Pancreatic cancer pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]


The development of pancreatic cancer is influenced by complex interactions between several cellular signaling pathways that include inactivation of tumor suppressor genes, activation of oncogenes and deregulation of molecules in various signaling pathways. Some of the important tumor suppressor genes involved are p53, p16, p27CIP1, DPC4 and BRCA2. These tumor suppressor genes are commonly inactivated by deletion, hypermethylation or mutation. The oncogenes involved in the pathogenesis of pancreatic cancer include Ras, Cox-2, Akt-2, Notch, Cyclin- D1 genes. Signal transduction pathways such as EGFR, Akt, NF-kB and Hedgehog pathways undergo genomic alterations and crosstalk between these pathways plays an important role in pancreatic tumorigenesis.


Pathogenesis and Genetics

Inactivation of tumor suppressor genes:

Activation of oncogenes:

Deregulation of EGFR signalling:[50]

Deregulation of NF-κB signalling: [55][56][57][58][59][60][61][62]

Deregulation of Akt signaling:

Deregulation of Hedgehog signaling:[12][66][67][68][69]

Gross Pathology

The gross pathology of pancreatic adenocarcinoma, which accounts for three-fourths of all pancreatic malignancies is as follows:[70]

Microscopic Pathology

On microscopic histopathological analysis, the following features are noted:[71]

  • Microscopic study reveals the following:
  • Other features:


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