Hepatobiliary Cancer, Pancreatic Cancer, and Neuroendocrine Cancers of the Gastrointestinal Tract

Intussusception is defined as the invagination of one part of the gastrointestinal tract into another. Jejunogastric intussusception is a rare phenomenon following major upper abdominal surgery, where its aetiology is not well understood. We describe a 68-year-old woman who presented with abdominal pain and haematemesis on the background of a previous pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer. Gastroscopy demonstrated retrograde jejunogastric intussusception, where part of the efferent jejunal limb had prolapsed into the remnant stomach. As a consequence, this intussuscepted segment had become oedematous and ischaemic. The patient subsequently underwent a laparotomy, where the original gastrojejunostomy was resected, which showed the intussuscepted jejunum. The non-viable portion was removed and a Roux-en-Y anastomosis was created. This case highlights the need to ‘think outside the box’ with respect to differential diagnoses when a patient presents with abdominal pain on the background of previous complex abdominal surgery.

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Glycoprotein 2 in health and disease: lifting the veil

Genes and Environment ◽

10.1186/s41021-021-00229-8 ◽

2021 ◽

Vol 43 (1) ◽

Author(s):

Yingsong Lin ◽

Masahiro Nakatochi ◽

Naoki Sasahira ◽

Makoto Ueno ◽

Naoto Egawa ◽

...

Keyword(s):

Pancreatic Cancer ◽

Gastrointestinal Tract ◽

Genome Wide Association Study ◽

Cancer Susceptibility ◽

Acinar Cells ◽

Pancreatic Acinar Cells ◽

Intestinal Lumen ◽

Zymogen Granules ◽

A Genome ◽

Health And Disease

AbstractIn 2020, we discovered glycoprotein 2 (GP2) variants associated with pancreatic cancer susceptibility in a genome-wide association study involving the Japanese population. Individuals carrying a missense coding variant (rs78193826) in the GP2 gene resulting in a p.V432M substitution had an approximately 1.5-fold higher risk of developing pancreatic cancer than those without this variant. GP2 is expressed on the inner surface of zymogen granules in pancreatic acinar cells, which are responsible for the sorting, storage and secretion of digestive enzymes. Upon neuronal, hormonal, or other stimulation, GP2 is cleaved from the membrane of zymogen granules and then secreted into the pancreatic duct and intestinal lumen. While the functions of GP2 remain poorly understood, emerging evidence suggests that it plays an antibacterial role in the gastrointestinal tract after being secreted from pancreatic acinar cells. Impaired GP2 functions may facilitate the adhesion of bacteria to the intestinal mucosa. In this review article, we summarize the role of GP2 in health and disease, emphasizing its functions in the gastrointestinal tract, as well as genetic variations in the GP2 gene and their associations with disease susceptibility. We hope that its robust genetic associations with pancreatic cancer, coupled with its emerging role in gastrointestinal mucosal immunity, will spur renewed research interest in GP2, which has been understudied over the past 30 years compared with its paralog uromodulin (UMOD).

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Increased risk of cancer in patients with primary sclerosing cholangitis

Hepatology International ◽

10.1007/s12072-021-10214-6 ◽

2021 ◽

Author(s):

Aiva Lundberg Båve ◽

Annika Bergquist ◽

Matteo Bottai ◽

Anna Warnqvist ◽

Erik von Seth ◽

...

Keyword(s):

Colorectal Cancer ◽

Pancreatic Cancer ◽

Primary Sclerosing Cholangitis ◽

Sclerosing Cholangitis ◽

Cox Regression ◽

Hepatobiliary Cancer ◽

Kaplan Meier ◽

Increased Risk ◽

Inflammatory Bowel ◽

Risk Of Cancer

Abstract Background and aims Primary sclerosing cholangitis (PSC) is associated with an increased risk of hepatobiliary and colorectal cancer, but the risks of other cancer forms have not been explored. The aim of this study was to evaluate the risk of intestinal and extraintestinal cancers in a large, well-defined cohort of PSC patients. Material and method A matched cohort study of Swedish PSC patients was performed with up to ten comparators for each patient, matched for sex, age, and residency. The data were retrieved from national registers. Patients were followed from PSC diagnosis until cancer diagnosis, liver transplantation, first emigration date, death, or December 31, 2016. The risk of cancer was estimated using the Kaplan–Meier method and Cox regression models. Results In total, 1432 PSC patients with a verified diagnosis and 14,437 comparators were studied. The mean follow-up time was 15.9 years. Eighty-eight percent of the PSC patients had concomitant inflammatory bowel disease. PSC patients ran significantly increased risks of developing any cancer [HR 3.8, 95% confidence interval (CI) 3.3–4.3], hepatobiliary cancer (HR 120.9, 95% CI 72.0–203.1), colorectal cancer (HR 7.5, 95% CI 5.6–10.0), pancreatic cancer (HR 8.0, 95% CI 3.2–20.2), gastric cancer (HR 4.2, 95% CI 1.5–11.3), small bowel cancer (HR 21.1, 95% CI 3.5–128.2), and lymphoma (HR 3.0, 95% CI 1.6–5.7). PSC was not associated with a lower risk of any cancer form. Conclusions PSC patients have a four times overall increased risk of developing cancer compared to the general population, with increased risk of developing hepatobiliary, colorectal, and pancreatic cancer, as well as lymphoma.

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Habitat Association of Klebsiella Species

Infection Control ◽

10.1017/s0195941700062603 ◽

1985 ◽

Vol 6 (2) ◽

pp. 52-58 ◽

Cited By ~ 111

Author(s):

Susan T. Bagley

Keyword(s):

Drinking Water ◽

Gastrointestinal Tract ◽

Surface Waters ◽

Industrial Effluents ◽

Opportunistic Pathogen ◽

Habitat Associations ◽

Habitat Association ◽

Klebsiella Species ◽

Almost All ◽

Polluted Waters

AbstractThe genus Klebsiella is seemingly ubiquitous in terms of its habitat associations. Klebsiella is a common opportunistic pathogen for humans and other animals, as well as being resident or transient flora (particularly in the gastrointestinal tract). Other habitats include sewage, drinking water, soils, surface waters, industrial effluents, and vegetation. Until recently, almost all these Klebsiella have been identified as one species, ie, K. pneumoniae. However, phenotypic and genotypic studies have shown that “K. pneumoniae” actually consists of at least four species, all with distinct characteristics and habitats. General habitat associations of Klebsiella species are as follows: K. pneumoniae—humans, animals, sewage, and polluted waters and soils; K. oxytoca—frequent association with most habitats; K. terrigena— unpolluted surface waters and soils, drinking water, and vegetation; K. planticola—sewage, polluted surface waters, soils, and vegetation; and K. ozaenae/K. rhinoscleromatis—infrequently detected (primarily with humans).

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