简介：AbstractPancreatic neuroendocrine tumors (PNETs) are a rare group of neoplasms originating from the endocrine pancreas. PNETs are classified as functional or non-functional tumors. PNETs are more often diagnosed at a higher stage with distant metastases or advanced locoregional disease. The majority of individuals with hepatic metastases will ultimately die of liver failure; therefore, the treatment of liver tumor burden is critical to providing a survival impact. While surgical resection remains the only chance of cure for disease confined to the pancreas or for locoregional disease, the treatment of advanced or metastatic PNETs is more complex and often requires a multimodal approach. This review focuses on treatment options for well and moderately differentiated PNETs with metastatic disease to the liver. These include surgery, liver-directed therapies including ablative and intra-arterial therapies, and systemic therapies such as somatostatin analogues, targeted therapies, chemotherapy, and peptide receptor radionuclide therapy. Developing an individualized treatment strategy requires careful assessment of liver tumor burden and predicted biological behavior. Aggressive surgical resection of hepatic metastases secondary to PNET primary tumors is associated with improved survival in multiple retrospective studies. General goals of treatment for metastatic disease include prolonging overall survival and progression free survival, improving quality of life, and control of symptoms.

简介：Objective:Intra-abdominalfatisariskfactorforpancreaticcancer(PC),butlittleisknownaboutitscontributiontoPCprecursorsknownasintraductalpapillarymucinousneoplasms(IPMNs).Ourgoalwastoevaluatequantitativeradiologicmeasuresofabdominal/visceralobesityaspossiblediagnosticmarkersofIPMNseverity/pathology.Methods:Inacohortof34surgically-resected,pathologically-confirmedIPMNs(17benign;17malignant)withpreoperativeabdominalcomputedtomography(CT)images,wecalculatedbodymassindex(BMI)andfourradiologicmeasuresofobesity:totalabdominalfat(TAF)area,visceralfatarea(VFA),subcutaneousfatarea(SFA),andvisceraltosubcutaneousfatratio(V/S).MeasureswerecomparedbetweengroupsusingWilcoxontwo-sampleexacttestsandothermetrics.Results:MeanBMIforindividualswithmalignantIPMNs(28.9kg/m~2)washigherthanmeanBMIforthosewithbenignIPMNs(25.8kg/m~2)(P=0.045).MeanVFAwashigherforpatientswithmalignantIPMNs(199.3cm~2)comparedtobenignIPMNs(120.4cm~2),P=0.092.V/Swassignificantlyhigher(P=0.013)forpatientswithmalignantversusbenignIPMNs(1.25vs.0.69cm~2),especiallyamongfemales.Theaccuracy,sensitivity,specificity,andpositiveandnegativepredictivevalueofV/SinpredictingmalignantIPMNpathologywere74%,71%,76%,75%,and72%,respectively.Conclusions:PreliminaryfindingssuggestmeasuresofvisceralfatfromroutinemedicalimagesmayhelppredictIPMNpathology,actingaspotentialnoninvasivediagnosticadjunctsformanagementandtargetsforinterventionthatmaybemorebiologically-relevantthanBMI.Furtherinvestigationofgender-specificassociationsinlarger,prospectiveIPMNcohortsiswarrantedtovalidateandexpandupontheseobservations.

