Adult Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK.
Experimental Histopathology, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK.
Cell Rep. 2017 Oct 24;21(4):966-978. doi: 10.1016/j.celrep.2017.09.093.
The cell of origin of pancreatic ductal adenocarcinoma (PDAC) has been controversial. Here, we show that identical oncogenic drivers trigger PDAC originating from both ductal and acinar cells with similar histology but with distinct pathophysiology and marker expression dependent on cell of origin. Whereas acinar-derived tumors exhibited low AGR2 expression and were preceded by pancreatic intraepithelial neoplasias (PanINs), duct-derived tumors displayed high AGR2 and developed independently of a PanIN stage via non-mucinous lesions. Using orthotopic transplantation and chimera experiments, we demonstrate that PanIN-like lesions can be induced by PDAC as bystanders in adjacent healthy tissues, explaining the co-existence of mucinous and non-mucinous lesions and highlighting the need to distinguish between true precursor PanINs and PanIN-like bystander lesions. Our results suggest AGR2 as a tool to stratify PDAC according to cell of origin, highlight that not all PanIN-like lesions are precursors of PDAC, and add an alternative progression route to the current model of PDAC development.
胰腺导管腺癌 (PDAC) 的起源细胞一直存在争议。在这里,我们表明,相同的致癌驱动因素会引发起源于导管和腺泡细胞的 PDAC,这些细胞具有相似的组织学特征,但起源细胞决定了其不同的病理生理学和标志物表达。虽然腺泡来源的肿瘤表现出低 AGR2 表达,并以前体胰腺上皮内瘤变 (PanIN) 为前驱,但导管来源的肿瘤表现出高 AGR2,并且通过非黏液性病变独立于 PanIN 阶段发展。通过原位移植和嵌合体实验,我们证明 PanIN 样病变可以被 PDAC 作为相邻健康组织中的旁观者诱导,这解释了黏液性和非黏液性病变的共存,并强调了需要区分真正的前体 PanIN 和旁观者 PanIN 样病变。我们的结果表明 AGR2 可作为一种根据起源细胞对 PDAC 进行分层的工具,突出表明并非所有 PanIN 样病变都是 PDAC 的前体,并为 PDAC 发展的现有模型增加了一种替代的进展途径。