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Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2019; 25(31): 4343-4359
Published online Aug 21, 2019. doi: 10.3748/wjg.v25.i31.4343
Common features between neoplastic and preneoplastic lesions of the biliary tract and the pancreas
Piera Zaccari, Vincenzo Cardinale, Carola Severi, Federica Pedica, Guido Carpino, Eugenio Gaudio, Claudio Doglioni, Maria Chiara Petrone, Domenico Alvaro, Paolo Giorgio Arcidiacono, Gabriele Capurso
Piera Zaccari, Carola Severi, Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome, Rome 00161, Italy
Vincenzo Cardinale, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00161 Rome, Italy
Federica Pedica, Claudio Doglioni, Pathology Department, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan 20132, Italy
Guido Carpino, Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome "Foro Italico", Rome 00161, Italy
Eugenio Gaudio, Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Division of Human Anatomy, Sapienza University of Rome, Rome 00161, Italy
Maria Chiara Petrone, Paolo Giorgio Arcidiacono, Gabriele Capurso, PancreatoBiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan 20132, Italy
Domenico Alvaro, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome 00161, Italy
Author contributions: Zaccari P performed literature search and drafted the manuscript; Cardinale V, Severi C, Petrone MC, Alvaro D, Arcidiacono PG and Capurso G critically revised the manuscript; Alvaro D, Arcidiacono PG and Capurso G provided scientific guidance; Pedica F, Doglioni C and Capurso G examined pathology samples and provided appropriate figures; all authors revised and approved the final version of this article.
Supported by Associazione Italiana Ricerca sul Cancro, Italy, No. AIRC: IG 17177 to Capurso G.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Paolo Giorgio Arcidiacono, MD, Chief Doctor, Director of Unit, Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy. arcidiacono.paologiorgio@hsr.it.
Telephone: +39-02-26435607 Fax: +39-02-26435607
Received: April 1, 2019
Peer-review started: April 1, 2019
First decision: April 30, 2019
Revised: July 13, 2019
Accepted: July 19, 2019
Article in press: July 19, 2019
Published online: August 21, 2019
Processing time: 143 Days and 16.7 Hours
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; Pancreatic; Progenitors; Preneoplastic; Common; Tumor

Core tip: The carcinogenesis process of the biliary tract and the pancreas has common histological, biologic and molecular characteristics possibly due to similar stem/progenitors origin. Such findings could set the base for studies aimed at identifying novel strategies for prevention, surveillance and treatment of these deadly diseases.