title: Neuroendocrine differentiation in pancreatic duct carcinoma special emphasis on duct-endocrine cell carcinoma of the pancreas.
abstract: To evaluate the significance of neuroendocrine differentiation in duct carcinoma of the pancreas, we investigated 79 pancreatic carcinomas, applying histochemistry and immunohistochemistry (chromogranin A, Leu-7, synaptophysin and neuron-specific enolase (NSE), and correlated the morphologic differentiation pattern with clinicopathological characteristics. There were two types of neuroendocrine differentiation: scattered (n = 23) and diffuse (n = 3). The scattered type of pancreatic duct carcinoma contained scattered endocrine cells amounting to less than 10% of the neoplastic cells and was seen more frequently in well-differentiated carcinomas. There was no characteristic clinical feature found in the scattered type when compared with the tumors devoid of endocrine cells (n = 53). In contrast, the diffuse type showed diffuse immunostaining with NSE and synaptophysin in tumor cells and dense core granules ultrastructurally. These tumors showed a greater hypervascularity in angiography (p < 0.01) and the patients had relatively longer survival (33.3 months, p < 0.05) than unresectable cases of other histological types of pancreatic cancer. Two types of neuroendocrine differentiation (scattered and diffuse) existed in pancreatic ductal carcinoma. The diffuse type (Duct-Endocrine Cell Carcinoma of the Pancreas) showed synchronous duct and endocrine differentiation and particular clinical features.
authors.affiliation: Department of Medicine, Tokyo Metropolitan Komagome Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kamisawa
authors.forename: M
authors.initials: M
authors.lastname: Fukayama
authors.forename: I
authors.initials: I
authors.lastname: Tabata
authors.forename: T
authors.initials: T
authors.lastname: Isawa
authors.forename: K
authors.initials: K
authors.lastname: Tsuruta
authors.forename: A
authors.initials: A
authors.lastname: Okamoto
authors.lastname: Koike
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000473:pathology*; D018278:Carcinoma, Neuroendocrine / Q000276:immunology / Q000473:pathology*; D002454:Cell Differentiation / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000276:immunology / Q000473:pathology*