Pathology

The majority of exocrine tumours are ductal adenocarcinomas (90%) and 1-2% are acinar; the remainder are of diverse histology. 75% arise in the head of the organ, 15% in the body, and 10% in the tail. Genetic abnormalities found in pancreatic cancer include the K-ras oncogene (90-100%) and mutations in p53 (60%), p16 (80%), and SMAD4 (50%) tumour suppressor genes.

Spread is mainly to retroperitoneal tissue, the liver, and the peritoneum, with distant metastases to the lung, liver, and the bone.

The most significant prognostic indicators are tumour size, grade, stage, and resection margin status. Staging is according to TNM classification.

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