PDF(Pubmed)
Abstract：
UNASSIGNED: After pancreaticoduodenectomy, 20-40% of patients develop steatotic liver disease (SLD), and steatohepatitis can be a problem. Although patatin-like phospholipase domain-containing 3 protein (PNPLA3) and transmembrane 6 superfamily member 2 (TM6SF2) polymorphisms are involved in SLD and steatohepatitis development, whether this is the case after pancreaticoduodenectomy is unclear.
UNASSIGNED: Forty-three patients with pancreatic cancer who underwent pancreaticoduodenectomy at our hospital between April 1, 2018, and March 31, 2021, were included. We extracted DNA from noncancerous areas of residual specimens after pancreaticoduodenectomy and determined PNPLA3 and TM6SF2 gene polymorphisms using real-time polymerase chain reaction. SLD was defined as a liver with an attenuation value of ≤40 HU or a liver-to-spleen ratio of ≤0.9 on computed tomography. We defined high hepatic fibrosis indexes (HFI) instead of steatohepatitis as a Fibrosis-4 index of ≥2.67 or nonalcoholic fatty liver disease fibrosis score of ≥0.675 in patients with SLD. The cumulative incidence of SLD (P = 0.299) and high HFI (P = 0.987) after pancreaticoduodenectomy were not significantly different between the PNPLA3 homozygous and minor allele groups. The incidences of high HFI at 1 year after pancreaticoduodenectomy were 16.8% and 27.0% in the TM6SF2 major homozygous and minor allele groups, respectively, with a significant difference in the cumulative incidence (P = 0.046).
UNASSIGNED: The TM6SF2 minor allele may contribute to steatohepatitis development after pancreaticoduodenectomy.
UNASSIGNED: Forty-three patients with pancreatic cancer who underwent pancreaticoduodenectomy at our hospital between April 1, 2018, and March 31, 2021, were included. We extracted DNA from noncancerous areas of residual specimens after pancreaticoduodenectomy and determined PNPLA3 and TM6SF2 gene polymorphisms using real-time polymerase chain reaction. SLD was defined as a liver with an attenuation value of ≤40 HU or a liver-to-spleen ratio of ≤0.9 on computed tomography. We defined high hepatic fibrosis indexes (HFI) instead of steatohepatitis as a Fibrosis-4 index of ≥2.67 or nonalcoholic fatty liver disease fibrosis score of ≥0.675 in patients with SLD. The cumulative incidence of SLD (P = 0.299) and high HFI (P = 0.987) after pancreaticoduodenectomy were not significantly different between the PNPLA3 homozygous and minor allele groups. The incidences of high HFI at 1 year after pancreaticoduodenectomy were 16.8% and 27.0% in the TM6SF2 major homozygous and minor allele groups, respectively, with a significant difference in the cumulative incidence (P = 0.046).
UNASSIGNED: The TM6SF2 minor allele may contribute to steatohepatitis development after pancreaticoduodenectomy.
摘要：
■胰十二指肠切除术后，20-40％的患者发展为脂肪变性肝病（SLD），脂肪性肝炎可能是个问题.尽管含patatatin样磷脂酶结构域的3蛋白（PNPLA3）和跨膜6超家族成员2（TM6SF2）多态性参与SLD和脂肪性肝炎的发展，胰十二指肠切除术后是否是这种情况尚不清楚。
■纳入了2018年4月1日至2021年3月31日在我院接受胰十二指肠切除术的43例胰腺癌患者。我们从胰十二指肠切除术后残留标本的非癌区域提取DNA，并使用实时聚合酶链反应确定PNPLA3和TM6SF2基因多态性。SLD定义为在计算机断层扫描中衰减值≤40HU或肝脾比≤0.9的肝脏。我们定义高肝纤维化指数（HFI）而不是脂肪性肝炎为纤维化-4指数≥2.67或SLD患者的非酒精性脂肪性肝病纤维化评分≥0.675。胰十二指肠切除术后SLD（P=0.299）和高HFI（P=0.987）的累积发生率在PNPLA3纯合和次要等位基因组之间没有显着差异。胰十二指肠切除术后1年高HFI的发生率在TM6SF2主要纯合子和次要等位基因组中分别为16.8%和27.0%。分别,累积发生率有显著差异(P=0.046)。
■TM6SF2次要等位基因可能有助于胰十二指肠切除术后脂肪性肝炎的发展。
■纳入了2018年4月1日至2021年3月31日在我院接受胰十二指肠切除术的43例胰腺癌患者。我们从胰十二指肠切除术后残留标本的非癌区域提取DNA，并使用实时聚合酶链反应确定PNPLA3和TM6SF2基因多态性。SLD定义为在计算机断层扫描中衰减值≤40HU或肝脾比≤0.9的肝脏。我们定义高肝纤维化指数（HFI）而不是脂肪性肝炎为纤维化-4指数≥2.67或SLD患者的非酒精性脂肪性肝病纤维化评分≥0.675。胰十二指肠切除术后SLD（P=0.299）和高HFI（P=0.987）的累积发生率在PNPLA3纯合和次要等位基因组之间没有显着差异。胰十二指肠切除术后1年高HFI的发生率在TM6SF2主要纯合子和次要等位基因组中分别为16.8%和27.0%。分别,累积发生率有显著差异(P=0.046)。
■TM6SF2次要等位基因可能有助于胰十二指肠切除术后脂肪性肝炎的发展。
