- Email: [email protected]
Irreversible electroporation in locally advanced pancreatic cancer: A systematic review
Abstracts / Pancreatology 14 (2014) S1eS129
Patients & methods: A 72-year-old patient was presented with rapidly progressing jaundice and loss of weight. He had no medical history. CT scan revealed biliary- and pancreatic duct dilatation, caused by pancreatic head mass and hepatosplenomegaly. Prior to the operation all indices of cholestasis were elevated. The intraoperative FNAB showed signs of malignancy, therefore we performed pylorus preserving pancreaticoduodenectomy with lymphadenectomy. The final histological examination resulted a grade III, T3N1 stage basaloid carcinoma. Results: Tumor cells were diffusely immunoreactive for CK-5/6, CK-19 and EGFR, focally positive for CK-14 and CK-17, negative for CK-7 and BRCA1. 70% of the tumorcells showed positive reactions with p53 and Ki-67 labeling index. One lymph node of the resected 9 showed metastasis. The patient was treated with gemcitabine postoperatively. After three months there is no sign of local recurrence or metastasis. Conclusion: Based on the reviewed literature, radical surgical removal should be the first step of the treatment of the basaloid carcinomas. It would be desirable to establish adjuvant chemotherapy protocol in the future, regarding its similar histopathologic traits in the different anatomical sites. Considering the increasing number of basaloid carcinomas, their inclusion in the WHO classification system would also be advantageous.
S43
solely on a diagnostic test were excluded. Data on baseline characteristics, type of pancreatic resection, diagnostic test for EPI and occurrence of EPI were extracted. Prevalence of EPI was calculated from these data. Results: After screening 3203 articles, 9 observational cohort (4 prospective, 5 retrospective) studies were included on a total of 664 patients. Of these patients 333 (50%) underwent pancreatoduodenectomy (PD), 23 (3%) total pancreatectomy (TP), 114 (17%) distal pancreatectomy (DP) and 194 (33%) no resection due to locally advanced pancreatic cancer. Median preoperative prevalence of EPI was 44% (range 42-67%) before PD; 20% (1667%) before DP; 63% before TP; and 50% in unresectable patients. The median prevalence of EPI at least 6 months postoperative was 84% (36100%) after PD; 67-80% after DP; and 100% after TP. Conclusion: EPI is frequently seen in patients before resection for pancreatic or peri-ampullary cancer. The prevalence increases markedly following resection.
W-082. History of previous breast and genitourinary tract neoplasms in patients undergoing resection for pancreatic adenocarcinoma (PDAC) Francesca Gavazzi, Maria Rachele Angiolini, Cristina Ridolfi, Maria Carla Tinti, Fara Uccelli, Marco Madonini, Marco Montorsi, Alessandro Zerbi
W-080. Intraductal tubulopapillary pancreatic carcinoma, complicated with massive GI bleeding. Case report and review of the literature a
b
Section of Pancreatic Surgery, Surgery Department, University of Milan School of Medicine, Humanitas Research Hospital, Milan, Italy
a
Vyacheslav Egorov , Irene Esposito , Natalia Ratnikova , Natalia Starostina a, Roman Petrov a, Olga Kosheleva a a
5th Moscow City Hospital, Moscow, Russia, Russia b Technische Universit€ at München, Munchen, Germany, Germany Background: Intraductal tubulopapillary neoplasm (ITPN) is a very rare pancreatic tumor. Aims: Demonstration of a rare pancreatic tumor with its rare complication Patients & methods: A 36-year old woman was referred to ICU department of our hospital for massive upper GI bleeding and jaundice. After stabilization CT and endoscopy showed a non-mucinous tumor of the pancreatic head invading duodenum with a large crater of the vertical branch. Intraductal spread along the pancreas was suspected without any sign of dissemination. Six days after decompression of bile system and correction of coagulopathy Whipple procedure was performed and pancreatectomy was completed because of repeated positive margins on the levels of pancreatic body and tail. Uneventfull postoperative course. Results: Histopathology revealed massive intraductal tubulopapillary carcinoma of the pancreatic head with invasion of the duodenum on the background of ITPN of the pancreatic body and tail. Conclusion: This is the thirty first description of ITPN and the first case of such a tumor, complicated with massive GI bleeding and jaundice.
