Hyperplastic, preneoplastic and neoplastic lesions found in 83 human pancreases.
Hyperplastic, preneoplastic and neoplastic lesions found in 83 human pancreases.
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在 83 个人类胰腺中发现了增生性、肿瘤前期和肿瘤性病变。
DOI：
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发表时间：
1982
影响因子：
3.5
通讯作者：
Gabr Sayed
中科院分区：
文献类型：
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作者：
P. Pour;Soad Sayed;Gabr Sayed
对83例35-88岁退伍军人的尸检材料进行了胰腺的彻底组织学检查。增生、癌前及癌前病变按严重程度、多样性、部位及年龄进行记录。从这些资料来看，2例患者临床已知为原发性胰腺癌，3例为继发性（转移性）胰腺癌。发现以下隐匿性恶性病变：2例早期癌（1例腺癌和1例腺鳞癌），1例导管原位癌和7例导管原位癌。在导管原位癌患者中，3例患有胰腺癌，其余4例患有其他部位的癌症（筛、耳、结肠、前列腺）。1例临床诊断为肺癌选择性转移至胰腺的患者发现为胰腺腺鳞癌伴肺转移。因此，外分泌肿瘤病变的发生率约为10%。此外，导管和导管上皮增生（分别占57%和39%），导管鳞状细胞化生（占48%），以及内分泌肿瘤（胰岛细胞腺瘤，占10%；导管-岛状混合腺瘤，占3%）。大多数病变发生在胰腺头部，少数发生在胰腺尾部。这些数据和其他报告得出的结论是，首先，胰腺癌的总发病率似乎比以前报道的要高。恶性病变似乎在临床上仍然是隐匿的，要么是因为患者死于其他疾病，要么是因为癌前病变与临床可识别的侵袭性癌症之间存在明显的长潜伏期。其次，导管细胞似乎是多种肿瘤类型的祖细胞，包括作者实验模型中的鳞状细胞癌和胰岛细胞瘤。
A thorough histologic examination of the pancreas was performed on autopsy material from 83 military veterans aged 35-88 years. Hyperplastic, preneoplastic and neoplastic alterations were recorded by severity, multiplicity, location and age. From this material, two patients had clinically known primary, and three had secondary (metastatic), pancreatic cancer. The following occult malignant lesions were found: two early cancers (one adenocarcinoma and one adenosquamous cell carcinoma), one ductal carcinoma in situ and seven ductular carcinomas in situ. Among patients with ductular carcinoma in situ, three had pancreatic caner and the remaining four had cancers of other sites (ethmoid, ear, colon, prostate). One patient who was clinically diagnosed as having lung cancer with selective metastases to the pancreas was found to have pancreatic adenosquamous cell carcinoma with lung metastases. Hence, the incidence of neoplastic exocrine lesions was around 10%. In addition, hyperplasia of the ductal and ductular epithelium (in 57% and 39% of the patients, respectively), squamous cell metaplasia of the ductules (in 48% of the cases), as well as endocrine tumors (islet cell adenoma, 10%; mixed ductular-insular adenoma, 3%) were found. Most lesions occurred in the pancreatic head, a few in the tail. These data and other reports led to the conclusion that, first, the overall incidence of pancreatic cancer appears to be higher than previously reported. Malignant lesions seem to remain clinically occult, either because patients die of other diseases or because of the significantly long latency between premalignant lesions and clinically recognizable invasive cancer. Second, the ductular cells appear to be the progenitor cells of a variety of tumor types, including squamous cell cancer and islet cell tumors, as in the authors' experimental model.