Department of Pathology and Host-Defense, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Pathol Int. 2019 Aug;69(8):450-462. doi: 10.1111/pin.12837. Epub 2019 Jul 24.
Age-related pathological changes in the pancreas have been unclear because they are often minor and nonspecific. However, recent studies have shown that they are closely related to various pathological conditions such as pancreatic cancer and diabetes mellitus. Knowledge of age-related changes is important to determine appropriate prevention, detection, and treatment strategies for various diseases observed in elderly patients. We present a review of the pathological age-related non-neoplastic changes in the exocrine pancreas such as pancreatic fatty replacement, lobulocentric pancreatic atrophy, pancreatic duct ectasia, and metaplasia of exocrine pancreas, as well as changes in islet cells. We have discussed common pancreatic neoplasms in elderly patients, such as pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasms (IPMNs), and pancreatic ductal adenocarcinoma (PDAC). Age-related pathological changes play a key role in pancreatic carcinogenesis via telomere dysfunction. Further studies are warranted to clarify molecular mechanisms of pancreatic carcinogenesis in elderly patients.
胰腺的年龄相关性病理改变尚不明确，因为它们通常较小且无特异性。然而，最近的研究表明，它们与各种病理状况密切相关，如胰腺癌和糖尿病。了解与年龄相关的变化对于确定老年患者中观察到的各种疾病的适当预防、检测和治疗策略非常重要。我们回顾了外分泌胰腺的与年龄相关的非肿瘤性病理变化，如胰腺脂肪替代、小叶中心性胰腺萎缩、胰腺导管扩张和外分泌胰腺化生，以及胰岛细胞的变化。我们还讨论了老年患者中常见的胰腺肿瘤，如胰腺上皮内瘤变（PanIN）、导管内乳头状黏液性肿瘤（IPMNs）和胰腺导管腺癌（PDAC）。端粒功能障碍在胰腺癌变中起关键作用，年龄相关性病理改变。需要进一步的研究来阐明老年患者胰腺癌变的分子机制。
