Shockley Kylie E, To Briana, Chen Wei, Lozanski Gerard, Cruz-Monserrate Zobeida, Krishna Somashekar G
Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
Cancers (Basel). 2023 Mar 11;15(6):1722. doi: 10.3390/cancers15061722.
Intraductal papillary mucinous neoplasms (IPMN) have the potential to progress to pancreatic ductal adenocarcinoma (PDAC). As with any progression to malignancy, there are a variety of genetic and metabolic changes, as well as other disruptions to the cellular microenvironment including immune alterations and inflammation, that can contribute to tumorigenesis. Previous studies further characterized these alterations, revealing changes in lipid and glucose metabolism, and signaling pathways that mediate the progression of IPMN to PDAC. With the increased diagnosis of IPMNs and pancreatic cysts on imaging, the opportunity to attenuate risk with the removal of high-risk lesions is possible with the understanding of what factors accelerate malignant progression and how they can be clinically utilized to determine the level of dysplasia and stratify the risk of progression. Here, we reviewed the genetic, metabolic, inflammatory, and immunologic pathways regulating the progression of IPMN to PDAC.
导管内乳头状黏液性肿瘤（IPMN）有进展为胰腺导管腺癌（PDAC）的可能。与任何恶性进展一样，存在多种基因和代谢变化，以及对细胞微环境的其他干扰，包括免疫改变和炎症，这些都可能促进肿瘤发生。先前的研究进一步对这些改变进行了特征描述，揭示了脂质和葡萄糖代谢的变化，以及介导IPMN进展为PDAC的信号通路。随着影像学检查中IPMN和胰腺囊肿诊断率的提高，通过了解哪些因素会加速恶性进展以及如何在临床上利用这些因素来确定发育异常的程度和对进展风险进行分层，从而通过切除高危病变来降低风险成为可能。在此，我们综述了调节IPMN进展为PDAC的基因、代谢、炎症和免疫途径。
