Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
Pancreas. 2019 Jul;48(6):817-822. doi: 10.1097/MPA.0000000000001338.
Except pancreatic adenocarcinoma, pancreatic cancer has several uncommon histological subtypes, including invasive intraductal papillary mucinous neoplasm (IPMN), pancreatic neuroendocrine tumor (pNET), adenosquamous carcinoma, invasive mucinous cystic neoplasm (MCN), acinar cell carcinoma (ACC), squamous cell carcinoma (SCC), and invasive solid pseudopapillary tumor (SPT). However, features of theses uncommon subtypes are not systematically analyzed.
Subjects with different histological subtypes of pancreatic cancers were retrieved from the Surveillance, Epidemiology, and End Results registry. Characteristics and behaviors of uncommon subtypes were compared.
Pancreatic adenocarcinoma (85.8%) represented most primary pancreatic cancers, and other subtypes were rare (14.2%). Features of uncommon subtypes included females with SPT and MCN, located at the pancreatic body/tail of pNET, SPT, and MCN; poor differentiation of adenosquamous carcinoma and SCC; and large size of MCN, SPT, ACC, and SCC. In addition, IPMN, pNET, MCN, ACC, and SPT were indolent. For indolent subtypes, patients with locoregional tumor had prominent prognosis compared with patients with distant disease, especially for invasive IPMN (median survival, localized, 30.0 months; regional, 11.0 months; distant, 4.0 months).
The study systematically summarizes characteristics and behaviors of primary pancreatic cancer by histological subtypes, which can facilitate the management of pancreatic cancer.
除了胰腺腺癌，胰腺癌症还有几种罕见的组织学亚型，包括浸润性导管内乳头状黏液性肿瘤（IPMN）、胰腺神经内分泌肿瘤（pNET）、腺鳞癌、浸润性黏液性囊腺瘤（MCN）、腺泡细胞癌（ACC）、鳞状细胞癌（SCC）和实性假乳头状肿瘤（SPT）。然而，这些罕见亚型的特征并没有系统地分析。
从监测、流行病学和最终结果登记处检索出不同组织学类型的胰腺癌症患者。比较罕见亚型的特征和行为。
胰腺腺癌（85.8%）是最常见的原发性胰腺癌症，其他亚型罕见（14.2%）。罕见亚型的特征包括女性的 SPT 和 MCN、pNET 的胰体/尾部、SPT 和 MCN 的位置、腺鳞癌和 SCC 的分化差以及 MCN、SPT、ACC 和 SCC 的肿瘤体积大。此外，IPMN、pNET、MCN、ACC 和 SPT 是惰性肿瘤。对于惰性亚型，局部区域肿瘤的患者与远处疾病的患者相比预后显著，尤其是侵袭性 IPMN（中位生存时间，局限性为 30.0 个月；区域性为 11.0 个月；远处转移为 4.0 个月）。
本研究通过组织学亚型系统地总结了原发性胰腺癌症的特征和行为，有助于胰腺癌症的管理。
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