Pancreatic Cystic Lesions: Pathogenesis and Malignant Potential

Abstract

Pancreatic cancer remains one of the most lethal cancers despite extensive research. Further understanding of precursor lesions may enhance the ability to treat and prevent pancreatic cancer. Pancreatic cystic lesions (PCLs) with malignant potential include: mucinous PCLs (intraductal papillary mucinous neoplasms and mucinous cystic neoplasm), solid pseudopapillary tumors and cystic neuroendocrine tumors. This review summarizes the latest literature describing what is known about the pathogenesis and malignant potential of these PCLs, including unique epidemiological, radiological, histological, genetic and molecular characteristics.

The potential of the malignancy of cystic neoplasms of the pancreas

“…Вероятность развития инвазивной карциномы составляет 9,4% для желудочного типа IPMN, 41,6% -для кишечного, 63,2% для панкреато-билиарного и 45,8% для онкоцитарного. В зависимости от гистологического субтипа развиваются различные типы карциномы, соответственно отличается процент послеоперационных рецидивов и пятилетняя выживаемость [31]. Например, из кишечного типа IPMN наиболее часто развивается тубулярный или коллоидный тип инвазивной карциномы [32].…”

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“…Oncogenesis in the pancreas goes through several stages, which consist of the formation of a precancerous change, a further change in the degree of dysplasia and the formation of foci of malignancy [79]. One of the strategies for early detection of pancreatic cancer is to detect changes that precede its development.…”

Nanomedicine for Imaging and Therapy of Pancreatic Adenocarcinoma

“…PDAC evolves from early precursor lesions, including pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasia (MCN), a highly invasive neosplasms characterized by an ovarian-type stroma and a mucin-producing epithelium (Hruban et al, 2007; Distler et al, 2014; Pusateri and Krishna, 2018). While PanIN often occurs as a progressive multifocal disease with hardly detectable small lesions (Bardeesy and DePinho, 2002; Makohon-Moore and Iacobuzio-Donahue, 2016), IPMNs mostly localize in the main pancreatic duct and in its related branches (Torisu et al, 2019).…”