Pancreatic Malignant Neoplasm


Pancreatic Malignant Neoplasm

Pancreatic cancer is the most common pancreatic malignant neoplasm and is the third most common cause of cancer-related deaths from NCI data in 2018. In the United States, pancreatic cancer accounts for about 3% of all cancers in the United States and about 7% of all cancer deaths. PDAC is the major subtype of exocrine tumor and constitutes more than 90% of all pancreatic malignancies. Because of the tumor’s unique microenvironment and aggressive nature, PDAC has a relatively poor response to the conventional systemic chemotherapy and poor prognosis, with an overall 5-year survival rate of 8.5%. Studies found that CP has markedly increased risk for pancreatic cancer. Five years after diagnosis, CP has a nearly eightfold risk for pancreatic cancer. Inflammation participates in the development of tumor initiation, progression, treatment response, metastasis, and prognosis. The typical histopathologic features of CP contain acinar cell atrophy, pancreatic fibrosis, leukocyte infiltration, fatty replacement, and distorted and blocked ducts. These findings in CP and PDAC suggest that there are similar radiologic appearances. Further, the upstream pancreas (toward the tail end of the tumor) can have changes of CP due to duct obstruction.

Contrast-enhanced CT was used in PDAC detection, staging, and evaluation of prognosis. A previous study also found that CT radionics could predict PDAC SMAD4 status and tumor stromal content. X-ray radiation and iodine allergy are the major risks of CT. Endoscopic ultrasonography (EUS) is the most sensitive non-operative imaging method for the detection of pancreatic cancer and showed to be superior to CT. EUS-guided fine needle aspiration (FNB) can achieve cytological information. However, it is invasive and highly operator dependent.


Editorial Assistant
Pancreatic Disorder and Therapy