Thermal liquid biopsy (TLB) focused on benign and premalignant pancreatic cyst diagnosis

Background: Current efforts in the identification of new biomarkers are directed towards an accurate differentiation between benign and premalignant cysts. Thermal Liquid Biopsy (TLB) has been previously applied to inflammatory and tumor diseases and could offer an interesting point of view in this type of pathology. Methods: In this work, twenty patients (12 males and 8 females, average ages 62) diagnosed with a pancreatic cyst benign (10) and premalignant (10) cyst lesions were recruited, and biological samples were obtained during the endoscopic ultrasonography procedure. Results: Proteomic content of cyst liquid samples was studied and several common proteins in the different groups were identified. TLB cyst liquid profiles reflected protein content. Also, TLB serum score was able to discriminate between healthy and cysts patients (71% sensitivity and 98% specificity) and between benign and premalignant cysts (75% sensitivity and 67% specificity). Conclusions: TLB analysis of plasmatic serum sample, a quick, simple and non-invasive technique that can be easily implemented, reports valuable information on the observed pancreatic lesion. These preliminary results set the basis for a larger study to refine TLB serum score and move closer to the clinical application of TLB providing useful information to the gastroenterologist during patient diagnosis

Dietary Fat Patterns and Outcomes in Acute Pancreatitis in Spain

Background/Objective: Evidence from basic and clinical studies suggests that unsaturated fatty acids (UFAs) might be relevant mediators of the development of complications in acute pancreatitis (AP). Objective: The aim of this study was to analyze outcomes in patients with AP from regions in Spain with different patterns of dietary fat intake. Materials and Methods: A retrospective analysis was performed with data from 1,655 patients with AP from a Spanish prospective cohort study and regional nutritional data from a Spanish cross-sectional study. Nutritional data considered in the study concern the total lipid consumption, detailing total saturated fatty acids, UFAs and monounsaturated fatty acids (MUFAs) consumption derived from regional data and not from the patient prospective cohort. Two multivariable analysis models were used: (1) a model with the Charlson comorbidity index, sex, alcoholic etiology, and recurrent AP; (2) a model that included these variables plus obesity. Results: In multivariable analysis, patients from regions with high UFA intake had a significantly increased frequency of local complications, persistent organ failure (POF), mortality, and moderate-to-severe disease in the model without obesity and a higher frequency of POF in the model with obesity. Patients from regions with high MUFA intake had significantly more local complications and moderate-to-severe disease; this significance remained for moderate-to-severe disease when obesity was added to the model. Conclusions: Differences in dietary fat patterns could be associated with different outcomes in AP, and dietary fat patterns may be a pre-morbid factor that determines the severity of AP. UFAs, and particulary MUFAs, may influence the pathogenesis of the severity of AP

LOE pancreática ¿otro caso de adenocarcinoma pancreático?

La tuberculosis continúa siendo la enfermedad infecciosa con mayor mortalidad a nivel mundial, con más de 1, 5 millo-nes de fallecimientos al año 1. Hasta el 12, 5% de los casos son extrapulmonares 2 y, aunque el páncreas es una localización poco frecuente, su diagnóstico está aumentando debido al incremento de pacientes inmunodeprimidos, así como la mejoría de las herramientas diagnósticas como la punción aspiración con aguja fina (PAAF) mediante ecoendoscopia. No existen hallazgos clínicos ni de imagen patognomónicos, por lo que el índice de sospecha debe ser alto para poderdiagnosticarla. Presentamos el caso de una mujer de 59 años, naturalde Venezuela, residente en España desde hace 10 años, sin viajes recientes a su país, sin antecedentes personales ni familiares de interés. Ingresa en planta de hospitalización por cuadro de inicio hace 6 meses consistente en dolor epigástrico progresivo y continuo, de intensidad moderada, aunque con episodios frecuentes de mayor intensidad, no claramente relacionado con la ingesta, que asociaba pérdida de peso reciente de unos 5 kg, náuseas y sensación distérmica o casional. En cuanto a las pruebas complementarias; analíticamente presentaba: GGT 180 U/l, FA 600 U/l, bilirrubina 2, 5 mg/dl, leucocitos 8.800/mm3, PCR 1, 49 mg/dl, CEA15 ng/ml, CA 19.9 240 U/ml, resto de bioquímica y coagulación normales. Se realizaron una ecografía y posteriormente una TAC (fig. 1) que informaba de: tumoración hipodensa en cuerpo y cabeza pancreática de 45 mm, que rodea vena porta y presenta límites mal definidos con área..