W-081. Exocrine pancreatic insufficiency in patients with pancreatic or periampullary cancer: A systematic review
Background: The expectancy of life increase recently observed in industrialized countries showed how cellular aging lead to cancer development. For this reason, surgical patients clinical history often reveals multiple tumors. Literature suggests a possible association between PDAC and other cancers, with genetic substrate probably but not exclusively implicated. Aims: Evaluation of the prevalence of other tumors among patient with PDAC. Materials & methods: We analyzed past medical history of 161 surgical PDAC patient (Jan-2010/Jun-2013), searching for previously occurred neoplasms. Cancer epidemiology in our country was obtained from TumorsRegistry Italian Association (AIRTUM) and ISS-Epidemiology Service. Results: Mean age of our patients was 68±10 years; 21,7% of them had a previous history of cancer, with mean age at diagnosis 60±11 years. The more frequent were breast (9,3%) and genitourinary tract neoplasms (7%), of which 3,1% prostate cancer. According to AIRTUM, standardized cancer prevalence in Italy is 1869/100.000 females (1,9%) for breast and 896/ 100.000(0,9%) for prostate. 73% of our patients with prostate or breast cancer received PDAC diagnosis during previous neoplasm follow-up. However, their PDAC stage (pTNM 7 Ed/AJCC) was not significantly lower compared with fortuitous diagnosis cases (p¼0.181). Conclusion: Even though breast and prostate cancer are notoriously high-incidence and long-survival related, their prevalence among PDAC patients seems to be interestingly higher. Further studies are necessary to investigate genetic and environmental bases. A clinical implication could be a different proportion of resectable and advanced PDAC at diagnosis among patient performing an oncologic follow-up. For this reason, a radiological assessment adequate for pancreas evaluation should be suggested during follow-up for breast and genitourinary cancer.
Dorine S.J. Tseng, C. Hjalmar, van Santvoort, H.M. Inne, Borel Rinkes, I. Quintus Molennaar University Medical Center Utrecht, Dept. of Surgery, Netherlands Background: Exocrine pancreatic insufficiency (EPI) is caused by loss of pancreatic parenchyma or obstruction of the pancreatic duct. This may occur in pancreatic or peri-ampullary cancer, both before and after resection. The prevalence and natural course of EPI in these patients has not been thoroughly studied. Aims: The aim of this study was to determine the prevalence of EPI in patients with pancreatic or peri-ampullary cancer. Patients & methods: We systematically reviewed the literature published up to February 20th 2014, according to the PRISMA guidelines. We included studies reporting on EPI in patients with pancreatic or periampullary cancer. Studies reporting on EPI due to other causes and focusing
W-083. Irreversible electroporation in locally advanced pancreatic cancer: A systematic review Steffi Rombouts a, Samira Fegrachi a, Hjalmar van Santvoort a, Marc Besselink b, Richard van Hillegersberg a, Quintus Molennaar a a b
University Medical Center Utrecht, Netherlands Academic Medical Center Amsterdam, Netherlands
Background: Ablative techniques are being explored as a new treatment option for locally advanced pancreatic cancer (LAPC). Unlike radiofrequency ablation, irreversible electroporation (IRE) is a non-thermal ablation technology and might preserve vascular and ductal structures.
S44
Abstracts / Pancreatology 14 (2014) S1eS129
Aims: The aim of this study was to evaluate the safety and potential benefits of IRE in patients with LAPC. Patients & methods: A systematic search was performed in PubMed, Embase and Cochrane Library for English articles published until March 2014 and subsequently reviewed according to PRISMA guidelines. Included were clinical studies reporting on outcomes of IRE in LAPC. Exclusion criteria were: 1) studies that did not report morbidity and mortality; 2) case reports; 3) conference abstracts. Baseline characteristics as well as study characteristics were extracted. Outcomes expressed as morbidity, mortality and overall survival were extracted from the articles. Results: After screening 143 studies, 4 clinical studies were included. These studies involving 176 patients, reported overall morbidity of 21-59%, IRE-related morbidity of 7-18.8%, and mortality of 0-3%. The IRE-related complications consisted of pancreatic fistula, portal vein thrombosis, duodenal leak and acute pancreatitis with reported rates of up to 3.7%, 7.4%, 7.4% and 7.1% respectively. Only one clinical study (n¼139) reported median survival of 20.2 months. Conclusion: IRE for LAPC seems feasible and safe based on clinical studies. However, the number of complications does not seem improved in comparison with RFA, except for pancreatic fistula. A large prospective, preferably randomized, study should establish whether morbidity, overall survival and quality of life are improved by IRE as compared to alternative established treatments.
