role in diagnosis and treatment of TNBC.
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Objective:To investigate the value of exocrine LncRNA SPINT1-AS1 in diagnosis and prognosis of papillary thyroid carcinoma (PTC) .Methods:qRT-PCR was used to detect the expression of SPINT1-AS1 in PTC tissues, cell lines (TPC-1, BCPAP, K1 and IHH4) , serum exocrine bodies of patients and normal tissues adjacent to cancer, human thyroid normal cell line Nthy-ori 3-1 and healthy volunteers. CCK-8 and colony formation assay were used to detect the effects of SPINT1-AS1 on the proliferation and colony formation of PTC cells. The interaction between SPINT1-AS1 and miR-128-3p, miR-128-3p and ITGA3 was verified by double luciferase report test.Results:The expression of SPINT1-AS1 in PTC tissues and cell lines was significantly higher than that in adjacent normal tissues and Nthy-ori 3-1 cell lines. Knockdown of SPINT1-AS1 inhibited the proliferation and colony formation of PTC cells. Bioinformatics analysis showed that there was a SPINT1-AS1/miR-128-3p/ITGA3 interaction regulatory network in PTC. The direct interaction of SPINT1-AS1, miR-128-3p and ITGA3 was verified by double luciferase reporter test. In addition, SPINT1-AS1 was significantly up-regulated in serum exocrine bodies of patients with PTC.Conclusion:Our study shows that SPINT1-AS1 regulates the miR-128-3p/ITGA3 axis to promote the proliferation and colony formation of PTC cells. Exocrine SPINT1-AS1 may be an effective molecular target for PTC in diagnosis and treatment of PTC.
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At present, there is still a lack of comprehensive diagnosis and treatment criteria for pancreatic exocrine insufficiency around the world. Pancreatic surgeons often ignore or misjudge pancreatic exocrine insufficiency secondary to pancreatic cancer, and as a result, pancreatic exocrine insufficiency is not adequately treated, which greatly affects the quality of life of patients with pancreatic cancer. This article summarizes the latest research advances in the pathogenesis, typical symptoms, and diagnostic methods of pancreatic exocrine insufficiency, as well as pancreatic enzyme replacement therapy in different stages of pancreatic cancer. It is pointed out that pancreatic enzyme replacement therapy can significantly improve the quality of life of patients with different stages of pancreatic cancer.