简介：AIM:Tostudythepossibleactionsandmechanismsofperoxisomeproliferator-activatedreceptorγ(PPARγ),aligand-activatedtranscriptionfactor,inpancreaticcarcinogenesis,especiallyinangiogenesis.METHODS:ExpressionsofPPARγandretinoidacidreceptor(RXRα)wereexaminedbyreverse-transcriptionpolymerasechainreaction(RT-PCR)withimmunocytochemicalstaining.Pancreaticcarcinomacells,PANC-1,weretreatedeitherwith9-cis-RA,aligandofRXRα,orwith15-deoxy-Δ12,14prostaglandinJ2(15d-PGJ2),aligandofPPARγ,orboth.Antiproliferativeeffectwasevaluatedbycellviabilityusingmethyltetrazolium(MTT)assay.ApancreaticcarcinomaxenografttumormodelofnudemicewasestablishedbyinoculatingPANC-1cellssubcutaneously.Rosiglitazone,aspecificligandofPPARγ,wasadministeredviawaterdrinkinginexperimentalgroupofnudemice.After75d,allmiceweresacrificed.Expressionofproliferatingcellnuclearantigen(PCNA)intumortissuewasexaminedwithimmunohistochemicalstaining.Expressionofvascularendothelialgrowthfactor(VEGF)mRNAinPANC-1cells,whichweretreatedwith15d-PGJ2or9-cis-RAatvariousconcentrationsordifferentduration,wasdetectedbysemi-quantitativeRT-PCR.EffectsofRosiglitazoneonchangesofmicrovasculardensity(MVD)andVEGFexpressionwereinvestigatedinxenografttumortissue.Neovasculaturewasdetectedwithimmunohistochemistrystaininglabeledwithanti-Ⅳcollagenantibody,andindicatedbyMVD.RESULTS:RT-PCRandimmunocytochemicalstainingshowedthatPPARγandRXRαwereexpressedinPANC-1cellsatbothtranscriptionlevelandtranslationlevel.MTTassaydemonstratedthat15d-PGJ2,9-cis-RAandtheircombinationinhibitedthegrowthofPANC-1cellsinadose-dependentmanner.9-cis-RAhadacombinedinhibitingactionwith15d-PGJ2onthegrowthofpancreaticcarcinoma.InvivostudiesrevealedthatRosiglitazonesignificantlysuppressedthegrowthofpancreaticcarcinomaascomparedtocontrolgroup(0.48±0.23cm3vs2.488±0.59cm3,P<0.05),andthegro

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简介：在病人作为首要或第二线的治疗评估paclitaxel，cisplatin和5-FU(PCF)的联合政体的功效和毒性与的目的进展胃并且在中国的esophagogastric连接(EGJ)腺癌。病人与paclitaxel被对待的方法d1上的150mg/m2；fractionatedcisplatin15mg/m2和连续注入5-FU600mg/(m2朠楬污映扩楲汬牡????????????М

简介：Transesterificationbetweenmethyl-butyrateand1-butanolinnonaqueoussystemswascatalyzedbyporcinepancreaticlipasewhichwasimmobilizedoncross-linkedpolystyrene.Organicsolvents,substrateconcentration,contentsofwaterandotherparameterswhichaffecttheimmobilizedenzymeactivitywerestudied.Lipaseimmobilizedonhydrophobiccrosslinkedpolystyrenecanreduceitsdiffusionlimitinthereaction.Itwasfoundthattheactivityofimmobilizedlipaseinorganicsystemswastwotimesashighasthatoffreelipase.

简介：Apoptotic房间转移被发现了能便于allograft的嫁接。然而，内在的机制尚待充分被理解。这里，我们证明施主apoptoticsplenocytes的静脉内的管理能由导致tolerogenic的产生支持胰腺的小岛嫁接树枝状的房间(Tol-DCs)和CD4+Foxp3+规章的T房间(Tregs)。在vivo，树枝状的房间(DC)或Tregs的清理由apoptotic房间管理阻止了有免疫力的忍耐的正式就职。用anti-CD25的Tregs的短暂消除，monoclonal抗体(mAb)在apoptoticsplenocytes的管理以后废除了Tol-DCs的产生。相互地，在用白喉毒素(DT)的CD11c数据终端就绪老鼠以内的DC的弄空与apoptoticsplenocytes的管理在接受者阻止了Tregs的产生。在二个房间之间的房间接触打的由直接要求，并且规划了死亡1ligand(PD-L1)的Tol-DCs的Tregs的正式就职在Tregs扩大起了重要作用。Apoptotic房间管理没能在IL-10-deficient和Smad3缺乏的老鼠导致Tol-DCs，建议那IL-10和转变生长factor-β；(TGF-β；)被需要处于tolerogenic状态维持DC。因此，我们证明Tol-DCs在他们的表面上并且相互地经由PD-L1支持Tregs的扩大Tregs便于Tol-DCs维持apoptotic房间经由secretingIL-10和TGF-β导致的移植忍耐；。

