Pancreatic Fatty Degeneration and Fibrosis as Predisposing Factors for the Development of Pancreatic Ductal Adenocarcinoma

Autor: Yoshihiro Kamada, Mioka Kishida, Yasuhiko Tomita, Miki Tomoeda, Eiji Miyoshi, Masahiro Tanemura, Kanako Azuma, Yuji Nonaka
Rok vydání: 2014
Předmět:
Male
Pathology
endocrine system diseases
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Comorbidity
Degeneration (medical)
Endocrinology
Risk Factors
Fibrosis
skin and connective tissue diseases
Ultrasonography
Aged
80 and over
Pancreatic Elastase
Chemoradiotherapy
Middle Aged
Combined Modality Therapy
Neoadjuvant Therapy
Cell Transformation
Neoplastic
Treatment Outcome
medicine.anatomical_structure
Adipose Tissue
Pancreatectomy
Disease Progression
Female
CA19-9
medicine.symptom
Pancreas
Carcinoma
Pancreatic Ductal
Adult
medicine.medical_specialty
Pancreatic ductal adenocarcinoma
Lesion
Pancreatitis
Chronic
Internal Medicine
medicine
Humans
Obesity
Aged
Hepatology
business.industry
medicine.disease
digestive system diseases
Pancreatic Neoplasms
Early Diagnosis
business
Precancerous Conditions
Zdroj: Pancreas. 43:1032-1041
ISSN: 0885-3177
DOI: 10.1097/mpa.0000000000000159
Popis: Knowledge of risk factors for development of pancreatic ductal adenocarcinoma (PDAC) is limited. To clarify the background condition of the pancreas for the development of PDAC, we analyzed pancreatic histological changes in noncancerous lesion specimens after pancreatectomy in PDAC patients.Seventy-six patients with PDAC were enrolled in this study. The PDAC was in the pancreatic head in 37 patients, in the body in 31, and in the tail in 8. No patients had a history of clinical chronic pancreatitis. As controls, 98 patients without PDAC were enrolled. The following parameters were examined: fibrosis, fatty degeneration, and inflammatory cell infiltration. More than 5% of fatty degeneration in the specimen, more than 10% of fibrosis, and more than 5% of inflammatory cell infiltration were considered positive changes.Pancreatectomy specimens showed a higher ratio of positive change in fibrosis (86% vs 42%), fatty degeneration (72% vs 44%), and inflammatory cell infiltration (14% vs 3%) than control samples. Multivariate analyses demonstrated that each histological change was a significant, independent determinant for PDAC.Our study demonstrated that cryptogenic pancreatic inflammation with fatty changes represents an important predisposing factor for PDAC. Screening for subclinical chronic pancreatitis in healthy populations may enable the detection of PDAC at an early stage.
Databáze: OpenAIRE
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