Clinicopathological Features of 15 Occult and 178 Clinical Pancreatic Ductal Adenocarcinomas in 8339 Autopsied Elderly Patients

Abstract

Pancreatic cancers in elderly patients tend to progress asymptomatically, but once symptoms develop, they are more often fatal than those in younger patients.

A genetic roadmap of pancreatic cancer: still evolving

“…These experimental data would suggest that PDA lacks an extended locally invasive. This is consistent with the observation that a large fraction of patients with stage I/II PDA undergoing surgical resection succumb to metastatic disease within 2 years,99 100 and that approximately one-third of incidental PDA cases with small primary tumours already harbour metastases 101. Moreover, recent analyses of disseminated lesions indicate little genetic heterogeneity in metastases, suggesting that there is short latency period between the ability of an invasive clone to seed metastases 102.…”

Age‐related morphological changes in the pancreas and their association with pancreatic carcinogenesis

“…Furthermore, fibrosis may play an important role in the development of pancreatic cancer, primarily via fibroblast‐induced production of cytokines and extracellular matrices . The prominent fibrosis in the pancreatic body and tail might have contributed to the higher incidence of PanIN identified in these locations, which may explain the reportedly high incidence of PDAC in the pancreatic body and tail in elderly patients …”

Relationship between pancreatic intraepithelial neoplasias, pancreatic ductal adenocarcinomas, and single nucleotide polymorphisms in autopsied elderly patients

“…In Japan, pancreatic cancer represents the fifth and the fourth leading cause of cancer‐related deaths in men and women, respectively. Tobacco use, heavy alcohol consumption, diabetes, obesity, pancreatitis, low 25‐(OH) vitamin D levels due to low exposure to solar radiation, and aging are known to be risk factors for pancreatic cancer . Studies on autopsied patients, surgically resected tissue specimens, and recent molecular studies have shown that pancreatic cancer does not arise de novo; it progresses through a multistep process involving either intraepithelial proliferation or through a dysplasia‐cancer sequence …”

“…Tobacco use, 3 heavy alcohol consumption, diabetes, obesity, pancreatitis, low 25-(OH) vitamin D levels due to low exposure to solar radiation, and aging are known to be risk factors for pancreatic cancer. 4,5 Studies on autopsied patients, surgically resected tissue specimens, and recent molecular studies have shown that pancreatic cancer does not arise de novo; it progresses through a multistep process involving either intraepithelial proliferation or through a dysplasiacancer sequence. [6][7][8] The vast majority of pancreatic cancers are thought to arise from pancreatic intraepithelial neoplasias (PanINs); high-grade PanINs (carcinomas in situ) are believed to be immediate precursors of pancreatic ductal adenocarcinomas (PDACs), which are the most common type of pancreatic cancers.…”