Summary
In 21 patients who had undergone total pancreatectomy for pancreatic head carcinoma, the uninvolved pancreas was examined with regard to the type, incidence and regional distribution of duct epithelial proliferation. The results were compared with those in 37 operative specimens from patients with chronic pancreatitis, in 46 normal pancreases from autopsies and with findings in experimental pancreatic carcinogenesis.
While the incidence of squamous metaplasia and non-papillary epithelial hypertrophy varied little in the different groups, papillary epithelial hyperplasia was found three times more often in cases of carcinoma, with associated mild duct obstruction. Atypical epithelial proliferation was only detected in the vicinity of carcinomas. Unequivocal transition from papillary hyperplasia to atypical proliferation was not observed. In hamsters treated with dihydroxy-di-n-propylnitrosamine (DHPN) for induction of pancreatic duct carcinomas, the early duct lesions closely resembled atypical epithelial proliferation of human pancreas.
It is concluded that (1) papillary epithelial hyperplasia is probably only indicative of early duct obstruction and/or a general neoplastic stimulus, (2) intraductal epithelial proliferation with atypia is a true precursor of duct carcinoma, and (3) chronic pancreatitis lacks atypical duct lesions.
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References
Althoff, J., Pour, P., Malick, L.: Pancreatic neoplasm induced in Syrian golden hamsters. Am. J. Pathol. 83, 517–530 (1976)
Becker, V.: Carcinoma of the pancreas and chronic pancreatitis — a possible relationship. Acta Hepatogastroenterol. Stuttg. 25, 257–259 (1978)
Brooks, J.R., Culebras, J.M.: Cancer of the pancreas. Palliative operation, Whipple procedure, or total pancreatectomy. Am. J. Surg. 131, 516–519 (1976)
Cubilla, A.L., Fitzgerald, P.J.: Morphological lesions associated with human primary invasive nonendocrine pancreas cancer. Cancer Res. 36, 2690–2698 (1976)
Hicks, R.E., Brooks, J.R.: Total pancreatectomy for ductal carcinoma. Surg. Gynecol. Obstet. 133, 16–20 (1971)
Ihse, I., Lilja, P., Arnesjö, B., Bengmark, S.: Total pancreatectomy for cancer: an appraisal of 65 cases. Ann. Surg. 186, 675–680 (1977)
Klöppel, G., Bommer, G., Rückert, K., Seifert, G.: Pankreasgangproliferationen und Pankreaskarzinogenese: Vergleich menschlicher und tierexperimenteller Veränderungen. Verh. Dtsch. Ges. Pathol. 63, 387–391 (1979)
Korpassy, B.: Die Basalzellmetaplasie der Ausführungsgänge des Pankreas. Virchows Arch. Pathol. Anat. 303, 359–373 (1939)
Kozuka, S., Sassa, R., Taki, T., Masamoto, K., Nagasawa, S., Saga, S., Hasegawa, K., Takeuchi, M.: Relation of pancreatic duct hyperplasia to carcinoma. Cancer 43, 1418–1428 (1979)
Levitt, M.H., Harris, C.C., Squire, R., Springer, S., Wenk, M., Mollelo, C., Thomas, D., Kingsbury, D., Newkirk, C.: Experimental pancreatic carcinogenesis. I. Morphogenesis of pancreatic adenocarcinoma in the Syrian golden hamster induced by N-nitroso-bis (2-hydroxypropyl)amine. Am. J. Pathol. 88, 5–28 (1977)
Orci, L., Malaisse-Lagae, F., Baetens, D., Perrelet, A.: Pancreatic polypeptide-rich regions in the human pancreas. Lancet 2, 1201 (1978)
Pliam, M.B., Remine, W.H.: Further evaluation of total pancreatectomy. Arch. Surg. 110, 506–512 (1975)
Pour, P., Krüger, F.W., Althoff, J., Cardesa, A., Mohr, U.: Cancer of the pancreas induced in the Syrian golden hamster. Am. J. Pathol. 76, 349–358 (1974)
Pour, P., Althoff, J., Takahashi, M.: Early lesions of pancreatic ductal carcinoma in the hamster model. Am. J. Pathol. 88, 291–308 (1977)
Roberts. P.F.: Pyloric gland metaplasia of the human pancreas. Arch. Pathol. Lab. Med. 97, 92–95 (1974)
Ross, D.E.: Cancer of the pancreas. A plea for total pancreatectomy. Am. J. Surg. 87, 20–33 (1954)
Sato, T., Saitch, Y., Noto, N., Matsuno, S.: Factors influencing the late results of operation for carcinoma of the pancreas. Am. J. Surg. 136, 582–586 (1978)
Sommers, S.C., Murphy, S.A., Warren, S.: Pancreatic duct hyperplasia and cancer. Gastroenterology 27, 629–640 (1954)
Takahashi, M., Pour, P., Althoff, J., Donelly, T.: The pancreas in Syrian golden hamsters. I — Anatomical study. Lab. Anim. Sci. 27, 336–342 (1977a)
Takahashi, M., Pour, P., Althoff, J., Donelly, T.: Sequential alteration of the pancreas during carcinogenesis in Syrian hamsters by N-nitroso-bis (2-oxopropyl)amine. Cancer Res. 37, 4602–4607 (1977b)
Tryka, A.F., Brooks, J.R.: Histopathology in the evaluation of total pancreatectomy for ductal carcinoma. Ann. Surg. 190, 373–379 (1979)
Volkholz, H., Stolte, M., Becker, V.: Epitheldysplasien bei chronischer Pankreatitis. Verh. Dtsch. Ges. Pathol. 63, 383–386 (1979)
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Klöppel, G., Bommer, G., Rückert, K. et al. Intraductal proliferation in the pancreas and its relationship to human and experimental carcinogenesis. Virchows Arch. A Path. Anat. and Histol. 387, 221–233 (1980). https://doi.org/10.1007/BF00430702
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DOI: https://doi.org/10.1007/BF00430702