Медицинская литература. Новинки

 

 

 

 

 

 

Внутрипротоковые папиллярные муцинозные неоплазии поджелудочной железы в ассоциации с протоковым раком – две раздельные клинические сущности

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Цель. Анализ последних взглядов на концепцию злокачественной прогрессии внутрипротоковой папиллярной муцинозной опухоли поджелудочной железы и наиболее значимых перспектив научных исследований в этой области.Материал и методы. Обзор литературных данных, анализ данных канцер-регистра г. Москвы. Результаты. Приведены наиболее значимые молекулярно-генетические исследования за последние десятилетия. На примере анализа данных операционного материала по кодам ICD-O г. Москвы за 2023–2024 гг. рассмотрены основные трудности морфологической диагностики внутрипротоковой папиллярной муцинозной опухоли поджелудочной железы с ассоциированной инвазивной карциномой.Заключение. Геномные изменения во внутрипротоковой папиллярной муцинозной опухоли поджелудочной железы как фоновые поражения для протокового рака поджелудочной железы, обусловливающие их генетическую гетерогенность, имеют большое клиническое значение для понимания поликлональной теории развития рака, поиска новых мишеней и подходов в терапии. Ассоциированный инвазивный компонент во внутрипротоковой папиллярной муцинозной опухоли поджелудочной железы, согласно своему молекулярному профилю, чаще является генетически независимым.

Ключевые слова:
поджелудочная железа, внутрипротоковая папиллярная муцинозная опухоль, IPMNассоциированная карцинома, канцерогенез, поликлональная теория, pancreas, intraductal papillary mucinous neoplasm, IPMN-associated carcinoma, carcinogenesis, polyclonal theory

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Intraductal papillary mucinous neoplasms of the pancreas associated with ductal carcinoma as two distinct clinical entities

Aim. To analyze current perspectives on the concept of malignant progression in intraductal papillary mucinous neoplasms (IPMNs) of the pancreas and to outline the most prospective research trends in this area.Materials and Methods. A literature review and an analysis of data from the cancer registry of Moscow were conducted. Results. The paper summarizes key molecular genetic studies from recent decades. Using surgical specimen data coded according to ICD-O in Moscow for the years 2023–2024, the main challenges in the histopathological diagnosis of IPMN with associated invasive carcinoma are discussed.Conclusion. Genomic alterations in IPMNs of the pancreas, as background lesions for pancreatic ductal adenocarcinoma, reflect their genetic heterogeneity and carry significant clinical implications for understanding the polyclonal theory of carcinogenesis, as well as for identifying novel therapeutic targets and approaches. The invasive component associated with IPMN is frequently genetically independent based on its molecular profile.

Keywords:
поджелудочная железа, внутрипротоковая папиллярная муцинозная опухоль, IPMNассоциированная карцинома, канцерогенез, поликлональная теория, pancreas, intraductal papillary mucinous neoplasm, IPMN-associated carcinoma, carcinogenesis, polyclonal theory