Klöppel G, Lüttges J
Department of Pathology, University of Kiel.
Verh Dtsch Ges Pathol. 2001;85:219-28.
The new WHO-classification is more than a histological description of the tumors of the exocrine pancreas. It is a clinicopathological overview that also covers the most recent genetic data on each tumor-type. New issues concern the possible ductal adenocarcinoma precursor lesions and the further characterization of pancreatic neoplasms showing a ductal phenotype. Pancreatic duct lesions have been discussed as tumor precursors. We will present the recently adopted standard system for these lesions, which distinguishes between three grades of pancreatic intraepithelial neoplasia (PanIN). Molecular studies revealed that PanIN-2 and PanIN-3 lesions represent a distinct step towards invasive carcinoma. Another focus of the review will be the advances that have been made in the further immunocytochemical and molecular characterization of special pancreatic neoplasms showing a ductal phenotype, such as undifferentiated carcinoma, mucinous noncystic (colloid) carcinoma, intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, medullary carcinoma and other rare tumors.
世界卫生组织的新分类不仅仅是对胰腺外分泌肿瘤的组织学描述。它是一种临床病理概述，还涵盖了每种肿瘤类型的最新基因数据。新问题涉及可能的导管腺癌前体病变以及表现出导管表型的胰腺肿瘤的进一步特征描述。胰腺导管病变已被讨论为肿瘤前体。我们将介绍最近采用的针对这些病变的标准系统，该系统区分了胰腺上皮内瘤变（PanIN）的三个等级。分子研究表明，PanIN-2和PanIN-3病变代表了向浸润性癌发展的一个独特阶段。综述的另一个重点将是在对表现出导管表型的特殊胰腺肿瘤（如未分化癌、黏液性非囊性（胶样）癌、导管内乳头状黏液性肿瘤、黏液性囊性肿瘤、髓样癌和其他罕见肿瘤）进行进一步免疫细胞化学和分子特征描述方面所取得的进展。
