La Rosa 2012: clinicopathologic study of 62 acinar cell carcinomas of the pancreas
The largest single pathology series of acinar cell carcinoma, from a European network, confirmed which stains identify the tumour, described its variants and showed that stage at diagnosis is what determines survival.
Overview
Multicentre European series of 62 acinar cell carcinomas of the pancreas with detailed morphology, immunohistochemistry and follow-up. The study compared the sensitivity of trypsin, chymotrypsin, lipase and BCL10 as markers of acinar differentiation, characterised mixed acinar-neuroendocrine and acinar-ductal tumours, and examined the acinar cell cystadenocarcinoma variant.
Survival was better than in ductal adenocarcinoma but depended strongly on stage: patients with localised, resected tumours could survive for years while metastatic disease behaved aggressively. Trypsin and BCL10 were the most useful diagnostic markers.
- Trypsin and BCL10 immunostains were the most sensitive markers of acinar differentiation.
- Stage (tumour size, nodal and distant spread) was the dominant prognostic factor; resected localised tumours had a favourable course.
The paper underpins the WHO diagnostic criteria for acinar cell carcinoma and its variants and supports aggressive surgery for localised disease.
- Retrospective pathology series with heterogeneous treatment.
- Molecular characterisation was not part of this study; the genomic profile came later.
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