Publications by authors named "Milanetto A"

An asymptomatic 79-year old woman presented with a 40 mm pancreatic cystic lesion, located in the pancreatic body-tail and consistent with branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) without "high risk stigmata". During a 4-year follow-up period, imaging showed no mural nodules or main pancreatic duct dilation, and serum CEA and CA19.9 were within normal range.

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with patients having unresectable or metastatic disease at diagnosis, with poor prognosis and very short survival. Given that genetic variation within autophagy-related genes influences autophagic flux and susceptibility to solid cancers, we decided to investigate whether 55,583 single nucleotide polymorphisms (SNPs) within 234 autophagy-related genes could influence the risk of developing PDAC in three large independent cohorts of European ancestry including 12,754 PDAC cases and 324,926 controls. The meta-analysis of these populations identified, for the first time, the association of the BID variant with an increased risk of developing the disease (OR = 1.

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Article Synopsis
  • CoRSIVs are regions in the genome with consistent DNA methylation patterns across tissues but show individual differences and are influenced by nearby genetic variants.
  • This study focused on investigating SNPs within CoRSIVs and their potential link to pancreatic ductal adenocarcinoma (PDAC) risk, analyzing data from over 14,000 patients and 247,000 controls.
  • The research identified that the A allele of SNP rs2976395 is linked to a higher risk of PDAC in Europeans and is associated with changes in DNA methylation and overexpression of the prostate stem cell antigen gene, highlighting the need for further functional studies.
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Pleiotropic variants (i.e., genetic polymorphisms influencing more than one phenotype) are often associated with cancer risk.

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Genome-wide association studies (GWAS) are a powerful tool for detecting variants associated with complex traits and can help risk stratification and prevention strategies against pancreatic ductal adenocarcinoma (PDAC). However, the strict significance threshold commonly used makes it likely that many true risk loci are missed. Functional annotation of GWAS polymorphisms is a proven strategy to identify additional risk loci.

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  • Pancreatic cystic lesions, often discovered incidentally, vary in severity regarding their risk for cancer, with intraductal papillary mucinous neoplasms (IPMN) being particularly concerning as they can range from benign to malignant.
  • The detection and management of IPMN have been enhanced by the use of imaging techniques like CT and MRI, with MRI being the primary tool for diagnosis and ongoing monitoring, especially for branch-duct IPMN, which are the most common and challenging to manage.
  • This review focuses on showcasing the MRI characteristics of IPMN, discussing risk assessment frameworks, and addressing both common and rare imaging changes in branch-duct IPMN, while also debating current management approaches.
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(1) Background: Patients with pancreatic Neuroendocrine Neoplasms (PanNENs) often have a long overall survival. We evaluated determinants of quality of life (QoL) after surgery for PanNENs. (2) Methods: Patients operated on for a PanNEN in our center (1990-2021) received three EORTC QoL questionnaires (QLQ-C30, QLQ-GI.

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Introduction: Pancreatic cancer (PC) surveillance of high-risk individuals (HRI) is becoming more common worldwide, aiming at anticipating PC diagnosis at a preclinical stage. In 2015, the Italian Registry of Families at Risk of Pancreatic Cancer was created. We aimed to assess the prevalence and incidence of pancreatic findings, oncological outcomes, and harms 7 years after the Italian Registry of Families at Risk of Pancreatic Cancer inception, focusing on individuals with at least a 3-year follow-up or developing events before.

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Coding sequence variants comprise a small fraction of the germline genetic variability of the human genome. However, they often cause deleterious change in protein function and are therefore associated with pathogenic phenotypes. To identify novel pancreatic ductal adenocarcinoma (PDAC) risk loci, we carried out a complete scan of all common missense and synonymous SNPs and analysed them in a case-control study comprising four different populations, for a total of 14 538 PDAC cases and 190 657 controls.

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  • Modern non-Africans have 1-3% Neandertal DNA due to interbreeding events that occurred 50,000-60,000 years ago, which may affect traits linked to diseases like pancreatic ductal adenocarcinoma (PDAC).
  • In this study, researchers examined how specific Neandertal-related genetic variations (aSNPs) correlate with PDAC risk in European and East Asian populations, using data from over 200,000 individuals.
  • While no significant link was found in Europeans, a specific allele in East Asians was associated with a 35% increased risk of developing PDAC, suggesting only a limited role of Neandertal genes in this cancer's risk.
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Pancreatic cancer has an incidence that almost matches its mortality. Only a small number of risk factors and 33 susceptibility loci have been identified. so Moreover, the relative rarity of pancreatic cancer poses significant hurdles for research aimed at increasing our knowledge of the genetic mechanisms contributing to the disease.

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Introduction: Only a small number of risk factors for pancreatic ductal adenocarcinoma (PDAC) has been established. Several studies identified a role of epigenetics and of deregulation of DNA methylation. DNA methylation is variable across a lifetime and in different tissues; nevertheless, its levels can be regulated by genetic variants like methylation quantitative trait loci (mQTLs), which can be used as a surrogate.

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Background: Early-onset pancreatic cancer (EOPC) represents 5-10% of all pancreatic ductal adenocarcinoma (PDAC) cases, and the etiology of this form is poorly understood. It is not clear if established PDAC risk factors have the same relevance for younger patients. This study aims to identify genetic and non-genetic risk factors specific to EOPC.

