Pour P M
UNMC/Eppley Cancer Center and Department of Pathology and Microbiology, University of Nebraska Medoical Center, 600 South 42 nd Street, Omaha, NE 68198-6805, USA.
Front Biosci. 1997 Jun 1;2:d271-82. doi: 10.2741/a190.
An intimate relationship between the exocrine and endocrine pancreas has been convincingly demonstrated in recent years. Animal experiments have shed some light into the complex dialog between the two tissues. This interaction is pronounced in diseases of the pancreas, especially in experimentally-induced and human pancreatic cancers. New evidence highlights the importance of intact islets in the development of exocrine pancreatic cancer. Although tumors arise from large and small ducts, invasive and malignant adenocarcinomas of ductal phenotype also derive from stem cells within islets. Development of cancer within islets explains the association between pancreatic cancer and impaired glucose tolerance or diabetes. Hence, the previous epidemiological studies suggesting that diabetes is a predisposing factor for pancreatic cancer are refuted. The available evidence suggests that pancreatic cancer in a large number of pancreatic cancer patients ultimately leads to diabetes, and that removal of the tumors improves or cures the diabetes. Both in the hamster pancreatic cancer model and in patients, the development of cancer is associated with elevated plasma levels of islet amyloid polypeptide, which may be used as a tumor marker.
近年来，外分泌胰腺与内分泌胰腺之间的密切关系已得到令人信服的证明。动物实验为这两种组织之间复杂的对话提供了一些线索。这种相互作用在胰腺疾病中尤为明显，特别是在实验诱导的和人类胰腺癌中。新证据凸显了完整胰岛在胰腺外分泌癌发生发展中的重要性。尽管肿瘤起源于大小导管，但具有导管表型的侵袭性和恶性腺癌也源自胰岛内的干细胞。胰岛内癌症的发生解释了胰腺癌与糖耐量受损或糖尿病之间的关联。因此，先前表明糖尿病是胰腺癌易感因素的流行病学研究被推翻。现有证据表明，大量胰腺癌患者的胰腺癌最终会导致糖尿病，而切除肿瘤可改善或治愈糖尿病。在仓鼠胰腺癌模型和患者中，癌症的发展都与血浆胰岛淀粉样多肽水平升高有关，该多肽可用作肿瘤标志物。