W-084. Dilation of malignant duodenal stenosis due to pancreatic or biliary cancer with temporary placement of partially covered self expandible metal stent(SEMS). a m Tarpay, Richa rd Szmola, Ma ria Burai, Jo r zsef Pozsa Akos Pap, Ad Budapest (National Institute of Oncology, Invasive Gastroenterology), Hungary Background: Malignant stricture of duodenum can occur parallelly with biliary stenosis preventing ERCP, intraductal brushing, sphincterotomy and stenting of the common bileduct. Temporary placement of covered SEMS for several days proved to be effective for dilation of benign strictures. Aims: We used partially covered SEMS for progressive dilation of malignant stricture of duodenum before ERCP and stenting for jaundice. Patients & methods: Six patients (3 females, 3 males), mean age 69(62-83) years with pancreatic (4), gallbladder or parapapillary bile duct(1-1) cancer were stented for duodenal stenosis for 4.7(1-9) days.The SEMSs were removed before ERCP because migration or difficulty to pass the duodenoscope to the level of papilla through the stent. Results: After dilation of duodenum, a 13mm Jumbo (4 cases) or 12mm duodenoscope (1 patient) could be used for ERCP with intraductal cytology, sphincterotomy and biliary SEMS placement. In 1 patient rendez-vous technique through PTD and 9.5mm gastroscope was necessary for complex endotherapy even after 7-day dilation thus the SEMS was replaced into the duodenum and the patient survived 36 weeks due to successful chemotherapy. The other 5 patients needed no replacement of duodenal SEMS: the bileduct case survives since 39 weeks, that with gallbladder tumour died after 11 weeks, the 3 remaining pancreas cases deceased after 12, 7 and 4 weeks in terminal state without gastric outlet problems. Conclusion: Temporary placement of covered SEMS for several days can dilate malignant duodenal stenosis to make endotherapy possible in cases with locally advanced pancreatic and biliary cancers. The gastric outlet may remain sufficient definitely without replacement of duodenal SEMS.
W-085. The ABO blood group gene in pancreatic cancer: The A1 phenotype increases the risk for pancreatic ductal adenocarcinoma Khadija El Jellas a, Heike Immervoll b, K.G. Hagen c, Sura Aziz d, May Britt Kalvenes a, Solrun Steine a, Dag Hoem e, Stefan Johansson f, Anders Molven a a Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Norway, Norway b Department of Pathology, Ålesund Hospital, Ålesund, Norway, Norway c Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway, Norway d Department of Pathology, Haukeland University Hospital, Bergen, Norway, Norway e Department of Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway, Norway f Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway, Norway
Background: Several studies have observed a link between the ABO gene and the risk for pancreatic cancer. The mechanism for such an association is not known, although suggested explanations are an involvement of Helicobacter infection or an immunologically protective effect of A-like antigens produced by the pancreatic cancer cells. Aims: To evaluate the association between ABO status and pancreatic cancer in a Norwegian cohort of verified pancreatic ductal adenocarcinomas (PDAC). Patients & methods: Using TaqMan genotyping assays ABO status was determined for both cases (n¼188) and healthy blood donor controls (n¼379). Results: We found that the A blood group was associated with higher risk for pancreatic cancer (51.1% in PDAC vs. 40.6% in controls; p¼0.019, OR¼1.52). The O phenotype tended to be protective (34.6% vs. 42.7%, p¼0.062). The A blood group risk seemed to be restricted to those having the A1 subtype (42.0% vs. 29.3%, p¼0.002, OR¼1.74) as an association with A2 was not seen (9.0% vs. 11.4%, p¼0.401) . The blood group O frequency among patients who presented with non-resectable tumours was lower than in those who underwent surgical resection (29.9% vs. 38.6%), although not statistically significant (p¼0.27). Conclusion: Blood group A1 individuals are at a higher risk for PDAC than A2 and O individuals. Among O patients there could be a higher proportion of resectable tumours at the time of diagnosis than among non-O patients, but this needs to be followed up in larger studies. Our results call for studies of the role of ABO glycosyl-transferase activity in the development of PDAC.
W-086. Hepatitis B virus and hepatitis C virus infection are not risk of pancreatic adenocarcinoma in Taiwan Ming-Chu Chang a, Chien-Hung Chen a, Ja-Der Liang a, Yu-Wen Tien b, Chiun Hsu c, Yu-Ting Chang a a
Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan b Department of Surgery, National Taiwan University Hospital ,College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan c Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan Background: Previous studies on HBV status and pancreatic cancer risk have produced conflicting results. Aims: To investigate whether HBV and HCV infections increase the risk for pancreatic ductal adenocarcinoma (PDAC) in a high endemic area for HBV.