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Background: Pancreatic neuroendocrine neoplasms (pNENs) are often detected as large primary lesions, even with distant metastases, and their prognosis may be difficult to predict.

Methods: In this retrospective study, we retrieved data of patients treated for a large pNEN in our Surgical Unit (1979-2017) to evaluate the possible prognostic role of clinic-pathological features and surgery. Cox-proportional hazard regression models were used to find possible associations among some variables (clinical features, surgery, and histology) and survival at univariate and multivariate analyses.

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Article Synopsis
  • The study investigates the genetic factors contributing to pancreatic ductal adenocarcinoma (PDAC) by analyzing low-penetrance genetic variants in 29 familial PDAC-associated genes.
  • A large-scale analysis was conducted on 14,666 PDAC cases and 221,897 controls, examining 7,745 single nucleotide polymorphisms (SNPs).
  • The rs1412832 polymorphism in the CDKN2B-AS1/ANRIL gene was found to significantly increase PDAC risk, emphasizing the importance of genetic variability in the 9p21.3 region for understanding PDAC development.
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  • * Researchers conducted a two-phase study with over 12,000 female participants focusing on single nucleotide polymorphisms (SNPs) related to hormone pathways, finding 14 significant associations initially, but none were validated in the replication phase.
  • * Though the study didn't confirm the influence of common polymorphisms on PDAC risk tied to hormone pathways, it did validate a link between variants in the NR5A2 gene and increased PDAC risk.
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Background: Despite the important advances in research on neuroendocrine neoplasms of the gastro-entero-pancreatic tract, their precursor lesions are much less well known.

Summary: This review analyzes the preneoplastic neuroendocrine lesions of the gastro-entero-pancreatic tract, by adopting a coherent anatomical benchmark. In particular, the settings in which neuroendocrine precursor lesions represent well-recognized pathophysiological and morphological entities (with eventual molecular correlates) have been distinguished from the ones in which the nature of preneoplastic changes is still obscure.

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Background: Duodenal gastric metaplasia (DGM) is considered a precancerous lesion. No data are available regarding its possible role as a risk factor for duodenal neuroendocrine neoplasms (dNENs).

Aims: To assess the prevalence of DGM in a cohort of dNENs.

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Neuroendocrine neoplasms (NENs) of the major and minor ampulla are rare diseases with clinico-pathologic features distinct from non-ampullary-duodenal NENs. However, they have been often combined and the knowledge on prognostic factors specific to ampullary NENs (Amp-NENs) is limited. The aim of this study was to identify factors associated with metastatic potential and patient prognosis in Amp-NENs.

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Introduction: Telomere length (TL) is a potential indicator of cancer predisposition; however, the multitude of techniques used to measure it causes the results to be heterogeneous and, in some cases, controversial. In the last years, several studies adopted a strategy based on TL-associated genetic variants to generate a polygenic score, often referred as teloscore, used in lieu of direct TL measurement. For pancreatic neuroendocrine neoplasms (PanNEN), this strategy has not been attempted yet.

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Although 21 pancreatic cancer susceptibility loci have been identified in individuals of European ancestry through genome-wide association studies (GWASs), much of the heritability of pancreatic cancer risk remains unidentified. A recessive genetic model could be a powerful tool for identifying additional risk variants. To discover recessively inherited pancreatic cancer risk loci, we performed a re-analysis of the largest pancreatic cancer GWAS, the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4), including 8,769 cases and 7,055 controls of European ancestry.

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Genetic factors play an important role in the susceptibility to pancreatic cancer (PC). However, established loci explain a small proportion of genetic heritability for PC; therefore, more progress is needed to find the missing ones. We aimed at identifying single nucleotide polymorphisms (SNPs) affecting PC risk through effects on micro-RNA (miRNA) function.

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Article Synopsis
  • The study examines the relationship between mitochondrial metabolism and pancreatic ductal adenocarcinoma (PDAC) risk, highlighting a lack of previous systematic investigations into the genetic variability associated with this link.
  • A two-phase analysis was conducted on a large group of almost 56,000 individuals, focusing on both mitochondrial and nuclear genetic variations related to mitochondrial function.
  • The results showed no significant association between genetic variations (n-mtSNPs or mtSNPs) and PDAC risk, suggesting that mitochondrial metabolism may not play a significant role in PDAC etiology despite prior hypotheses.
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Pancreatic ductal adenocarcinoma (PDAC) is among the most lethal cancers. Its poor prognosis is predominantly due to the fact that most patients remain asymptomatic until the disease reaches an advanced stage, alongside the lack of early markers and screening strategies. A better understanding of PDAC risk factors is essential for the identification of groups at high risk in the population.

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The knowledge of the molecular landscape of ileal neuroendocrine tumors (NETs) is affected by the lack of systematic studies investigating intra-tumoral heterogeneity. In this study, intra-tumoral heterogeneity was investigated in 27 primary ileal G1-NETs and their matched nodal and liver metastases in order to assess the tumor grading, the expression status of two somatostatin receptor isoforms (i.e.

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