Download PDF
TumorDiagnostik & Therapie 2019; 40(03): 165-170
DOI: 10.1055/a-0824-9933
Schwerpunkt Pankreaskarzinom
© Georg Thieme Verlag KG Stuttgart · New York

Pathogenese und Diagnostik beim Pankreaskarzinom

Alexander Ioannis Damanakis
,
Florian Gebauer
,
Felix Popp
,
Christiane Bruns
Further Information

Publication History

Publication Date:
03 April 2019 (online)

Also available at
    Permissions and Reprints

Trotz komplexer multimodaler Behandlungsansätze sterben ca. 90 % der Patienten am Pankreaskarzinom. In den letzten Jahren hat vor allem die bessere Aufarbeitung genetischer Alterationen das Verständnis zur Pathogenese des Pankreaskarzinoms verbessern können. Wir fassen die neuen Erkenntnisse zur Pathogenese zusammen und erläutern Methoden zur Detektion und diagnostischen Aufarbeitung.
 

  • Literatur

  • 1 Basturk O, Hong SM, Wood LD. et al. A Revised Classification System and Recommendations From the Baltimore Consensus Meeting for Neoplastic Precursor Lesions in the Pancreas. Amer J Surg Pathol 2015; 39: 1730-1741
    CrossrefPubMedGoogle Scholar
  • 2 Ott C, Heinmöller E, Gaumann A. et al. Intraepitheliale Neoplasien (PanIN) und intraduktale papillär-muzinöse Neoplasien (IPMN) des Pankreas als Vorläufer des Pankreaskarzinoms. Med Klinik 2007; 102: 127-135
    CrossrefPubMedGoogle Scholar
  • 3 Vincent A, Herman J, Schulick R. et al. M. Pancreatic cancer. Lancet 2011; 378: 607-620
    CrossrefPubMedGoogle Scholar
  • 4 Mateos R, Conlon KC. Pancreatic cancer. Surgery 2016; 34: 282-291
    PubMedGoogle Scholar
  • 5 Haugk B, Raman S. Pancreatic pathology: an update. Surgery 2016; 34: 273-281
    PubMedGoogle Scholar
  • 6 Kamisawa T, Wood LD, Itoi T. et al. Pancreatic cancer. Lancet 2016; 388: 73-85
    CrossrefPubMedGoogle Scholar
  • 7 Jones S, Zhang X, Parsons DW. et al. Core Signaling Pathways in Human Pancreatic Cancers Revealed by Global Genomic Analyses. Science 2008; 321: 1801
    CrossrefPubMedGoogle Scholar
  • 8 Gukovsky I, Li N, Todoric J. et al. Inflammation, Autophagy, and Obesity: Common Features in the Pathogenesis of Pancreatitis and Pancreatic Cancer. Gastroenterol 2013; 144: 1199-1209.e4
    CrossrefPubMedGoogle Scholar
  • 9 Ansari D, Gustafsson A, Andersson R. Update on the management of pancreatic cancer: Surgery is not enough. World J Gastroenterol 2015; 21: 3157-3165
    CrossrefPubMedGoogle Scholar
  • 10 Korc M. Smad4-TGF-β Signaling Pathways in Pancreatic Cancer Pathogenesis. Pancreatic Cancer 2018; Second edition: 431-455 . doi:10.1007/978-1-4939-7193-0_17
    PubMedGoogle Scholar
  • 11 Tanaka S. Molecular Pathogenesis and Targeted Therapy of Pancreatic Cancer. Ann Surg Oncol 2016; 23: 197-205
    PubMedGoogle Scholar
  • 12 Yamada S, Fujii T, Shimoyama Y. et al. SMAD4 Expression Predicts Local Spread and Treatment Failure in Resected Pancreatic Cancer. Pancreas 2015; 44: 660-664
    CrossrefPubMedGoogle Scholar
  • 13 Lennon A, Wolfgang CL, Canto MI. et al. The Early Detection of Pancreatic Cancer: What Will It Take to Diagnose and Treat Curable Pancreatic Neoplasia?. Cancer Res 2014; 74: 3381-3389
    CrossrefPubMedGoogle Scholar
