What A Wonderful Winter Wonderland
2025 was an illuminating year in the world of pancreatic disease research, with Secretin on its way to becoming a staple of pancreatic screening tools at an international level. In Europe, United European Gastroenterology implemented an update to their pediatric clinical guidelines calling for pancreatic function testing to be used in conjunction with patient’s symptoms and nutritional status.1 Over 97% of doctors on this panel agreed that only one of these diagnostic considerations is not enough to adequately determine if a patient has Pancreatic Exocrine Insufficiency (PEI), except in cases where the patient has a high likelihood of PEI, like those with a history of pancreatic cancer or pancreatic resectioning surgery.1 While this sounds like highly invasive measures will be needed to properly diagnose failure-to-thrive caused by PEI, doctors in the States have determined sMRCPs could be used to assess exocrine pancreatic function.2 This would provide doctors worldwide with the ability to diagnose PEI in pediatrics with the same level of invasiveness as a simple MRI.
In Japan, doctors identified KRAS mutations in duodenal fluid after Secretin stimulation.5 This suggests the ability to avoid the risk of post-ERCP pancreatitis normally associated with the collection of pancreatic juice directly from the pancreas.5 And, again, back here in America, researchers at the Mayo Clinic not only reaffirmed the findings from Japan, but furthered their feasibilitywith research into how best to preserve DNA between collection and testing.3,4 They identified a 1:1 ratio of pancreatic juice to EDTA buffer increased the recovery of DNA over a 24-hour period by over 24%.4 These findings will be crucial for the increasing number of samples collected as early-detection pancreatic cancer screenings become the norm for more and more patient groups.
With revolutionary studies like these to close out 2025, defeating pancreatic cancer and disease is one step closer to becoming a realized resolution. It truly is the most wonderful time of the year!
Works Cited
1Cahen, D., Dominguez-Muñoz, J., Vujasinovic, M., de la Iglesia, D., Capurso, G., & Gubergrits, N. (2025). European guidelines for the diagnosis and treatment of pancreatic exocrine insufficiency: UEG, EPC, EDS, ESPEN, ESPGHAN, ESDO, and ESPCG evidence-based recommendations. United European Gastroenterol, 13, 125-172. doi:10.1002/ueg2.12674
2Fu, Y., Nguyen, H. N., Ponrartana, S., Piester, T. L., Trout, A. T., Alharbi, O., . . . Zheng, Y. (2025). Endoscopic pancreatic function test and other modalities for exocrine pancreatic disease measures. J Pediatr Gastroenterol Nutr, 80, 847-854. doi:10.1002/jpn3.70006
3Majumder, S., Wallace, M. B., Engels, M. M., Abu Dayyeh, B. K., Raimondo, M., Mahoney, D. W., & Rajan, E. (2025, April 1). Multimodal Pancreatic Cancer Detection Using Methylated DNA Biomarkers in Pancreatic Juice and Plasma CA 19-9: A Prospective Multicenter Study. Clinical Gastroenterology and Hepatology, 23(5), 766-775. doi:10.1016/j.cgh.2024.07.048
4Mills, K., Taylor, W., Berger, C., Foote, P., Mahoney, D., Berger, K., . . . Majumder, S. (2025). Optimization of Endoscopically Collected Pancreatic Juice for Enhanced DNA Yield for Detection of Pancreatic Ductal Adenocarcinoma. Mayo Clinic.
5Yachida, S., Yoshinaga, S., Shiba, S., Takeda, Y., Matsumoto, K., & Yamashita, T. (2025). KRAS mutations in duodenal lavage fluid after secretin stimulation for detection of pancreatic cancer. Annals of Surgery. doi:10.1097/SLA.0000000000006645