Patients & methods: A 72-year-old patient was presented with rapidly progressing jaundice and loss of weight. He had no medical history. CT scan revealed biliary- and pancreatic duct dilatation, caused by pancreatic head mass and hepatosplenomegaly. Prior to the operation all indices of cholestasis were elevated. The intraoperative FNAB showed signs of malignancy, therefore we performed pylorus preserving pancreaticoduodenectomy with lymphadenectomy. The final histological examination resulted a grade III, T3N1 stage basaloid carcinoma. Results: Tumor cells were diffusely immunoreactive for CK-5/6, CK-19 and EGFR, focally positive for CK-14 and CK-17, negative for CK-7 and BRCA1. 70% of the tumorcells showed positive reactions with p53 and Ki-67 labeling index. One lymph node of the resected 9 showed metastasis. The patient was treated with gemcitabine postoperatively. After three months there is no sign of local recurrence or metastasis. Conclusion: Based on the reviewed literature, radical surgical removal should be the first step of the treatment of the basaloid carcinomas. It would be desirable to establish adjuvant chemotherapy protocol in the future, regarding its similar histopathologic traits in the different anatomical sites. Considering the increasing number of basaloid carcinomas, their inclusion in the WHO classification system would also be advantageous.
S43
solely on a diagnostic test were excluded. Data on baseline characteristics, type of pancreatic resection, diagnostic test for EPI and occurrence of EPI were extracted. Prevalence of EPI was calculated from these data. Results: After screening 3203 articles, 9 observational cohort (4 prospective, 5 retrospective) studies were included on a total of 664 patients. Of these patients 333 (50%) underwent pancreatoduodenectomy (PD), 23 (3%) total pancreatectomy (TP), 114 (17%) distal pancreatectomy (DP) and 194 (33%) no resection due to locally advanced pancreatic cancer. Median preoperative prevalence of EPI was 44% (range 42-67%) before PD; 20% (1667%) before DP; 63% before TP; and 50% in unresectable patients. The median prevalence of EPI at least 6 months postoperative was 84% (36100%) after PD; 67-80% after DP; and 100% after TP. Conclusion: EPI is frequently seen in patients before resection for pancreatic or peri-ampullary cancer. The prevalence increases markedly following resection.
W-082. History of previous breast and genitourinary tract neoplasms in patients undergoing resection for pancreatic adenocarcinoma (PDAC) Francesca Gavazzi, Maria Rachele Angiolini, Cristina Ridolfi, Maria Carla Tinti, Fara Uccelli, Marco Madonini, Marco Montorsi, Alessandro Zerbi
W-080. Intraductal tubulopapillary pancreatic carcinoma, complicated with massive GI bleeding. Case report and review of the literature a
b
Section of Pancreatic Surgery, Surgery Department, University of Milan School of Medicine, Humanitas Research Hospital, Milan, Italy
a
Vyacheslav Egorov , Irene Esposito , Natalia Ratnikova , Natalia Starostina a, Roman Petrov a, Olga Kosheleva a a
5th Moscow City Hospital, Moscow, Russia, Russia b Technische Universit€ at München, Munchen, Germany, Germany Background: Intraductal tubulopapillary neoplasm (ITPN) is a very rare pancreatic tumor. Aims: Demonstration of a rare pancreatic tumor with its rare complication Patients & methods: A 36-year old woman was referred to ICU department of our hospital for massive upper GI bleeding and jaundice. After stabilization CT and endoscopy showed a non-mucinous tumor of the pancreatic head invading duodenum with a large crater of the vertical branch. Intraductal spread along the pancreas was suspected without any sign of dissemination. Six days after decompression of bile system and correction of coagulopathy Whipple procedure was performed and pancreatectomy was completed because of repeated positive margins on the levels of pancreatic body and tail. Uneventfull postoperative course. Results: Histopathology revealed massive intraductal tubulopapillary carcinoma of the pancreatic head with invasion of the duodenum on the background of ITPN of the pancreatic body and tail. Conclusion: This is the thirty first description of ITPN and the first case of such a tumor, complicated with massive GI bleeding and jaundice.
