Results of surveillance in individuals at high-risk of pancreatic cancer: A systematic review and meta-analysis

Background: Data on surveillance for pancreatic ductal adenocarcinoma (PDAC) in high-risk individuals (HRIs) with “familial pancreatic cancer” (FPC) and specific syndromes are limited and heterogeneous. Objective: We conducted a systematic review and meta-analysis of PDAC surveillance studies in HRIs. Methods: Prevalence of solid/cystic pancreatic lesions and of lesions considered a successful target of surveillance (proven resectable PDAC and high-grade precursors) was pooled across studies. The rate of lesions diagnosed by endoscopic ultrasonography (EUS)/magnetic resonance imaging (MRI) and across different HRI groups was calculated. Results: Sixteen studies incorporating 1588 HRIs were included. The pooled prevalence of pancreatic solid and cystic lesions was 5.8% and 20.2%, respectively. The pooled prevalence of patients with lesions considered a successful target of surveillance was 3.3%, being similar to EUS or MRI and varying across subgroups, being 3% in FPC, 4% in hereditary pancreatitis, 5% in familial melanoma, 6.3% in hereditary breast/ovarian cancer, and 12.2% in Peutz-Jeghers syndrome. The pooled estimated rate of lesions considered a successful target of surveillance during follow-up was 5/1000 person-years. Conclusion: Surveillance programs identify successful target lesions in 3.3% of HRIs with a similar yield of EUS and MRI and an annual risk of 0.5%. A higher rate of target lesions was reported in HRIs with specific DNA mutations

An overview of Alpine and Mediterranean palaeogeography, terrestrial ecosystems and climate history during MIS 3 with focus on the Middle to Upper Palaeolithic transition

This paper summarizes the current state of knowledge about the millennial scale climate variability characterizing Marine Isotope Stage 3 (MIS 3) in S-Europe and the Mediterranean area and its effects on terrestrial ecosystems. The sequence of Dansgaard-Oeschger events, as recorded by Greenland ice cores and recognizable in isotope profiles from speleothems and high-resolution palaeoecological records, led to dramatic variations in glacier extent and sea level configuration with major impacts on the physiography and vegetation patterns, both latitudinally and altitudinally. The recurrent succession of (open) woodlands, including temperate taxa, and grasslands with xerophytic elements, have been tentatively correlated to GIs in Greenland ice cores. Concerning colder phases, the Greenland Stadials (GSs) related to Heinrich events (HEs) appear to have a more pronounced effect than other GSs on woodland withdrawal and xerophytes expansion. Notably, GS 9-HE4 phase corresponds to the most severe reduction of tree cover in a number of Mediterranean records. On a long-term scale, a reduction/opening of forests throughout MIS 3 started from Greenland Interstadials (GIs) 14/13 (ca. 55\u201348 ka), which show a maximum in woodland density. At that time, natural environments were favourable for Anatomically Modern Humans (AMHs) to migrate from Africa into Europe as documented by industries associated with modern hominin remains in the Levant. Afterwards, a variety of early Upper Palaeolithic cultures emerged (e.g., Uluzzian and Proto-Aurignacian). In this chronostratigraphic framework, attention is paid to the Campanian Ignimbrite tephra marker, as a pivotal tool for deciphering and correlating several temporal-spatial issues crucial for understanding the interaction between AMHs and Neandertals at the time of the Middle to Upper Palaeolithic transition

