Pathology Three different epithelial cell types can be found in the normal pancreas:(1) Acinar cells, which account for about 80% of the gland volume(2) Ductal cells, composing 10% to 15%(3) Endocrine (islet) cells, making up about 1% to 2% More than 95% of the malignant neoplasms of the pancreas arise from the exocrine elements of the gland (ductal and acinar cells) and demonstrate features consistent with adenocarcinoma.Endocrine neoplasms account for only 1% to 2% of pancreatic tumorsNonepithelial malignancies are exceedingly rare
Multiple cohort and case-control studies have found that the relative risk for smokers of developing pancreatic cancer is at least 1.5A high intake of fat and/or meat has been linked to the development of this neoplasmWomen taking 14 tablets or more of aspirin per week for 4 years or more increased their risk of pancreatic cancer by 86%An association between Helicobacter pylori infection and pancreatic cancer has also been reported In several population studies, 7% to 8% of patients with pancreatic cancer have a first-degree relative with the diseaseDiabetes mellitus is very common in pancreatic cancer, recent onset of diabetes without family history may help identify patients with pancreatic cancer, particularly in individuals older than 50 years, higher production of islet amyloid polypeptide (amylin) by the tumor is responsible for the diabetogenic stateCigarette smoking. A multinational study found this risk to be 2% per decade, independent of the type of pancreatitisGenetic factors predispose to pancreatic cancer in some families.
Risk factors Hereditary pancreatitis 10%, abnormal trypsin gene that is transmitted as an autosomal dominant trait, risk for pancreatic cancer by age 70 years is estimated at 40%Nonhereditary forms of chronic pancreatitis also have a higher likelihood of pancreatic cancer. The incidence in black men is 14.8 per 100,000, compared with 8.8 in the general populationThe etiology of pancreatic cancer remains unknown
PANCREATIC CANCER Second most common gastrointestinal malignancyIt is a disease with an extremely poor prognosisFewer than 20% of affected patients survive the first yearOnly 4% are alive 5 years after diagnosisPancreatic cancer is the fourth leading cause of cancer death in both men and womenPancreatic cancer is very rare before the age of 45 yearsIt affects males more than femalesmore common in black persons. Al.ObeidyFICMS, FICMS GE&HepKirkuk General Hospital
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