简介：人的pluripotent干细胞代表功能的胰腺的内分泌的系房间的潜在地无限的来源。这里，我们报导一条高度有效的途径导致人的胚胎的茎(ES)细胞和导致的pluripotent茎(iPS)在一个定义化学药品的文化系统区分进成熟生产胰岛素的细胞的细胞。这条途径获得的区分的人的ES房间由流动cytometry分析作为assayed包括了将近25%胰岛素积极的房间，它以比得上成年人的小岛的一种方式响应葡萄糖刺激释放了insulin/C-peptide。大多数这些生产胰岛素的房间共同表示成熟尾房间特定的标记象NKX6-1和PDX1那样，在vivo显示一个类似的基因表示模式到成年小岛尾房间。在这研究，我们也证明EGF便于PDX1积极的胰腺的祖先的扩大。而且，我们的协议也成功了高效地导致人的iPS房间区分进生产胰岛素的房间。因此，这个工作不仅提供一个新模型在vitro学习人的胰腺的专门化和成熟的机制，而且提高为糖尿病的处理利用病人特定的iPS房间的可能性。

简介：AbstractObjective:Most patients with advanced lung cancer have a poor prognosis. Recent studies have identified TRIM59 as a novel molecule that serves as a prognostic factor for the progression of non-small cell lung cancer. In the present study, we investigated the role of TRIM59 in predicting the prognosis of lung adenocarcinoma (LUAD) as well as the correlation between TRIM59 expression and immune infiltrates.Methods:We analyzed TRIM59 expression in normal and tumor tissues based on RNA-sequencing datasets from The Cancer Genome Atlas and Genotype-Tissue Expression databases. Forty-seven cases of LUAD tissues and their matching adjacent tissues were collected, and TRIM59 expression in tissue samples was demonstrated by immunohistochemistry. All tissue specimens were obtained under the approval of the Medical Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval No. IR2019001101; approved on April 3, 2019). The immune cell scores were calculated using the CIBERSORT database. The Tumor Immune Estimation Resource database was used to analyze the correlation between TRIM59 and immune cell activities.Results:TRIM59 was up-regulated in most cancer types. High TRIM59 expression predicted a worse prognosis in patients with LUAD (overall survival, P= 0.00096; disease-specific survival, P= 0.00056; disease-free interval, P= 0.0009; progression-free interval, P= 0.0012). Moreover, TRIM59 was highly expressed in patients with LUAD who had a poorer prognosis. TRIM59 also showed a significant correlation with the ESTIMATE score (P = 0.04) and stromal score (P = 0.005) in patients with LUAD. Notably, a significant correlation between TRIM59 and the tumor mutation burden was found in LUAD but in no other cancer types (P < 0.001). Further investigation showed that TRIM59 had a significant correlation with gene markers on neutrophils and dendritic cells.Conclusion:TRIM59 is a potential prognosticator in LUAD and may be correlated with immune cell identification, immune cell infiltration, and immunotherapy checkpoints in LUAD.

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简介：尽管为有类型1糖尿病的个人的小岛移植被显示了产出优异的血葡萄糖控制，它为长期的控制仍然保持不适当。这是部分，由于小岛损害和压力，那能导致贝它房间损失。过量IL-1β的抑制；活动可能最小化小岛损害，因此保存工作。IL-1受体对手(IL-1Ra)，IL-1β的一个内长的禁止者；，保护小岛免受导致cytokine的坏死和apoptosis的伤害。因此，在IL-1β之间的不平衡；并且IL-1Ra可能影响到小岛的allogeneic和自体免疫的回答的功课。我们的组以前证明传播丝氨酸朊酶禁止者人alpha-1-antitrypsin(hAAT)，以及immunomodulatory活动。在现在的学习，我们寻求了决定是否胰腺的小岛hAAT的allograft保护的活动被IL-1Ra调停感应。我们的结果证明hAAT在刺激巨噬细胞在IL-1Ra表示导致了2.04褶层增加并且hAAT-pre-treated小岛接枝在IL-1Ra抄本层次展出了4.851褶层增加，它与中等煽动性的侧面被联系。出人意料地，从IL-1Ra-knockout鼠标被孤立并且在grafting前与hAAT预先对待进野类型的鼠标的小岛在大概从渗入主机房间被导出的intragraftIL-1Ra表示产出增加，当主机的hAAT处理不在时的虽然。确实，hAAT-pre-treated小岛产生了能在有教养的巨噬细胞导致IL-1Ra生产的hAAT免费的调节媒介。最后，我们证明hAAT为p65支持了不同phosphorylation和原子translocation模式，为IL-1Ra要求的一个关键抄写因素表示。