W-081. Exocrine pancreatic insufficiency in patients with pancreatic or periampullary cancer: A systematic review
Background: The expectancy of life increase recently observed in industrialized countries showed how cellular aging lead to cancer development. For this reason, surgical patients clinical history often reveals multiple tumors. Literature suggests a possible association between PDAC and other cancers, with genetic substrate probably but not exclusively implicated. Aims: Evaluation of the prevalence of other tumors among patient with PDAC. Materials & methods: We analyzed past medical history of 161 surgical PDAC patient (Jan-2010/Jun-2013), searching for previously occurred neoplasms. Cancer epidemiology in our country was obtained from TumorsRegistry Italian Association (AIRTUM) and ISS-Epidemiology Service. Results: Mean age of our patients was 68±10 years; 21,7% of them had a previous history of cancer, with mean age at diagnosis 60±11 years. The more frequent were breast (9,3%) and genitourinary tract neoplasms (7%), of which 3,1% prostate cancer. According to AIRTUM, standardized cancer prevalence in Italy is 1869/100.000 females (1,9%) for breast and 896/ 100.000(0,9%) for prostate. 73% of our patients with prostate or breast cancer received PDAC diagnosis during previous neoplasm follow-up. However, their PDAC stage (pTNM 7 Ed/AJCC) was not significantly lower compared with fortuitous diagnosis cases (p¼0.181). Conclusion: Even though breast and prostate cancer are notoriously high-incidence and long-survival related, their prevalence among PDAC patients seems to be interestingly higher. Further studies are necessary to investigate genetic and environmental bases. A clinical implication could be a different proportion of resectable and advanced PDAC at diagnosis among patient performing an oncologic follow-up. For this reason, a radiological assessment adequate for pancreas evaluation should be suggested during follow-up for breast and genitourinary cancer.
Dorine S.J. Tseng, C. Hjalmar, van Santvoort, H.M. Inne, Borel Rinkes, I. Quintus Molennaar University Medical Center Utrecht, Dept. of Surgery, Netherlands Background: Exocrine pancreatic insufficiency (EPI) is caused by loss of pancreatic parenchyma or obstruction of the pancreatic duct. This may occur in pancreatic or peri-ampullary cancer, both before and after resection. The prevalence and natural course of EPI in these patients has not been thoroughly studied. Aims: The aim of this study was to determine the prevalence of EPI in patients with pancreatic or peri-ampullary cancer. Patients & methods: We systematically reviewed the literature published up to February 20th 2014, according to the PRISMA guidelines. We included studies reporting on EPI in patients with pancreatic or periampullary cancer. Studies reporting on EPI due to other causes and focusing
W-083. Irreversible electroporation in locally advanced pancreatic cancer: A systematic review Steffi Rombouts a, Samira Fegrachi a, Hjalmar van Santvoort a, Marc Besselink b, Richard van Hillegersberg a, Quintus Molennaar a a b
University Medical Center Utrecht, Netherlands Academic Medical Center Amsterdam, Netherlands
Background: Ablative techniques are being explored as a new treatment option for locally advanced pancreatic cancer (LAPC). Unlike radiofrequency ablation, irreversible electroporation (IRE) is a non-thermal ablation technology and might preserve vascular and ductal structures.
S44
Abstracts / Pancreatology 14 (2014) S1eS129
Aims: The aim of this study was to evaluate the safety and potential benefits of IRE in patients with LAPC. Patients & methods: A systematic search was performed in PubMed, Embase and Cochrane Library for English articles published until March 2014 and subsequently reviewed according to PRISMA guidelines. Included were clinical studies reporting on outcomes of IRE in LAPC. Exclusion criteria were: 1) studies that did not report morbidity and mortality; 2) case reports; 3) conference abstracts. Baseline characteristics as well as study characteristics were extracted. Outcomes expressed as morbidity, mortality and overall survival were extracted from the articles. Results: After screening 143 studies, 4 clinical studies were included. These studies involving 176 patients, reported overall morbidity of 21-59%, IRE-related morbidity of 7-18.8%, and mortality of 0-3%. The IRE-related complications consisted of pancreatic fistula, portal vein thrombosis, duodenal leak and acute pancreatitis with reported rates of up to 3.7%, 7.4%, 7.4% and 7.1% respectively. Only one clinical study (n¼139) reported median survival of 20.2 months. Conclusion: IRE for LAPC seems feasible and safe based on clinical studies. However, the number of complications does not seem improved in comparison with RFA, except for pancreatic fistula. A large prospective, preferably randomized, study should establish whether morbidity, overall survival and quality of life are improved by IRE as compared to alternative established treatments.
