Clinical Gastroenterology Vol.31 No.13(2)

Theme Diagnostic Strategy for Early Stage Pancreatic Cancer
Title Analysis of "Early Pancreatic Cancer" from a Pathological Standpoint -- and Its Developmental Mechanism
Publish Date 2016/12
Author Akio Yanagisawa Department of Pathology, Kyoto Prefectural University of Medicine / Department of Pathology, Japanese Red Cross Kyoto Daiichi Hospital
[ Summary ] There are two postulated developmental pathways for pancreatic ductal carcinoma : 1) the adenoma‒carcinoma sequence, in which invasive carcinoma develops via an adenoma, and 2) the de novo pathway, in which adenoma formation does not precede the development of invasive carcinoma. The former pathway results in the development of intraductal papillary mucinous neoplasm (IPMN)‒ derived carcinoma, while the latter results in the development of invasive pancreatic ductal carcinoma. Early pancreatic cancer, in which a good long‒term prognosis can be expected, includes non‒invasive cancer and invasive pancreatic cancer with slight invasion. Although the extent of invasion is unspecified in pancreatic cancer with slight invasion, it is speculated that less invasion is correlated with a better prognosis. For detecting cancer with slight invasion, it is important to know that some pancreatic cancers show invasion soon after their development, while others show invasion only after extending into the pancreatic duct. Mucous cell hyperplasia is highly likely to be a precancerous lesion of pancreatic cancer.
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