SPINK1 and CFTR variations were also associated with higher risk of PDAC among the Chinese population, whereas variations of these 2 genes were not associated with pancreatic cancer in patients in a study from Germany.23 Another study24 from JHH showed that variations in the pancreatic secretory enzyme genes CPA1 and CPB1 were associated with pancreatic cancer, whereas no variations of these 2 genes were detected in the Nanjing cohort. This evidence concerns the gene SPINK1 and pancreatic neoplasm.