Large-duct pattern invasive adenocarcinoma of the pancreas-a variant mimicking pancreatic cystic neoplasms: A minireview.
Large-duct pattern invasive adenocarcinoma of the pancreas-a variant mimicking pancreatic cystic neoplasms: A minireview.
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DOI：
10.3748/wjg.v27.i23.3262
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发表时间：
2021-06-21
影响因子：
4.3
通讯作者：
Mizukami Y
中科院分区：
文献类型：
--
作者：
Sato H;Liss AS;Mizukami Y
胰腺癌目前没有亚型，告知临床决策;因此，有机会重新排列形态学和分子分类学，指导更好地了解肿瘤特征。尽管如此，迄今为止的累积研究已经揭示了大导管型变异，这是胰腺导管腺癌（PDA）的一种独特亚型，具有囊性特征。这种亚型在影像学上常与导管内乳头状粘液性肿瘤相似，累及多发性小囊肿，偶尔伴有实性肿块。葡萄串征是IPMNs的影像学特征，但在大导管PDA中不存在。大导管PDA定义了粘蛋白谱，并且遗传改变在区分大导管PDA和IPMN中是有用的。在组织学上，肿瘤导管测量超过0.5 mm，形成大的导管成分。与经典PDA相似，该亚型经常伴有神经周围浸润和丰富的促结缔组织增生反应，并且密码子12中的KRAS突变几乎普遍存在。尽管与IPMNs的形态相似，但大导管PDA的预后与经典PDA相当。因此，鉴别诊断至关重要。
Pancreatic cancer currently has no subtypes that inform clinical decisions; hence, there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteristics. Nonetheless, accumulating studies to date have revealed the large-duct type variant, a unique subtype of pancreatic ductal adenocarcinoma (PDA) with cystic features. This subtype often radiographically mimics intraductal papillary mucinous neoplasms (IPMNs) and involves multiple small cysts occasionally associated with solid masses. The “bunch-of-grapes” sign, an imaging characteristic of IPMNs, is absent in large-duct PDA. Large-duct PDA defines the mucin profile, and genetic alterations are useful in distinguishing large-duct PDA from IPMNs. Histologically, neoplastic ducts measure over 0.5 mm, forming large ductal elements. Similar to classic PDAs, this subtype is frequently accompanied by perineural invasion and abundant desmoplastic reactions, and KRAS mutations in codon 12 are nearly ubiquitous. Despite such morphological similarities with IPMNs, the prognosis of large-duct PDA is equivalent to that of classic PDA. Differential diagnosis is therefore essential.
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影响因子：
7.3
作者：
Amato, Eliana;dal Molin, Marco;Mafficini, Andrea;Yu, Jun;Malleo, Giuseppe;Rusev, Borislav;Fassan, Matteo;Antonello, Davide;Sadakari, Yoshihiko;Castelli, Paola;Zamboni, Giuseppe;Maitra, Anirban;Salvia, Roberto;Hruban, Ralph H.;Bassi, Claudio;Capelli, Paola;Lawlor, Rita T.;Goggins, Michael;Scarpa, Aldo
通讯作者：
Scarpa, Aldo
影响因子：
4.6
作者：
Cáceres M;Quesada R;Iglesias M;Real FX;Villamonte M;de Villarreal JM;Pérez M;Andaluz A;Moll X;Berjano E;Dorcaratto D;Sánchez-Velázquez P;Grande L;Burdío F
通讯作者：
Burdío F
影响因子：
5.6
作者：
Adsay, NV;Merati, K;Klimstra, DS
通讯作者：
Klimstra, DS
影响因子：
5.6
作者：
Adsay, V;Logani, S;Vaitkevicius, V
通讯作者：
Vaitkevicius, V
影响因子：
1.6
作者：
Chang YR;Park JK;Jang JY;Kwon W;Yoon JH;Kim SW
通讯作者：
Kim SW