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Molecular Pathology of Pancreatic Cancer Precursor Lesions

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Molecular Genetics of Pancreatic Cancer

Abstract

Pancreatic cancer is the fourth leading cause of cancer-related death in the USA. Each year about 44,000 patients are newly diagnosed with pancreatic cancer in the USA. Most of these patients present with advanced disease and have a very poor prognosis.

Given this dismal prognosis, the challenge is to identify pancreatic cancer in an early stage or, better, patients at risk for pancreatic cancer before an incurable invasive carcinoma has developed. Several distinctive precursor lesions of pancreatic cancer are now known, which theoretically allows for detection of patients at risk of developing pancreatic cancer. These precursor lesions are the microscopic pancreatic intraepithelial neoplasia (PanIN) and the macroscopic cystic precursor lesions intraductal papillary mucinous neoplasia (IPMN), intraductal tubulopapillary neoplasm (ITPN), and mucinous cystic neoplasia/mucinous cystadenoma (MCN).

Insight in the molecular biology of pancreatic adenocarcinoma and these precursor lesions has substantially increased during the past decades. Accurate understanding of the successive molecular genetic alterations in these lesions may eventually lead to biomarkers that can predict biological behavior and guide treatment of patients at risk of invasive pancreatic cancer. This chapter reviews the clinical, diagnostic, and molecular genetic aspects of these pancreatic cancer precursor lesions.

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Acknowledgments

We thank Folkert Morsink for help with the figures.

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  1. Department of Pathology (H04-312), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Lodewijk A. A. Brosens & G. Johan Offerhaus

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  2. G. Johan Offerhaus
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Correspondence to Lodewijk A. A. Brosens .

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  1. MED CTR ROOM 2922D, TC, University of Michigan, E Medical CTR Drive 1500, Ann Arbor, 48109-0999, Michigan, USA

    Diane M. Simeone

  2. CRB 2/STE 345, Johns Hopkins University, Orleans Street 1550, Baltimore, 21231, Maryland, USA

    Anirban Maitra

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Brosens, L.A.A., Offerhaus, G.J. (2013). Molecular Pathology of Pancreatic Cancer Precursor Lesions. In: Simeone, D., Maitra, A. (eds) Molecular Genetics of Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6549-2_2

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