Аннотация
Заключение
Pancreatic cancer (PC) is among the most aggressive
malignant tumors, characterized by high mortality
and poor prognosis. According to international sources
(GLOBOCAN, SEER) and statistics from the Republic of
Tajikistan, the incidence of PC remains relatively low;
however, mortality rates are extremely high. The main
reason for this is late diagnosis, when radical surgical
intervention is possible only in a limited number of
patients. In recent years, data have accumulated on
the important role of hereditary factors and germline
pathogenic variants in the development of the disease.
The most studied genes associated with an increased
risk of PC are BRCA (Breast Cancer gene), PALB2, ATM,
TP53, CDKN2A, as well as mismatch repair (MMR) genes.
Several of them are linked to hereditary syndromes such
as Li–Fraumeni syndrome, Lynch syndrome, familial
adenomatous polyposis, Peutz–Jeghers syndrome, and
hereditary pancreatitis. Molecular genetic testing in
patients with a family history of cancer or suspected
hereditary syndrome is of key importance for early
detection, disease prognosis, and the choice of optimal
management strategies. Thus, the study of molecular
genetic mechanisms of PC provides a basis for precision
diagnostics and improvement of clinical outcomes in this
group of patients
Ключевые слова
Pancreas
cancer
carcinoma
pancreatic cancer
PDAC [Carcinoma
Pancreatic Ductal]
FAP [Adenomatous Polyposis Coli]
FAMMM [Melanoma].
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Список литературы
- Abe K, et al. Hereditary pancreatic cancer. J Hepatobiliary Pancreat Sci. 2021;28(6):497–506. doi:10.1002/jhbp.1063. Available from: [https://pmc.ncbi.nlm.nih.gov/articles/PMC8449773/](https://pmc.ncbi.nlm.nih.gov/articles/PMC8449773/)
- Bennett C, Suguitan M, Abad J, Chawla A. Identification of high-risk germline variants for the development of pancreatic cancer: Common characteristics and potential guidance to screening guidelines. Pancreatology. 2022;22(6):719–729. doi:10.1016/j.pan.2022.05.005. Available from: [https://pubmed.ncbi.nlm.nih.gov/35798629/](https://pubmed.ncbi.nlm.nih.gov/35798629/)
- Biller LH, Syngal S, Yurgelun MB. Recent advances in Lynch syndrome. Fam Cancer. 2019;18:211–19.
- Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: an overview. Int J Cancer. 2021;148(4):1047–1059. doi:10.1002/ijc.33588. Available from: [https://pubmed.ncbi.nlm.nih.gov/33818764/](https://pubmed.ncbi.nlm.nih.gov/33818764/)
- Ghiorzo P, Pastorino L, Battistuzzi L, et al. Genetic predisposition to pancreatic cancer. World J Gastroenterol. 2014;20(31):10778-10787. doi:10.3748/wjg.v20.i31.10778. Available from: [https://www.wjgnet.com/1007-9327/full/v20/i31/10778.htm](https://www.wjgnet.com/1007-9327/full/v20/i31/10778.htm)
- Giardiello FM, Trimbath JD. Peutz-Jeghers syndrome and management of gastrointestinal hamartomatous polyposis syndromes. Gastroenterology. 2006;130(3):1036–1043. doi:10.1053/j.gastro.2005.11.045. Available from: [https://www.cghjournal.org/article/S1542-3565(05)01093-1/fulltext](https://www.cghjournal.org/article/S1542-3565(05)01093-1/fulltext)
- Golan T, Hammel P, Reni M, et al. Maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer. NEJM. 2019;381(4):317–27.
- Karstensen JG, et al. Cancer in patients with familial adenomatous polyposis. Gastroenterology. 2023;165(4):1073–1084. doi:10.1053/j.gastro.2023.06.015. Available from: [https://www.sciencedirect.com/science/article/pii/S0016508523007321](https://www.sciencedirect.com/science/article/pii/S0016508523007321)
- Katona BW, Singer CF, Karlan BY, et al. The incidence of pancreatic cancer in women with germline BRCA1 and BRCA2 mutations. Cancer Prev Res (Phila). 2025;14(11):1033-1040. doi:10.1158/1940-6207.CAPR-21-0161. Available from: [https://pubmed.ncbi.nlm.nih.gov/39611336/](https://pubmed.ncbi.nlm.nih.gov/39611336/)
- Korsse SE, et al. Pancreatic cancer risk in Peutz-Jeghers syndrome patients. Fam Cancer. 2013;12(4):513–518. doi:10.1007/s10689-013-9631-7. Available from: [https://pubmed.ncbi.nlm.nih.gov/23240097/](https://pubmed.ncbi.nlm.nih.gov/23240097/)
- Landi S. Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature. Mutat Res. 2009;681(2–3):299–307. doi:10.1016/j.mrrev.2008.12.001. Available from: [https://pubmed.ncbi.nlm.nih.gov/19150414/](https://pubmed.ncbi.nlm.nih.gov/19150414/)
- Langer EM, Harlan DM, Hall W, et al. Genetic testing in pancreatic cancer and its family history. J Genet Oncol. 2022;15(3):84-97.