Integrated multidisciplinary ecological analysis from the Uluzzian settlement at the Uluzzo C Rock Shelter, south-eastern Italy

open20siThe Middle to Upper Palaeolithic transition, between 50 000 and 40 000 years ago, is a period of important ecological and cultural changes. In this framework, the Rock Shelter of Uluzzo C (Apulia, southern Italy) represents an important site due to Late Mousterian and Uluzzian evidence preserved in its stratigraphic sequence. Here, we present the results of a multidisciplinary analysis performed on the materials collected between 2016 and 2018 from the Uluzzian stratigraphic units (SUs) 3, 15 and 17. The analysis involved lithic technology, use-wear, zooarchaeology, ancient DNA of sediments and palaeoproteomics, completed by quartz single-grain optically stimulated luminescence dating of the cave sediments. The lithic assemblage is characterized by a volumetric production and a debitage with no or little management of the convexities (by using the bipolar technique), with the objective to produce bladelets and flakelets. The zooarchaeological study found evidence of butchery activity and of the possible exploitation of marine resources, while drawing a picture of a patchy landscape, composed of open forests and dry open environments surrounding the shelter. Ancient mitochondrial DNA from two mammalian taxa were recovered from the sediments. Preliminary zooarchaeology by mass spectrometry results are consistent with ancient DNA and zooarchaeological taxonomic information, while further palaeoproteomics investigations are ongoing. Our new data from the re-discovery of the Uluzzo C Rock Shelter represent an important contribution to better understand the meaning of the Uluzzian in the context of the Middle/Upper Palaeolithic transition in south-eastern Italy.First published: 13 July 2021openSARA SILVESTRINI, MATTEO ROMANDINI, GIULIA MARCIANI, SIMONA ARRIGHI, LISA CARRERA, ANDREA FIORINI, JUAN MANUEL LÓPEZ-GARCÍA, FEDERICO LUGLI, FILOMENA RANALDO, VIVIANE SLON, LAURA TASSONI, OWEN ALEXANDER HIGGINS, EUGENIO BORTOLINI, ANTONIO CURCI, MATTHIAS MEYER, MICHAEL CHRISTIAN MEYER, GREGORIO OXILIA, ANDREA ZERBONI, STEFANO BENAZZI, SPINAPOLICE ENZA ELENASARA SILVESTRINI, MATTEO ROMANDINI, GIULIA MARCIANI, SIMONA ARRIGHI, LISA CARRERA, ANDREA FIORINI, JUAN MANUEL LÓPEZ-GARCÍA, FEDERICO LUGLI, FILOMENA RANALDO, VIVIANE SLON, LAURA TASSONI, OWEN ALEXANDER HIGGINS, EUGENIO BORTOLINI, ANTONIO CURCI, MATTHIAS MEYER, MICHAEL CHRISTIAN MEYER, GREGORIO OXILIA, ANDREA ZERBONI, STEFANO BENAZZI, SPINAPOLICE ENZA ELEN

Effect of aspirin, ACE inhibitors/sartans and statins use on the progression of BD-IPMN in follow up: a multicenter study

No abstract availabl

The neutrophil/lymphocyte ratio at diagnosis is significantly associated with survival in metastatic pancreatic cancer patients

Different inflammation-based scores such as the neutrophil/lymphocyte ratio (NLR), the Odonera Prognostic Nutritional Index (PNI), the Glasgow Prognostic Score, the platelet/lymphocyte ratio, and the C-reactive protein/albumin ratio have been found to be significantly associated with pancreatic cancer (PDAC) prognosis. However, most studies have investigated patients undergoing surgery, and few of them have compared these scores. We aimed at evaluating the association between inflammatory-based scores and PDAC prognosis. In a single center cohort study, inflammatory-based scores were assessed at diagnosis and their prognostic relevance as well as that of clinic-pathological variables were evaluated through multiple logistic regression and survival probability analysis. In 206 patients, age, male sex, tumor size, presence of distant metastasis, access to chemotherapy, and an NLR > 5 but not other scores were associated with overall survival (OS) at multivariate analysis. Patients with an NLR 5. In the 81 patients with distant metastasis at diagnosis, an NLR > 5 resulted in the only variable significantly associated with survival. Among patients with metastatic disease who received chemotherapy, the median survival was 3 months in patients with an NLR > 5 and 7 months in those with an NLR < 5. The NLR might drive therapeutic options in PDAC patients, especially in the setting of metastatic disease