Genetische Analyse muzinöser Pankreasneoplasien

抗击胰腺癌的一个重要手段是研究胰腺囊性肿瘤(CNP)，这是目前胰腺切除最常见的适应证之一。CNP有十几种不同的类型，但它们大多由浆液性囊腺瘤、粘液性囊性肿瘤(MCN)和导管内乳头状粘液性肿瘤(IPMN)组成。IPMN和MCN都有粘液上皮，可以表现出不同程度的异型性，毫无疑问，它们可以窝藏胰腺癌。由于IPMN或MCN伴癌患者比胰腺导管癌患者年龄大5~12岁，且存活率高得多，提示IPMN中的肿瘤是一种更容易治愈的疾病。此外，在主管型IPMN和MCN中，癌的发生率似乎远高于支管型IPMN。我们建议使用高分辨率微阵列技术来确定主管和支管IPMN之间的关系，IPMN和MCN之间的关系，以及这些病变与更常见的胰腺导管癌之间的关系。这些差异可能在一定程度上解释了这些肿瘤独特的临床行为。假设：主干和分支IPMN、MCN和常见的胰腺导管癌在基因上是不同的，这些差异可能部分地支持了他们的临床行为。

An important means in the battle against pancreatic cancer is the study of cystic neoplasms of the pancreas (CNP), which are currently one of the most common indications for pancreatic resection. There are over a dozen different CNP, however they mostly are comprised by serous cystadenomas, mucinous cystic neoplasms (MCN), and intraductal papillary mucinous neoplasms (IPMNs). Both IPMNs and MCN are lined by mucinous epithelium that can exhibit various degrees of atypia and there is no question that they can harbour pancreatic carcinoma. As IPMN or MCN patients with carcinoma were 5-12 years older than those with pancreatic ductal carcinoma and their survival is much better, it is suggested that cancer arising in IPMN is a different disease which is more amenable to cure. Furthermore, in main duct IPMN and MCN, the frequency of cancer appears to be much higher than in branch duct IPMNs. We propose to use high-resolution microarray techniques to determine the relation between main and branch duct IPMNs, between IPMNs and MCN, and between these lesions and the more common pancreatic ductal carcinoma. These differences may in part explain the distinct clinical behaviour of these tumors. Hypothesis: Main and branch IPMNs, MCN and common pancreatic ductal carcinoma are genetically distinct, and these differences may in part underlie their clinical behaviour.