简介：Objective:Earlymetastasisisamajorbiologicalfeatureofpancreaticcancer.ThecurrentstudyexaminedwhethersilencingSlc38a1,ageneinvolvedinenergymetabolism,usingshorthairpinRNA(shRNA)couldinhibitthegrowth,migration,andinvasivenessofpancreaticcancercells.Methods:AseriesofSlc38a1shRNAsweredesignedandclonedintothepGPU6/GFP/Neovectors.AnshRNAwiththemostefficaciousinhibitoryactiononSCL38A1expression(65%inhibition)uponscreeninginDH5αbacteriawasusedtotransfectSW1990humanpancreaticcancercells.Cellgrowth,migration,andinvasivenesswereexaminedusingcellcountingkit-8,BoydenchamberwithoutandwithMatrigel,respectively.Results:TransfectionofSW1990cellswiththeSLCs38A1shRNAsignificantlydecreasedtheproliferation(P<0.0001)andmigratorypotential(by46.7%,P=0.0399)ofthecancercells.Invasiveness,however,wasnotaffected.Conclusions:InhibitingSlc38a1usingshRNAtechnologycoulddecreasethegrowthandmigrationofrepresentativepancreaticcancercells.However,thefactthatinvasivenesswasnotaffectedsuggestedthatSLC38A1isunlikelytoberesponsibleforearlymetastasis.

简介：AbstractObjective:Pancreatic cancer (PC) is a highly lethal malignancy with an immunosuppressive environment. Yet, current immune checkpoint inhibitor monotherapies have shown limited efficacy in PC, prompting the need for combination therapies. Herein, we hypothesized that combinations of Notch signaling inhibitor and anti-ligand programmed death-ligand 1 (PD-L1) antibody immunotherapy would show synergistic efficacy.Methods:The baseline expression of PD-L1 and HES1 was measured in PC cell lines, single-cell RNA-seq data of PC (GSA: CRA001160), and cBioPortal databases. In an in vitro study, MIA PaCa2 and SW1990 were used to explore the mechanism between Notch signaling and PD-L1. To study the effects in vivo, a subcutaneous tumor model was established using Pan02 cells treated with either anti-PD-L1 monoclonal antibody and/or Notch inhibitor DAPT. The study performed involving human samples was approved by the Ethics Committee of Peking Union Medical College Hospital (approval No. S-K460, approval date: April 23, 2018). Animal studies were approved by the Animal Research Ethics Committee of Peking Union Medical College Hospital (approval No. XHDW-2019-049, approval date: November 28, 2019).Results:The Notch signaling inhibitor upregulated PD-L1 expression in PC tumor cells both in vitro and in vivo. Notch effector HES1 knockdown produced PD-L1 upregulation in both MIA PaCa2 and SW1990 cells. Combined DAPT and anti-PD-L1 antibody treatment of Pan02 subcutaneous tumor model resulted in significantly reduced tumor weights compared to that with monotherapy, as well as significantly reduced Ki67 than that in the monotherapy group and control group. Flow cytometry analysis revealed significantly increased CD8+ T cell infiltration in tumors of the combination group compared with those of the monotherapy group.Conclusion:Notch signaling blockade might enhance the antitumor effect of anti-PD-L1 therapy in PC.

