Tuyến ác tính đã thay thế hầu hết các tế bào đảo mà không có bất kỳ dấu hiệu của sự phá hủy tế bào hòn, bao gồm cả cuộc xâm lược của các tế bào đảo và các mô xung quanh. Trong một số lĩnh vực tế bào đảo còn nguyên vẹn có mặt trong biểu mô ác tính (ví dụ, khu vực dưới bên phải). | PART III Figure An enlarged islet in a patient with pancreatic cancer. Malignant glands have replaced most islet cells without any signs of islet cell destruction including invasion of the islet cells and the surrounding tissue. In some areas intact islet cells are present within the malignant epithelium . lower right area . Anti-insulin antibody ABC avidin-biotin complex method X 120. Figure Papillary projection of a well-differentiated pancreatic adenocarcinoma. Numerous insulin-producing cells are seen at the base and within the papillary fold. Antiinsulin ABC avidin-biotin complex method X 120. anaplastic cancers parallels the advanced loss of cellular differentiation in cultured islets where the cells lose every known islet-cell marker. Clinical studies supporting the role of islets in pancreatic carcinogenesis Although it has been known for almost a century that nearly 80 of patients with pancreatic cancer have im paired glucose metabolism either frank diabetes or impaired glucose tolerance IGT the reason has remained a mystery. Remarkably the degree of IGT and diabetes in these patients has been known to vary. Some patients require insulin treatment whereas others do not. Fasting serum glucose levels may be in the normal range but an oral glucose tolerance test may yield a diagnosis of IGT. On the other hand a small subset of patients shows normal glucose metabolism. It is possible that differences in the patient population are the reason that morphologic and molecular biological approaches have not provided clues for understanding the biology of this dismal disease. The association between diabetes and pancreatic cancer has remained a matter of controversy. According to recent studies IGT or diabetes mellitus develops shortly before the clinical manifestations of the disease or is diagnosed at the first clinical admission. There are however a few who believe that diabetes is a predisposing factor especially in cases where diabetes is present .
