Insights into the Pathogenesis of Pancreatic Cystic Neoplasms

Sethi, Vrishketan; Giri, Bhuwan; Saluja, Ashok K.; Dudeja, Vikas

doi:10.1007/s10620-017-4603-1

Cited by 18 publications

(23 citation statements)

References 33 publications

(48 reference statements)

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“…Ductal cells, usually quiescent in the adult pancreas, form an intricate network of ducts representing the conduit for the flow of digestive enzymes secreted by acinar cells. Acinar cells are responsible for the secretion of digestive enzymes and represent the preponderant cell type in the pancreas; these cells have an intrinsic plasticity in that they have the capacity to undergo metaplasia to ductal or ductal-like cells: this metaplastic process is known as acinar-ductal metaplasia, occurs during acute-chronic pancreatitis and may represent an initial step towards the pancreatic intraepithelial neoplasia formation [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Cancer: Molecular Characterization, Clonal Evolution and Cancer Stem Cells

2017

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Pancreatic Ductal Adenocarcinoma (PDAC) is the fourth most common cause of cancer-related death and is the most lethal of common malignancies with a five-year survival rate of <10%. PDAC arises from different types of non-invasive precursor lesions: intraductal papillary mucinous neoplasms, mucinous cystic neoplasms and pancreatic intraepithelial neoplasia. The genetic landscape of PDAC is characterized by the presence of four frequently-mutated genes: KRAS, CDKN2A, TP53 and SMAD4. The development of mouse models of PDAC has greatly contributed to the understanding of the molecular and cellular mechanisms through which driver genes contribute to pancreatic cancer development. Particularly, oncogenic KRAS-driven genetically-engineered mouse models that phenotypically and genetically recapitulate human pancreatic cancer have clarified the mechanisms through which various mutated genes act in neoplasia induction and progression and have led to identifying the possible cellular origin of these neoplasias. Patient-derived xenografts are increasingly used for preclinical studies and for the development of personalized medicine strategies. The studies of the purification and characterization of pancreatic cancer stem cells have suggested that a minority cell population is responsible for initiation and maintenance of pancreatic adenocarcinomas. The study of these cells could contribute to the identification and clinical development of more efficacious drug treatments.

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Section: Introductionmentioning

confidence: 99%

Pancreatic Cancer: Molecular Characterization, Clonal Evolution and Cancer Stem Cells

2017

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“…Mucins (MUC) are highly glycosylated proteins released into the cyst from the epithelium, and their subtypes vary with the histopathological IPMN subtypes: gastric, intestinal, pancreatobiliary, and oncocytic [39,40]. Given that IPMN subtypes also correlate with specific degrees of dysplasia, Maker et al investigated the ability of mucin to determine the degree of IPMN dysplasia [41].…”

Section: Amylase < 250mentioning

confidence: 99%

“…The exact pathophysiologic progression of IPMN towards frank adenocarcinoma is still unknown, but the pathology of resected specimens has given insight into the degeneration of the epithelial lining into further dysplasia [40]. This change in cell dysplasia is thought to give rise to a specific environmental milieu deposited into the cyst fluid [43].…”

Section: Panel Analysesmentioning

confidence: 99%

Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

Hao

Takahashi

Snyder

et al. 2020

IJMS

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A significant proportion of patients with intraductal papillary mucinous neoplasms (IPMNs) undergo surgical resection in order to prevent or treat pancreatic cancer at the risk of significant perioperative morbidity. Efforts have been made to stratify the potential risk of malignancy based on the clinical and radiographic features of IPMN to delineate which cysts warrant resection versus observation. An analysis of the cyst fluid obtained by preoperative endoscopic examination appears to be correlative of cyst type and risk, whereas serum markers and radiographic findings have not yet reached a level of sensitivity or specificity that proves they are clinically meaningful. In this review, we investigate the current cyst fluid analysis studies and present those that have shown promise in effectively stratifying high-risk versus low-risk lesions. While new cyst fluid markers continue to be identified, additional efforts in testing panels and marker composites in conjunction with clinical algorithms have also shown promise in distinguishing dysplasia and the risk of malignancy. These should be tested prospectively in order to determine their role in guiding the surveillance of low-risk lesions and to evaluate the new markers detected by proteomics and genetic sequencing.

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“…Предоперационная диагностика КНПЖ в значительной степени зависит от рентгенологических и клинических особенностей, которые зачастую обладают низкой чувствительностью, особенно в случае бессимптомных образований [10]. По данным литературы, даже в крупных специализированных медицинских центрах до одной пятой КНПЖ, диагностируемых как злокачественные на дооперационном этапе, при окончательном морфологическом исследовании оказываются доброкачественными [11]. Гипердиагностика часто приводит к ненужным операциям и как следствие серьезным осложнениям [5].…”

Section: Introductionunclassified

Combined method for differential diagnosis of pancreatic cystic neoplasm

Koshel

Дроздов

Kuznetsova³

et al. 2019

Sib. onkol. ž.

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Objective. The frequency of detection of cystic neoplasm of the pancreas (CNP) has recently increased. Some of these neoplasms are benign, while others are malignant. Differential diagnosis between benign and malignant CNP remains challenging.Aim: to develop a combined method for differential diagnosis of CNP and to evaluate the role of the neutrophil to leukocyte ratio (NLR) as a diagnostic criterion of malignant CNP.Material and Methods. A retrospective analysis of the treatment of 82 patients with CNP, who underwent surgery between 2008 and 2018, was carried out. Benign lesions were detected in 62 patients and malignant tumors were diagnosed in 20 patients. The NLR and the serum levels of CA 19-9 as well as the presence of intracystic lesions were assessed as predictors of malignant CNP.Results. The presence of intracystic lesions detected by contrast-enhanced computed tomography and the elevated levels of serum CA 19-9 (>39 U/mL) and NLI (>1.876) were proven to be independent predictors of malignant CNP with statistical significance. The combination of all three criteria indicated malignant cystic neoplasm. The sensitivity, specificity and overall accuracy of the combined method were 71.4 %, 95.6 % and 86.5%, respectively.Conclusions. The combined method for differential diagnosis of malignant CNP is easy to use and has high accuracy. There is a direct correlation between NLI and malignant CNP.

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Insights into the Pathogenesis of Pancreatic Cystic Neoplasms

Cited by 18 publications

References 33 publications

Pancreatic Cancer: Molecular Characterization, Clonal Evolution and Cancer Stem Cells

Pancreatic Cancer: Molecular Characterization, Clonal Evolution and Cancer Stem Cells

Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

Combined method for differential diagnosis of pancreatic cystic neoplasm

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