简介：AbstractObjective:Irreversible electroporation (IRE) is emerging as a new therapy for locally advanced pancreatic cancer (LAPC). We aimed to conduct survival and safety analyses in LAPC patients after treatment with IRE combined with chemotherapy.Methods:A total of 64 patients with LAPC who had received IRE and chemotherapy were retrospectively collected from August 2015 to March 2019 at Sun Yat-sen University Cancer Center. Overall survival (OS) and progression-free survival (PFS) were evaluated using Kaplan-Meier method and compared by the log-rank test. A multivariate Cox regression model was used to determine the prognostic factors of survival. The perioperative complications of IRE were also evaluated. The study was approved by the Institutional Review Board of Sun Yat-sen University Cancer Center (approval No. C2021-003).Results:The median survival of all included patients were 24.63 (95% confidence interval: 21.78-27.49) for overall survival and 13.00 (95% confidence interval: 8.81-17.19) months for progression-free survival, with 96.8%, 51.9%, 18.3%; and 52.3%, 21.5%, 7.9% as the 1-, 2-and 3-year OS and PFS rates, respectively. Tumor size [OS, hazard ratio (HR)=1.768, P= 0.048; PFS, HR= 0.304, P= 0.010], neoadjuvant chemotherapy (OS, HR= 0.338, P= 0.030; PFS, HR= 0.358, P= 0.034), carbohydrate antigen 19-9 variation after IRE (OS, HR= 19.320, P= 0.003; PFS, HR= 14.591, P= 0.021) and tumor response after neoadjuvant chemotherapy (OS, HR= 8.779, P= 0.033; PFS, HR= 5.562, P= 0.008) were predictive factors of survival in patients with LAPC after IRE. Complications were observed in 20.3% of patients. Grade B pancreatic fistula was the most common complication. The complication rates of the late treatment group (6.1%) were significantly lower than those of the first 15 patients after IRE treatment (66.7%). The median length of hospital stay of late treatment group was 8.6 days, which was also shorter than that of the early treatment group (10.0 days).Conclusions:IRE combined with chemotherapy could improve survival of LAPC patients with acceptable complication rates. Therefore, it may be a suitable method for LAPC but should be validated in prospective randomized trials.

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简介：AbstractObjective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma (AEG) of the esophagogastric junction.Methods:This was a retrospective case-control study of 903 patients with Siewert type II/III AEG treated from January 2012 to January 2015 at the Shanxi Cancer Hospital in China. All patients underwent gastrectomy, and their clinical characteristics were analyzed to identify associations with anastomotic leakage. Independent risk factors were identified by binary logistic regression. The 2-year disease-free survival was calculated and compared between patients with anastomotic leakage and control patients. The study was approved by the Institutional Review Board of Shanxi Medical University (approval No. 2014-09-39) on September 19, 2014.Results:Out of the 903 patients were included in the study, 80 (8.86%, 80/903) experienced anastomotic leakage. The mortality rate attributed to anastomotic leakage was 8.75% (7/80). Logistic regression analysis revealed that preoperative hypoalbuminemia (odds ratio (OR)=3.249, 95% confidence interval (CI): 1.569-6.725, P=0.002), type of reconstruction (OR=1.795, 95% CI: 1.026-3.142, P=0.040), and combined organ resection (OR=1.807, 95% CI: 1.069-3.055, P=0.027) were independent risk factors for anastomotic leakage.Conclusion:Preoperative hypoalbuminemia, type of reconstruction, and combined organ resection were identified as risk factors for anastomotic leakage in patients undergoing gastrectomy for Siewert type II/III AEG.