  • 14 Waddell N, Pajic M, Patch AM. et al. Whole genomes redefine the mutational landscape of pancreatic cancer. Nature 2015; 518: 495-501
    CrossrefPubMedGoogle Scholar
  • 15 Conroy T, Desseigne F, Ychou M. et al. FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer. N Engl J Med 2011; 364: 1817-1825
    CrossrefPubMedGoogle Scholar
  • 16 Suker M, Beumer BR, Sadot E. et al. FOLFIRINOX for locally advanced pancreatic cancer: a systematic review and patient-level meta-analysis. Lancet Oncol 2016; 17: 801-810
    CrossrefPubMedGoogle Scholar
  • 17 Feig C, Gopinathan A, Neesse A. et al. The Pancreas Cancer Microenvironment. Clin Cancer Res 2012; 18: 4266-4276
    CrossrefPubMedGoogle Scholar
  • 18 Ryan DP, Hong TS, Bardeesy N. Pancreatic Adenocarcinoma. N Engl J Med 2014; 371: 1039-1049
    CrossrefPubMedGoogle Scholar
  • 19 Choe JH. Emerging Therapeutic Targets in Pancreatic Adenocarcinoma. Springer 2018; DOI: 10.1007/978-1-4939-7193-0_92.
    CrossrefPubMedGoogle Scholar
  • 20 Perera RM, Bardeesy N. Pancreatic Cancer Metabolism: Breaking It Down to Build It Back Up. Cancer Discov 2015; 5: 1247-1261
    CrossrefPubMedGoogle Scholar
  • 21 Iodice S, Gandini S, Maisonneuve P. et al. Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbeck’s Arch Surg 2008; 393: 535-545
    CrossrefPubMedGoogle Scholar
  • 22 Raimondi S, Lowenfels AB, Morselli-Labate AM. et al. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Practice & Research Clin Gastroenterol 2010; 24: 349-358
    PubMedGoogle Scholar
  • 23 Bosetti C, Rosato V, Li D. et al. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium. Ann Oncol 2014; 25: 2065-2072
    CrossrefPubMedGoogle Scholar
  • 24 Jacobs EJ, Chanock SJ, Fuchs CS. et al. Family history of cancer and risk of pancreatic cancer: A pooled analysis from the Pancreatic Cancer Cohort Consortium (PanScan). Int J Cancer 2010; 127: 1421-1428
    CrossrefPubMedGoogle Scholar
  • 25 AWMF. S3-Leitlinie Exokrines Pankreaskarzinom, Langversion 1.0. 2013 www.awmf.org/leitlinien/detail/ll/032-010OL.html , abgerufen am 3.2.2019
    PubMedGoogle Scholar
  • 26 NCCN. NCCN Clinical Practice Guidelines in Oncology Pancreatic adenocarcinoma. 2016 www.nccn.org/professionals/physician_gls/default.aspx , abgerufen am 3.2.2019
    PubMedGoogle Scholar
  • 27 Walters DM, LaPar DJ, de Lange EE. et al. Pancreas-Protocol Imaging at a High-Volume Center Leads to Improved Preoperative Staging of Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 2011; 18: 2764-2771
    CrossrefPubMedGoogle Scholar
  • 28 Bipat S, Phoa SS, van Delden OM. et al. Ultrasonografy, Computed Tomografy and Magnetic Resonance Imaging for Diagnosis and Determining Resectability of Pancreatic Adenocarcinoma. J Comp Assist Tomogr 2005; 29: 438-445
    CrossrefPubMedGoogle Scholar
  • 29 Isaji S, Mizuno S, Windsor JA. et al. International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017. Pancreatol 2018; 18: 2-11
    CrossrefPubMedGoogle Scholar
  • 30 Chiorean E, von Hoff DD, Reni M. et al. CA19-9 decrease at 8 weeks as a predictor of overall survival in a randomized phase III trial (MPACT) of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic pancreatic cancer. Ann Oncology 2016; 27: 654-660
    CrossrefPubMedGoogle Scholar