- Le Cosquer G, Maulat C, Bournet B, et al. Pancreatic cancer in chronic pancreatitis: pathogenesis and diagnostic approach. Cancers (Basel). 2023;15(3):761. doi:10.3390/cancers15030761. Available from: [https://pubmed.ncbi.nlm.nih.gov/36765725/](https://pubmed.ncbi.nlm.nih.gov/36765725/)
- Mai PL, Best AF, et al. Risks of first and subsequent cancers among TP53 mutation carriers in the National Cancer Institute Li-Fraumeni syndrome cohort. Cancer. 2016;122(23):3673–3681. doi:10.1002/cncr.30248. Available from: [https://pubmed.ncbi.nlm.nih.gov/27496084/](https://pubmed.ncbi.nlm.nih.gov/27496084/)
- McWilliams RR, et al. Germline CDKN2A mutations in pancreatic cancer families. Cancer. 2011;117(13):2969–2976. doi:10.1002/cncr.25894. Available from: [https://pubmed.ncbi.nlm.nih.gov/21150883/](https://pubmed.ncbi.nlm.nih.gov/21150883/)
- National Comprehensive Cancer Network. Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate. Version 1.2026. Available from: [https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1545](https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1545)
- Okano N, Morizane C, Nomura S, et al. Phase II clinical trial of gemcitabine plus oxaliplatin in patients with metastatic pancreatic adenocarcinoma with a family history of pancreatic/breast/ovarian/prostate cancer or personal history of breast/ovarian/prostate cancer (FABRIC study). Int J Clin Oncol. 2020;25(10):1835–43.
- Resta N, et al. Cancer risk in Peutz-Jeghers syndrome: an updated cohort study. Am J Gastroenterol. 2013;108(10):1655–1665. doi:10.1038/ajg.2013.242. Available from: [https://pubmed.ncbi.nlm.nih.gov/23415580/](https://pubmed.ncbi.nlm.nih.gov/23415580/)
- Seppälä TT, Burkhart RA, Katona BW. Hereditary colorectal, gastric, and pancreatic cancer: comprehensive review. BJS Open. 2023;7(3):zrad023. doi:10.1093/bjsopen/zrad023. Available from: [https://pubmed.ncbi.nlm.nih.gov/37165697/](https://pubmed.ncbi.nlm.nih.gov/37165697/)
- Sun M, Li M, Lu X, et al. Cancer risks associated with ATM gene mutations: A systematic review. Oncol Lett. 2021;22(6):1-8.
- Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi:10.3322/caac.21660. Available from: [https://pubmed.ncbi.nlm.nih.gov/33538338/](https://pubmed.ncbi.nlm.nih.gov/33538338/)
- Timmer FEF, Geboers B, Nieuwenhuizen S, et al. Locoregional treatment of metastatic pancreatic cancer utilizing resection, ablation and embolization: a systematic review. Cancers. 2021;13(7):1608. doi:10.3390/cancers13071608. Available from: [https://www.mdpi.com/2072-6694/13/7/1608](https://www.mdpi.com/2072-6694/13/7/1608)
- Tischkowitz M, Balmaña J, Foulkes WD, et al. Management of individuals with germline variants in PALB2: a clinical practice resource of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2021;23(8):1416–1423. doi:10.1038/s41436-021-01151-8. Available from: [https://pubmed.ncbi.nlm.nih.gov/33976419/](https://pubmed.ncbi.nlm.nih.gov/33976419/)
- Tischkowitz M, Xia B. PALB2/FANCN: recombining cancer and Fanconi anemia. Cancer Res. 2010;70(19):7353-7359. doi:10.1158/0008-5472.CAN-10-1012. Available from: [https://pubmed.ncbi.nlm.nih.gov/20858716/](https://pubmed.ncbi.nlm.nih.gov/20858716/)
- Wang L, Xie K, Guo M, et al. Hereditary factors and genetic testing for pancreatic cancer: an updated review. Int J Cancer. 2021;148(11):2689–99.
- Wong W, Rauf AG, Safyan RA, et al. BRCA mutations in pancreatic cancer: spectrum, current management, challenges, and future prospects. Cancer Manag Res. 2020;12:2731–42.
- Yang X, Leslie G, Doroszuk A, et al. Cancer risks associated with germline PALB2 pathogenic variants. J Clin Oncol. 2020;38(14):1443–1451. doi:10.1200/JCO.19.01907. Available from: [https://pubmed.ncbi.nlm.nih.gov/31841383/](https://pubmed.ncbi.nlm.nih.gov/31841383/)
- Yang X, Leslie G, Doroszuk A, et al. Cancer risks associated with germline PALB2 pathogenic variants: an international study of 524 families. J Clin Oncol. 2019;38:674–85.
- Zanini S, et al. A review of lifestyle and environmental risk factors for pancreatic cancer. Pancreatology. 2021;21(1):1–8. doi:10.1016/j.pan.2020.11.001. Available from: [https://pubmed.ncbi.nlm.nih.gov/33423007/](https://pubmed.ncbi.nlm.nih.gov/33423007/)