简介：Objective:Todeterminethevalueofdiffusion-tensorimaging（DTI）asanadjuncttodynamiccontrastenhancedmagneticresonanceimaging（DCE-MRI）forimprovedaccuracyofdifferentialdiagnosisbetweenbreastductalcarcinomainsitu（DCIS）andinvasivebreastcarcinoma（IBC）.Methods:TheMRIdataof63patientspathologicallyconfirmedasbreastcancerwereanalyzed.TheconventionalMRIanalysismetricsincludedenhancementstyle,initialenhancementcharacteristic,maximumslopeofincrease,timetopeak,timesignalintensitycurve（TIC）pattern,andsignalintensityonFST2WI.Thevaluesofapparentdiffusioncoefficient（ADC）,directionally-averagedmeandiffusivity(Davg),exponentialattenuation（EA）,fractionalanisotropy（FA）,volumeratio（VR）andrelativeanisotropy（RA）werecalculatedandcomparedbetweenDCISandIBC.MultivariatelogisticregressionwasusedtoidentifyindependentfactorsfordistinguishingIBCandDCIS.Thediagnosticperformanceofthediagnosisequationwasevaluatedusingthereceiveroperatingcharacteristic（ROC）curve.ThediagnosticefficaciesofDCEMRI,DWIandDTIwerecomparedindependendyorcombined.Results:EAvalue,lesionenhancementstyleandTICpatternwereidentifiedasindependentfactorfordifferentialdiagnosisofIBCandDCIS.ThecombinationdiagnosisshowedhigherdiagnosticefficacythanasingleuseofDCE-MRI（P=0.02）,andtheareaofthecurvewasimprovedfrom0.84（95%CI,0.67-0.99）to0.94（95%CI,0.85-1.00）.Conclusions:QuantitativeDTImeasurementasanadjuncttoDCE-MRIcouldimprovethediagnosticperformanceofdifferentialdiagnosisbetweenDCISandIBCcomparedtoasingleuseofDCE-MRI.

简介：AbstractBackground:Excessive inflammatory responses play a critical role in the development of severe acute pancreatitis (SAP), and controlling such inflammation is vital for managing this often fatal disease. Dexmedetomidine has been reported to possess protective properties in inflammatory diseases. Therefore, this study aimed to investigate whether dexmedetomidine pre-treatment exerts an anti-inflammatory effect in rats with SAP induced by sodium taurocholate, and if so, to determine the potential mechanism.Methods:SAP was induced with sodium taurocholate. Rats received an intraperitoneal injection of dexmedetomidine 30 min before sodium taurocholate administration. α-bungarotoxin, a selective alpha-7 nicotinic acetylcholine receptor (α7nAchR) antagonist, was injected intra-peritoneally 30 min before dexmedetomidine administration. The role of the vagus nerve was evaluated by performing unilateral cervical vagotomy before the administration of dexmedetomidine. Efferent discharge of the vagal nerve was recorded by the BL-420F Data Acquisition & Analysis System. Six hours after onset, serum pro-inflammatory cytokine (tumor necrosis factor α [TNF-α] and interleukin 6 [IL-6]) levels and amylase levels were determined using an enzyme-linked immunosorbent assay and an automated biochemical analyzer, respectively. Histopathological changes in the pancreas were observed after hematoxylin and eosin staining and scored according to Schmidt criteria.Results:Pre-treatment with dexmedetomidine significantly decreased serum levels of TNF-α, IL-6, and amylase, strongly alleviating pathological pancreatic injury in the rat model of SAP (TNF-α: 174.2 ± 30.2 vs. 256.1±42.4 pg/ml; IL-6: 293.3 ± 46.8 vs. 421.7 ± 48.3 pg/ml; amylase: 2102.3 ± 165.3 vs. 3186.4 ± 245.2 U/L). However, the anti-inflammatory and pancreatic protective effects were abolished after vagotomy or pre-administration of α-bungarotoxin. Dexmedetomidine also significantly increased the discharge frequency and amplitude of the cervical vagus nerve in the SAP rat model (discharge frequency: 456.8 ± 50.3 vs. 332.4 ± 25.1 Hz; discharge amplitude: 33.4 ± 5.3 vs. 20.5 ± 2.9 μV).Conclusions:Dexmedetomidine administration attenuated the systemic inflammatory response and local pancreatic injury caused by SAP in rats through the cholinergic anti-inflammatory pathway involving vagus-and α7nAChR-dependent mechanisms.

