Yamaguchi Junpei, Yokoyama Yukihiro, Kokuryo Toshio, Ebata Tomoki, Nagino Masato
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
Surg Today. 2018 Jan;48(1):9-17. doi: 10.1007/s00595-017-1501-2. Epub 2017 Mar 4.
Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignant disease associated with poor prognosis, despite recent medical advances. It is of great importance to understand the initial events and cells of origin of pancreatic cancer to prevent the development and progression of PDAC. There are three distinct precursor lesions that develop into PDAC: pancreatic intraepithelial neoplasms (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs). Studies on genetically engineered mouse models have revealed that the initiation and development of these lesions largely depend on genetic alterations. These lesions originate from different populations in the pancreas. PanIN development seems to be the result of the transdifferentiation of acinar cells, whereas IPMNs most likely arise from the progenitor niche of the pancreatic ductal epithelium. Pancreatic carcinogenesis is dependent on various events, including gene alterations, environmental insults, and cell types. However, further studies are needed to fully understand the initial processes of pancreatic cancer.
尽管近年来医学取得了进步，但胰腺导管腺癌（PDAC）仍是一种预后不良的致命恶性疾病。了解胰腺癌的起始事件和起源细胞对于预防PDAC的发生和发展至关重要。有三种不同的前驱病变会发展为PDAC：胰腺上皮内瘤变（PanINs）、导管内乳头状黏液性肿瘤（IPMNs）和黏液性囊性肿瘤（MCNs）。对基因工程小鼠模型的研究表明，这些病变的起始和发展很大程度上依赖于基因改变。这些病变起源于胰腺中的不同细胞群。PanIN的发展似乎是腺泡细胞转分化的结果，而IPMNs很可能起源于胰腺导管上皮的祖细胞龛。胰腺癌的发生依赖于各种事件，包括基因改变、环境损伤和细胞类型。然而，需要进一步研究以充分了解胰腺癌的初始过程。