W-084. Dilation of malignant duodenal stenosis due to pancreatic or biliary cancer with temporary placement of partially covered self expandible metal stent(SEMS). a m Tarpay, Richa rd Szmola, Ma ria Burai, Jo r zsef Pozsa Akos Pap, Ad Budapest (National Institute of Oncology, Invasive Gastroenterology), Hungary Background: Malignant stricture of duodenum can occur parallelly with biliary stenosis preventing ERCP, intraductal brushing, sphincterotomy and stenting of the common bileduct. Temporary placement of covered SEMS for several days proved to be effective for dilation of benign strictures. Aims: We used partially covered SEMS for progressive dilation of malignant stricture of duodenum before ERCP and stenting for jaundice. Patients & methods: Six patients (3 females, 3 males), mean age 69(62-83) years with pancreatic (4), gallbladder or parapapillary bile duct(1-1) cancer were stented for duodenal stenosis for 4.7(1-9) days.The SEMSs were removed before ERCP because migration or difficulty to pass the duodenoscope to the level of papilla through the stent. Results: After dilation of duodenum, a 13mm Jumbo (4 cases) or 12mm duodenoscope (1 patient) could be used for ERCP with intraductal cytology, sphincterotomy and biliary SEMS placement. In 1 patient rendez-vous technique through PTD and 9.5mm gastroscope was necessary for complex endotherapy even after 7-day dilation thus the SEMS was replaced into the duodenum and the patient survived 36 weeks due to successful chemotherapy. The other 5 patients needed no replacement of duodenal SEMS: the bileduct case survives since 39 weeks, that with gallbladder tumour died after 11 weeks, the 3 remaining pancreas cases deceased after 12, 7 and 4 weeks in terminal state without gastric outlet problems. Conclusion: Temporary placement of covered SEMS for several days can dilate malignant duodenal stenosis to make endotherapy possible in cases with locally advanced pancreatic and biliary cancers. The gastric outlet may remain sufficient definitely without replacement of duodenal SEMS.
W-085. The ABO blood group gene in pancreatic cancer: The A1 phenotype increases the risk for pancreatic ductal adenocarcinoma Khadija El Jellas a, Heike Immervoll b, K.G. Hagen c, Sura Aziz d, May Britt Kalvenes a, Solrun Steine a, Dag Hoem e, Stefan Johansson f, Anders Molven a a Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Norway, Norway b Department of Pathology, Ålesund Hospital, Ålesund, Norway, Norway c Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway, Norway d Department of Pathology, Haukeland University Hospital, Bergen, Norway, Norway e Department of Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway, Norway f Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway, Norway
Background: Several studies have observed a link between the ABO gene and the risk for pancreatic cancer. The mechanism for such an association is not known, although suggested explanations are an involvement of Helicobacter infection or an immunologically protective effect of A-like antigens produced by the pancreatic cancer cells. Aims: To evaluate the association between ABO status and pancreatic cancer in a Norwegian cohort of verified pancreatic ductal adenocarcinomas (PDAC). Patients & methods: Using TaqMan genotyping assays ABO status was determined for both cases (n¼188) and healthy blood donor controls (n¼379). Results: We found that the A blood group was associated with higher risk for pancreatic cancer (51.1% in PDAC vs. 40.6% in controls; p¼0.019, OR¼1.52). The O phenotype tended to be protective (34.6% vs. 42.7%, p¼0.062). The A blood group risk seemed to be restricted to those having the A1 subtype (42.0% vs. 29.3%, p¼0.002, OR¼1.74) as an association with A2 was not seen (9.0% vs. 11.4%, p¼0.401) . The blood group O frequency among patients who presented with non-resectable tumours was lower than in those who underwent surgical resection (29.9% vs. 38.6%), although not statistically significant (p¼0.27). Conclusion: Blood group A1 individuals are at a higher risk for PDAC than A2 and O individuals. Among O patients there could be a higher proportion of resectable tumours at the time of diagnosis than among non-O patients, but this needs to be followed up in larger studies. Our results call for studies of the role of ABO glycosyl-transferase activity in the development of PDAC.
W-086. Hepatitis B virus and hepatitis C virus infection are not risk of pancreatic adenocarcinoma in Taiwan Ming-Chu Chang a, Chien-Hung Chen a, Ja-Der Liang a, Yu-Wen Tien b, Chiun Hsu c, Yu-Ting Chang a a
Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan b Department of Surgery, National Taiwan University Hospital ,College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan c Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan, Taiwan Background: Previous studies on HBV status and pancreatic cancer risk have produced conflicting results. Aims: To investigate whether HBV and HCV infections increase the risk for pancreatic ductal adenocarcinoma (PDAC) in a high endemic area for HBV.