臨牀消化器内科 Vol.31 No.13(5-1)


特集名 いわゆる“早期の膵癌”―その発生機序と診断
題名 最近の話題(1)Catastrophic hypothesisによる膵発癌―ヒト膵癌とマウスモデル膵癌
発刊年月 2016年 12月
著者 山口 高志 産業技術総合研究所創薬基盤研究部門(現 千葉大学大学院医学研究院腫瘍病理学教室)
著者 池原 早苗 産業技術総合研究所創薬基盤研究部門
著者 池原 譲 産業技術総合研究所創薬基盤研究部門/千葉大学大学院医学研究院腫瘍病理学教室
【 要旨 】 ヒト膵癌の特徴は,急速な経過で,catastrophic progressionとも表現される.一方,膵癌の発生と進展のメカニズムについて,PanIN‒PDAC linear pathwayが広く支持されており,前癌病変であるPanINを起点に,段階的な悪性形質の獲得により癌へと至ると考えられている.これらのことを踏まえて本稿では,臨床病理学的に膵癌の特徴を整理するとともに,膵発癌のマウスモデルについて,「段階的な遺伝子変異の蓄積によって膵癌が出現するもの」と,「catastrophic progressionをする膵癌がいきなり出現するもの」に分けて概説する.
Theme Diagnostic Strategy for Early Stage Pancreatic Cancer
Title Catastrophic Hypothesis of Pancreatic Cancer -- Human Pancreatic Cancer and Pancreatic Cancer Mouse Models
Author Takashi Yamaguchi Biotechnology Research Institute for Drug Discovery, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology (Present address : Department of Molecular and Tumor Pathology, Graduate School of Medicine
Author Sanae Ikehara Biotechnology Research Institute for Drug Discovery, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology
Author Yuzuru Ikehara Biotechnology Research Institute for Drug Discovery, Department of Life Science and Biotechnology, National Institute of Advanced Industrial Science and Technology / epartment of Molecular and Tumor Pathology, Graduate School of Medicine, Chiba University
[ Summary ] A characteristic feature of pancreatic ductal adenocarcinoma (PDAC) is a poor clinical course, called "catastrophic progression," that recalls the de novo carcinogenesis pathway. PDAC arises from pancreatic intraepithelial neoplasia (PanIN) as a pre‒cancerous lesion in a multi‒step manner. One essential point of catastrophic progression is whether the characteristic feature is confined to the end point of the PanIN‒PDAC linear pathway, or can be extended to the de novo carcinogenesis pathway.
From this viewpoint, we will provide an overview of the clinicopathological features of PDAC and genetically engineered mouse models (GEMs) that develop PDAC. We will provide an outline of the mouse models of pancreatic cancer, and then discuss the possibility of the presence of a "catastrophic progression without a pre‒cancerous lesion"
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