Common features between neoplastic and preneoplastic lesions of the biliary tract and the pancreas

Table 1 Main similarities and differences in terms of embryologic origin and molecular characteristics between biliary and pancreatic neoplastic lesions

	Biliary tract	Pancreas	Ref.
Embryologic origin of the ductal system	EHBDs and large IHBD from ventral part of foregut; small IHBD from Mesenchymal cells surrounding the septum transversum	Ventral part of MPD from the ventral part of foregut. Dorsal part of MPD from the dorsal bud that obliterates completely; the ducts of the dorsal bud fuse with the ductal system of the ventral part	[1-5]
Niches of Stem/progenitors’ cells	PBGs located in EHBDs and large IHBDs. Canals of Hering	PDGs located in MPD and larger interlobular ducts > 300 μm	[6-12]
Microscopic (intraepithelial) precursors of cancer	BilIN-1 low grade, BilIN-2 intermediate grade, BilIN-3 high grade	PanIN low grade, previously -1, -2 PanIN high grade, previously -3	[21-26,29,37-39]
Macroscopic (intraductal) precursors of cancer	IPNB	IPMN	[54-62]
Kras role in cancer	Mutated in 15%-30%	Mutated in > 90%	[44,123,124,127,129]
p53 role in cancer	Mutated in 35%-60%	Mutated 40%-87%	[49,125-129]
SHH role in cancer	Overexpressed ~ 50%	Overexpressed ~ 70%	[159,160]
Mucin expression in biliopancreatic cancers	MUC-1+ 45%-70% MUC-4+ 35%-50% (worse prognosis compared to MUC4 negative) MUC5AC+ 30%-60%	MUC-1 + ~ 80% MUC-4+ 30%-80% (worse prognosis compared to MUC4 negative) MUC5AC+ 10%-70%	[106-122]
S100P expression	upregulated in ~75%	upregulated in ~ 90%	[42,43,130,131]

EHBDs: Extrahepatic bile ducts; IHBDs: Intrahepatic bile ducts; MPD: Main pancreatic duct; PBGs: Peribiliary glands; PDGs: Pancreatic ductal glands; BilIN: Biliary intraepithelial neoplasm; PanIN: Pancreatic intraepithelial neoplasm; IPNB: Intraductal papillary neoplasm of the biliary tract; IPMN: Intraductal papillary mucinous neoplasm of the pancreas.