Kabachenko V. Pathomorphological characteristics of epithelial-mesenchymal transformation and stem cells in the progression of pancreatic ductal adenocarcinoma

The aim of this work was to improve the pathomorphological diagnostics and prediction of course of pancreatic ductal adenocarcinoma based on pathomorphological and immunohistochemical analysis of trepanobiopsy and surgical material. The main group consisted of 139 patients with pancreatic ductal adenocarcinoma (74 core biopsies, 65 samples of surgical material. The control group consisted of 10 samples of autopsy material. The age of the patients in the main group ranged from 36 to 84 years, the average was 61,68±7,75 years. The age of the patients in the control group was 56-73 years, the average age was 64,5±2,33 years. Scientific novelty of the results obtained. For the first time in the comparative analysis, the immunohistochemical parameters of the progression of the ductal adenocarcinoma of the pancreas, the expression of markers of epithelial-mesenchymal transformation and stem cells in each variant of the ductal adenocarcinoma of the pancreas were studied and identified. For the first time, an important role and features of the expression of epithelial, mesenchymal markers and markers of trunk cells in the papz tumors less and more 3 cm of varying degrees of differentiation were identified. There was a significant loss of e-cadgerin, SK7 and SK18 in epithelial-mesenchimically transformed cells and a significant increase in β-cathenin expression in the same cells. Also, in "derivated" cells and in their clusters (epithelial-mesenchymally transformed cells), poor and moderate expression of mesenchymal markers, which are not characteristic of epithelial cells, were established. With the deterioration of differentiation and progression of tumor size from less to more than 3 cm, a significant decrease in the expression of e-kadgerin, SK7 and SK18 in epithelial-mesenchymally transformed cells and a significant increase in β-cathenin expression in the same cells, and a significant increase "Detrimental" cells and in their clusters (epithelial-mesenchimically transformed cells). New data on the significant development of dense fibroplastic stroma in the Papz, which progressed in tumors from moderate to low differentiation and in tumors from less to more 3cm. The practical importance of the results obtained. The results of the work can be used for practical use in early pathomorphological diagnosis of the ductal adenocarcinoma of the pancreas. Also established differences of immunohistochemical and mofrometric parameters of cells and structures of cancer glandular-prototy depending on the size of the tumor and its degree of differentiation. With the increase in the size of the tumor and the deterioration of its degree of differentiation, a statistically significant decrease in the expression of epithelial markers (E-Kadgerin, SK7 and SK7) and statistically significant growth The "detrimental" cells and their accumulations of epithelial-mesenchymal transformation zones, the significant growth of markers of mesenchymal phenotype (vmitry and smooth-muscular actin) into the EMT zone, more pronounced in "detached" cells and their clusters. With the increase in the size of the tumor and the deterioration of the degree of differentiation, a statistically significant increase in the expression of mesenchymal markers (girls and smooth-muscular actin) in the stromal compartment of the ductal adenocarcinoma of the pancreas was established. The parallel results of the study of stem cells also showed the prognostic parameters of the deterioration of the ductal adenocaaritic of the pancreas.