PATHOBIOLOGY OF CANCER OF THE PANCREAS

被引:11
作者
DIGIUSEPPE, JA [1 ]
HRUBAN, RH [1 ]
机构
[1] JOHNS HOPKINS MED INST,DEPT PATHOL,BALTIMORE,MD 21205
来源
SEMINARS IN SURGICAL ONCOLOGY | 1995年 / 11卷 / 02期
关键词
PANCREAS; NEOPLASIA; K-RAS; P53; DELETED IN COLON CANCER; MULTIPLE TUMOR SUPPRESSOR-1 (MTS1);
D O I
10.1002/ssu.2980110203
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The diagnosis of infiltrating adenocarcinoma of the pancreas is associated with an overall 5-year survival of less than 5%. Although surgical resection has improved the prognosis for patients with localized disease, in the absence of ancillary techniques, clinical and pathologic assessment of pancreas cancer fails to predict outcome in many patients. Recent work has focused on the genetic alterations in pancreas cancer, offering the promise of improving our ability not only to predict survival but also to select the most appropriate therapy. The study of genetic alterations in colon cancer, wherein mutations in the oncogene, K-ras, and the loss of functional activity of several tumor suppressor genes is required for progression from small adenoma to invasive carcinoma, has served as a paradigm for the molecular analysis of pancreas cancer. A similar pattern is emerging for pancreas cancer, in that there is apparently progression from intraductal lesions to invasive cancer, and that K-ras, and several tumor suppressor genes, including p53, deleted in colon cancer (DCC), and multiple tumor suppressor-1 (MTS1), are frequent targets of mutation and/or deletion. Cytogenetic studies and molecular studies assessing allelic loss suggest that several additional oncogenes and tumor suppressor genes involved in the pathogenesis of pancreas cancer remain to be discovered. These recent findings enhance our understanding of the etiology of carcinoma of the pancreas, and serve as the basis for the early detection and, potentially, improved treatment of this typically fatal malignancy. (C) 1995 Wiley-Liss, Inc.
引用
收藏
页码:87 / 96
页数:10
相关论文
共 41 条
  • [21] Cerny WL, Mangold KA, Scarpelli DG, K‐ras mutation is an early event in pancreatic duct carcinogenesis in the Syrian widen hamster, Cancer Res, 52, pp. 4507-4513, (1992)
  • [22] Tada M, Ornata M, Ohto M, Ras gene mutations in intraductal papillary neoplasms of the pancreas, Cancer, 67, pp. 634-637, (1991)
  • [23] DiGiuscppe JA, Hruban RH, Offerhaus GJA, Et al., Detection of K‐ras mutations in mucinous pancreatic duct hyperplasia from a patient with a family history of pancreatic carcinoma, Am J Pathol, 144, pp. 889-895, (1994)
  • [24] Yanagisawa A, Ohtake K, Ohashi K, Et al., Frequent c‐Ki‐ras oncogene activation in mucous cell hyperplasias of pancreas suffering from chronic inflammation, Cancer Res, 53, pp. 953-956, (1993)
  • [25] Tada M, Ornata M, Kawai S, Et al., Detection of ras gene mutations in pancreatic juice and peripheral blood of patients with pancreatic adenocarcinoma, Cancer Res, 53, pp. 2472-2474, (1993)
  • [26] Caidas C, Hahn SA, Hruban RH, Et al., Detection of K‐ras mutations in the stool of patients with pancreatic adenocarcinoma and pancreatic ductal hyperplasia, Cancer Res, 54, pp. 3568-3573, (1994)
  • [27] Knudson AG, Antioncogenes and human cancer, Proc Natl Acad Sci U S A, 90, pp. 10914-10921, (1993)
  • [28] Harris CC, Hollstein M, Clinical implications of the p53 tumor‐suppressor gene, N Engl J Med, 329, pp. 1318-1327, (1993)
  • [29] Scarpa A, Capelli P, Mukai K, Et al., Pancreatic adenocar‐cinomas frequently show p53 gene mutations, Am J Pathol, 142, pp. 1534-1543, (1993)
  • [30] Redston M, Caldas C, Seymour AB, Et al., p53 mutations in pancreatic carcinoma and evidence of common involvement of homocopolymer tracts in DNA microdeletions, Cancer Res, 54, pp. 3025-3033, (1994)