Abstract：
Pancreatic carcinoma is a relatively common malignant tumor with increasing incidence and mortality. The tumor is usually diagnosed at an advanced stage and generally has a poor prognosis, with only 5% of patients surviving 5 years from the time of diagnosis. The stage of the disease at the time of diagnosis is a crucial factor for the prognosis; 25% of patients with localized tumors survive 3 years from diagnosis, compared to only 1% of those with generalized tumors. Radical surgical removal of the tumor (partial or total pancreatectomy) is a key factor in improving survival. Therefore, the topic is highly relevant to surgeons. Statistics on pancreatic carcinoma mainly focus on ductal adenocarcinoma, which is the most common and least favorable malignant tumor of the pancreas. This review focuses on ductal adenocarcinoma, its variants, and precancerous lesions. The article summarizes information from the latest WHO classification of 2019, which was released 11 years after the previous edition. Compared to the previous version, this new WHO classification introduced rather minor changes in the field of ductal adenocarcinoma. The delineation of rare variants of ductal adenocarcinoma is justified based on genetic and morphological similarities and clinical relevance, as individual subtypes significantly differ in prognosis. The article also includes a description of macroscopic and microscopic precursors of ductal adenocarcinoma and their definitions. Genetic and immunohistochemical differential diagnostic aspects are briefly discussed, as these are more relevant to pathologists than to surgeons.
摘要：
胰腺癌是一种较为常见的恶性肿瘤,发病率和病死率均呈逐年上升趋势。肿瘤通常在晚期诊断，通常预后不良，只有5％的患者从诊断之日起存活5年。诊断时的疾病阶段是预后的关键因素;25％的局部肿瘤患者在诊断后生存3年，相比之下，只有1%的人患有全身肿瘤。根治性手术切除肿瘤（部分或全胰腺切除术）是提高生存率的关键因素。因此,这个话题与外科医生高度相关。胰腺癌的统计主要集中在导管腺癌,这是胰腺最常见和最不利的恶性肿瘤。本文就导管腺癌,其变体,和癌前病变.文章总结了2019年世卫组织最新分类的信息，该分类在上一版发布11年后发布。与以前的版本相比，这一新的WHO分类在导管腺癌领域引入了相当小的变化.根据遗传和形态相似性以及临床相关性，对导管腺癌的罕见变异进行勾画是合理的。由于个体亚型的预后显着不同。本文还包括对导管腺癌的宏观和微观前体及其定义的描述。简要讨论了遗传和免疫组织化学鉴别诊断方面，因为这些与病理学家比与外科医生更相关。
