Mukada T, Yamada S
Tohoku J Exp Med. 1982 Jun;137(2):115-24. doi: 10.1620/tjem.137.115.
To clarify the morphological aspect of precancerous and related lesions of the exocrine pancreas, histological studies were carried out according to a systematized protocol. The pancreas, its head, body and tail including the papilla and adjacent duodenal mucosa and the distal common bile duct from 206 unselective autopsy cases, excluding those of pancreatic carcinoma, were systematically examined. Histological grading of dysplasia was performed based on structural (SAT) and cellular (CAT) atypia which were evaluated by coding 0, 1, 2, and 3. Dysplasia and related changes were encountered in 75 cases (36%) including 6 carcinoma in situ. 1 occult invasive carcinoma (3%), and 10 moderate to severe dysplasias (5%). Of these 75, 46 were associated with parenchymal fibrosis but 29 were not. Simple epithelial hyperplasia and squamous metaplasia were observed in 90 cases (44%), and 34 cases (17%), respectively. Among 90 hyperplasias, 61 were associated with fibrosis, but 29 were not. The incidence of these epithelial abnormalities was higher than that reported in the previous papers. Both dysplasia and hyperplasia showed characteristic age, sex and site preponderances. An intimate relationship between dysplasia and chronic pancreatitis, and possible transition from dysplasia into carcinoma in situ and then invasive cancer were emphasized.
为了阐明外分泌胰腺癌前病变及相关病变的形态学特征，我们按照系统化方案进行了组织学研究。对206例非选择性尸检病例（不包括胰腺癌病例）的胰腺及其头部、体部和尾部，包括乳头、相邻十二指肠黏膜和远端胆总管进行了系统检查。基于结构（SAT）和细胞（CAT）异型性进行发育异常的组织学分级，分别编码为0、1、2和3进行评估。在75例（36%）病例中发现发育异常及相关改变，其中包括6例原位癌、1例隐匿性浸润癌（3%）和10例中重度发育异常（5%）。在这75例中，46例与实质纤维化相关，29例则无。单纯上皮增生和鳞状化生分别见于90例（44%）和34例（17%）。在90例增生病例中，61例与纤维化相关，29例则无。这些上皮异常的发生率高于以往文献报道。发育异常和增生均显示出特征性的年龄、性别和部位优势。强调了发育异常与慢性胰腺炎之间的密切关系，以及发育异常可能转变为原位癌进而发展为浸润癌。
