Common features between neoplastic and preneoplastic lesions of the biliary tract and the pancreas

World J Gastroenterol. 2019 Aug 21;25(31):4343-4359. doi: 10.3748/wjg.v25.i31.4343.

Abstract

the bile duct system and pancreas show many similarities due to their anatomical proximity and common embryological origin. Consequently, preneoplastic and neoplastic lesions of the bile duct and pancreas share analogies in terms of molecular, histological and pathophysiological features. Intraepithelial neoplasms are reported in biliary tract, as biliary intraepithelial neoplasm (BilIN), and in pancreas, as pancreatic intraepithelial neoplasm (PanIN). Both can evolve to invasive carcinomas, respectively cholangiocarcinoma (CCA) and pancreatic ductal adenocarcinoma (PDAC). Intraductal papillary neoplasms arise in biliary tract and pancreas. Intraductal papillary neoplasm of the biliary tract (IPNB) share common histologic and phenotypic features such as pancreatobiliary, gastric, intestinal and oncocytic types, and biological behavior with the pancreatic counterpart, the intraductal papillary mucinous neoplasm of the pancreas (IPMN). All these neoplastic lesions exhibit similar immunohistochemical phenotypes, suggesting a common carcinogenic process. Indeed, CCA and PDAC display similar clinic-pathological features as growth pattern, poor response to conventional chemotherapy and radiotherapy and, as a consequence, an unfavorable prognosis. The objective of this review is to discuss similarities and differences between the neoplastic lesions of the pancreas and biliary tract with potential implications on a common origin from similar stem/progenitor cells.

Keywords: Biliary; Common; Pancreatic; Preneoplastic; Progenitors; Tumor.

Publication types

  • Review

MeSH terms

  • Bile Duct Neoplasms / etiology*
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / therapy
  • Biliary Tract / pathology
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism
  • Carcinogenesis / pathology
  • Carcinoma in Situ / etiology*
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / therapy
  • Carcinoma, Pancreatic Ductal / etiology*
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / therapy
  • Cholangiocarcinoma / etiology*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / therapy
  • Disease Progression
  • Humans
  • Pancreas / pathology
  • Pancreatic Neoplasms / etiology*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / therapy
  • Precancerous Conditions / etiology*
  • Precancerous Conditions / pathology
  • Precancerous Conditions / therapy
  • Stem Cells / pathology

Substances

  • Biomarkers, Tumor