Abstract
Pancreaticobiliary maljunction (PBM) is a high-risk factor for biliary tract cancer. Because of the excessive length of the common channel in PBM, sphincter action does not directly affect the pancreaticobiliary junction, which allows pancreatic juice to reflux into the biliary tract. The refluxed pancreatic juice injures the epithelium of the biliary tract and promotes the development of the cancer. Indeed, a nationwide survey in Japan revealed that biliary cancers were detected in 21.6 and 42.4% of PBM patients with and without biliary dilatation, respectively. The mechanism of carcinogenesis in PBM is considered to be the “hyperplasia-dysplasia-carcinoma sequence” which differs from the usual biliary carcinogenesis (the “adenoma-carcinoma sequence” or “de novo carcinogenesis”) in the population without PBM. Hyperplastic changes of the biliary epithelium were observed even in children with PBM, and the Ki-67 labeling index was higher. Several gene mutations were reported to be related in biliary carcinogenesis of PBM.
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Yada, K., Mori, H., Ishibashi, H., Shimada, M. (2018). Carcinogenesis of Biliary Tract in Pancreaticobiliary Maljunction. In: Kamisawa, T., Ando, H. (eds) Pancreaticobiliary Maljunction and Congenital Biliary Dilatation. Springer, Singapore. https://doi.org/10.1007/978-981-10-8654-0_21
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DOI: https://doi.org/10.1007/978-981-10-8654-0_21
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