Molekulare veranderungen bei pankreasund periampullaren karzinomen

Gene mutations as well as alterations in the expression of growth factors and their receptors play an important role in the pathogenesis of gastrointestinal cancers. In this review we describe relevant molecular alterations in human pancreatic and periampullary cancers. Overexpression of a variety of growth factors including members of the epidermal growth factor (EGF), fibroblast growth factor (FGF), platelet derived growth factor (PDGF), and transforming growth factor-β (TGF-β) families and their receptors are present in a significant number of pancreatic cancers. Furthermore, these tumors often harbor gene mutations (p53, K-ras, Smad4). These changes have the potential to stimulate tumor growth and enhance the metastatic behavior of pancreatic cancer cells. A negative influence on patient survival following tumor resection could be demonstrated for a number of these perturbations. These findings indicate that molecular alterations in pancreatic cancer cells are a major cause of the clinical aggressiveness of this malignancy. The molecular alterations of periampullary tumors have not been investigated intensively. There are, however, first reports about genetic and epigenetic abnormalities in this malignancy, suggesting that disturbances in growth-promoting and -inhibiting pathways are also present in periampullary cancer.