Molecular basis and diagnostic approach to pancreatic carcinoma

Added: 2026-05-20

[00:00:01][music] >> Pancreatic carcinoma is one of the malignant neoplasms with [music] the worst prognosis in the digestive system due to its typically late diagnosis and marked biological aggressiveness.

[00:00:14]In most cases, it is a pancreatic ductal adenocarcinoma, [music] which originates from the epithelium of the pancreatic ducts and develops in the context of precursor lesions such as pancreatic intraepithelial neoplasia.

[00:00:29]Pancreatic carcinogenesis, in turn, involves the progressive accumulation of molecular alterations including mutations in KRAS, inactivation of tumor suppressor [music] genes such as TP53, CDKN2A, and SMAD4, [music] as well as changes in the tumor microenvironment that favor early invasion and dissemination.

[00:00:55]From a histopathological perspective, ductal adenocarcinoma is characterized by the formation of atypical glandular [music] structures embedded in abundant desmoplastic stroma with marked fibrous reaction and frequent perineural and vascular invasion.

[00:01:13]Nuclear atypia, loss of cell polarity, and infiltration of the adjacent pancreatic parenchyma are [music] relevant diagnostic findings.

[00:01:23]Immunohistochemically, the expression of epithelial markers such as CK7 and CK19, along with the loss of [music] SMAD4 in a subgroup of cases, contributes to the differential diagnosis from other pancreatic neoplasms [music] and metastases.

[00:01:42]Therefore, the integration of morphological, molecular, and clinical findings is essential for accurate prognostic stratification and the selection of therapeutic strategies in a tumor of high biological complexity.

[00:01:57]>> [music]