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Am J Physiol Gastrointest Liver Physiol 287: G315-G319, 2004; doi:10.1152/ajpgi.00115.2004
0193-1857/04 $5.00
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THEMES

Inflammation and Cancer V. Chronic pancreatitis and pancreatic cancer

David C. Whitcomb

Departments of Medicine, Cell Biology and Physiology, and Human Genetics and the University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15213

Pancreatic inflammation appears to increase the risk of pancreatic cancer. This observation is striking in the hereditary pancreatitis kindreds but also occurs in alcoholic, idiopathic, and tropical chronic pancreatitis and cystic fibrosis. However, the mutations associated with hereditary pancreatitis or cystic fibrosis are not found in sporadic pancreatic adenocarcinomas, suggesting that the effects are indirect by causing recurrent pancreatitis and chronic inflammation. The process of mutation accumulation and clonal expansion that is required for development of invasive pancreatic adenocarcinoma must therefore be accelerated in chronic pancreatitis to account for the high incidence of pancreatic cancer in these patients.

cystic fibrosis; hereditary pancreatitis; tropical pancreatitis; alcohol; inflammation; KRAS


Address for reprint requests and other correspondence: D. C. Whitcomb, UPMC Presbyterian, GI Div., Mezzanine 2, C Wing, 200 Lothrop St., Pittsburgh, PA 15213 (E-mail: whitcomb{at}pitt.edu).




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