Open AccessChronic pancreatitis: pancreatic cancer risk factors
Author(s) -
Н. Б. Губергріц,
N. V. Byelyayeva,
А. В. Цыс,
T. L. Mozhynа,
Г. М. Лукашевич,
П. Г. Фоменко
Publication year - 2020
Publication title -
vestnik kluba pankreatologov
Language(s) - English
Resource type - Journals
ISSN - 2077-5067
DOI - 10.33149/vkp.2020.03.01
Subject(s) - pancreatitis , pancreatic cancer , hereditary pancreatitis , neoplastic transformation , medicine , concomitant , cancer , pancreas , gastroenterology , fibrosis , pathology , oncology , biology , carcinogenesis , trypsinogen , biochemistry , trypsin , enzyme
The article discusses the known risk factors for pancreatic cancer (PC) in patients with chronic pancreatitis (CP), starting with the hypothesis expressed by the German pathologist Rudolph Virchow at the end of the 19th century, to modern worldviews. The difficulties of timely PC diagnosis and the short life expectancy of patients with CP who have PC are noted. According to modern concepts, the transformation of the inflammatory process in the pancreatic tissue into a neoplastic formation is caused not only by the features of the ordinary diet and well-known bad habits, but also by the effects of a number of chemical compounds, the presence of a concomitant pathology and genetic predisposition. The article shows the average period of time required for the neoplastic transformation of acinar or ductal epithelial cells in a state of chronic inflammation. The results of clinical studies and meta-analysis showing the correlation between different types of CP and the development of PC are presented. It is emphasized that the total risk of PC in patients with confirmed CP is less than 5%, which indirectly indicates a lack of sensitivity and specificity of non-invasive procedures in screening for neoplastic pancreatic lesions. The probability of developing PC in patients with hereditary pancreatitis, carriers of the mutant K-ras gene, as well as in patients suffering from cystic fibrosis is considered. Emphasis is placed on the need for further development of biological tests and biomarkers, which make it possible to differentiate CP and PC. The exclusion of known risk factors in patients with recurrent attacks of acute pancreatitis, CP will reduce the risk and prevent the occurrence of PC.