Pancreaticcancerprobablyarisesfromnoninvasiveprecursorlesions(mostcommonly,PanINs),developingbyprogressiveaccumulationofmutationsofoncogenes(e.g.,KRAS)andtumorsuppressorgenes(e.g.,CDKN2A/p16,TP53, andSMAD4).
Typically,theseneoplasmsareductaladenocarcinomasthatproduceanintensedesmoplasticresponse.
Mostpancreaticcancersarediagnosedatanadvancedstage,accountingforthehighmortalityrate.
Obstructivejaundiceisafeatureofcarcinomaoftheheadofthepancreas;manypatientsalsoexperiencedebilitatingpain.
Carcinomasofthetailofthepancreasareoftennotdetecteduntillateintheircourse.
Andersen DK, Andren-Sandberg Å, Duell EJ, et al: Pancreatitisdiabetes-pancreatic cancer: summary of an NIDDK-NCI workshop,
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Hart PA, Zen Y, Chari ST: Recent advances in autoimmune pancreatitis, Gastroenterology 149:39–51, 2015. [An up-to-date review on the etiopathogenesis and clinical subtypes of autoimmune pancreatitis from one of the foremost expert groups on this subject.]
Knudson ES, O’Reilly EM, Brody JR, et al: Genetic diversity of pancreatic ductal adenocarcinoma and opportunities for precision medicine, Gastroenterology 150:48–63, 2016. [An up-to-date description of the molecular abnormalities in cancer of the pancreas revealed by next-generation sequencing and possible drug targets.]
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