简介：AbstractObjective:In 2015, the Chinese Pancreatic Association of the Chinese Society of Surgery of the Chinese Medical Association launched a national multicenter online system for registration of surgical treatment of pancreatic cancer in China, called China Pancreas Data Center (CPDC). With continued effort, the CPDC has developed over time. Herein, we report the general results of the CPDC from January 2016 to January 2020 to present the real-world situation of surgical treatment of pancreatic cancer in China.Methods:The data of the CPDC from January 2016 to January 2020 were retrieved and analyzed in this real-world study, including the data on patient demographics, comorbidities, diagnostic modalities, neoadjuvant treatment, surgical procedures, postoperative complications and treatment, pathological examinations, postoperative adjuvant treatment, survival, and risk factors.Results:A total of 13,595 cases from 70 centers in 28 provinces were retrieved for analysis. This study reported the largest cohort of patients who underwent surgical treatment for pancreatic cancer in China to date. More cases were derived from the Eastern regions, among which Shanghai, Beijing, and Zhejiang ranked in the top three. The peak age of the patients ranged from 60 to 69 years. The ratio of males to females was 1.5:1. Overall, 64.3% of the tumors were located in the head and neck of the pancreas, and 35.7% in the body and tail of the pancreas. Of the patients, 23.0% underwent positron-emission tomography-computed tomography, 21.6% underwent endoscopic ultrasound, and 4.8% underwent preoperative biopsy. Two percent of the patients underwent neoadjuvant treatment, while 68.9% underwent R0 surgical resection (margin free of tumor cells). Of the latter, 78.6% of the operations were open procedures, 12.6% were laparoscopic procedures, 2.9% were robotic procedures, and 3.7% were converted to open procedures. The in-hospital mortality rate after surgery was 0.4%. The incidence of grade 2 and grade 3 postoperative pancreatic fistulas was 25.5% and 2.5%, respectively. The incidence of complications based on the Clavien-Dindo classification was 17.9% of grade II, 4.3% of grade IIIa, 1% of grade IIIb, and 0.6% of grade IV. Of the patients, 28.9% underwent postoperative adjuvant chemotherapy. The 1-year, 2-year, and 3-year overall survival of these patients were 77%, 51%, and 38%, respectively. In the 8542 patients who underwent R0 resection, the 1-year, 2-year, and 3-year overall survival and disease-free survival were 77% , 54%, and 43%, and 68%, 49%, and 41%, respectively. The factors related to the prognosis of these patients were also identified after uni-and multi-variate analyses.Conclusion:The surgical quality, safety, and long-term survival of the patients in CPDC are similar to those of international high-volume pancreatic centers. However, neoadjuvant and postoperative adjuvant chemotherapy should be improved.

简介：AbstractBackground:Contrast-enhanced ultrasound (CEUS) can detect lesions hidden in inflammatory regions and find necrosis or areas of severe fibrosis within the lesion. This retrospective study aimed to compare the diagnostic accuracy of solid pancreatic lesions using percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) with or without CEUS assessment.Methods:Clinical, imaging, and pathologic data of 181 patients from January 2014 to December 2018 in Pecking Union Medical College Hospital, with solid pancreatic masses who underwent percutaneous US-FNA and ThinPrep cytologic test were retrospectively evaluated. Patients were divided into CEUS and US groups according to whether CEUS was performed before the biopsy. According to FNA cytology diagnoses, we combined non-diagnostic, neoplastic, and negative cases into a negative category. The positive category included malignant, suspicious, and atypical cases. The final diagnosis was confirmed by pathology or clinical and radiological follow-up for at least 12 months. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of US-FNA were evaluated between the two groups.Results:This study enrolled 107 male and 74 female patients (average age: 60 years). There were 58 cases in the US group and 123 cases in the CEUS group. No statistically significant differences in age, gender, or lesion size were found between the two groups. The diagnostic accuracy of the CEUS group was 95.1% (117/123), which was higher than the 86.2% (50/58) observed in the US group (P = 0.036). The sensitivity, specificity, PPV, and NPV of the CEUS group were increased by 7.5%, 16.7%, 3.4%, and 18.8%, respectively, compared with the US group. However, the differences of the two groups were not statistically significant.Conclusions:Compared with the conventional US, the use of CEUS could improve the biopsy accuracy and avoid the need for a repeat biopsy, especially for some complicated FNA cases.