BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas account for approximately 5% of pancreatic neoplasms. Prognosis is superior to that of pancreatic invasive ductal carcinoma. IPMNs reveal a variety of epithelial linings expressing different mucin staining patterns and may progress along different oncogenic pathways. MATERIALS AND METHODS: Fifty-two IPMNs were studied for expression of MUC1, MUC2, p16, p21, HER2, cyclin D1, and p53 protein and for mutations in K-ras, HER2, p53, EGFR, and BRAF genes. The cases were evaluated for dysplasia, presence of invasion, and morphology of lining epithelium. RESULTS: Twenty-six IPMNs appeared intestinal (IN). Five were low, 12 moderate, and 9 high grade. K-ras mutations were found in 15, EGFR mutations in 2, and BRAF mutation in 1. Seven cases were pancreaticobiliary (PB) and all showed moderate to high-grade dysplasia. Six K-ras mutations and 2 p53 mutations were found in PB tumors. p53 mutations were in cases with high-grade dysplasia. Nineteen IPMNs demonstrated a gastric foveolar (GF) pattern. The majority of GF cases had low or moderate dysplasia. Sixteen revealed K-ras mutations and 1 case each demonstrated a HER2 or p53 mutation. Five IPMNs revealed invasive adenocarcinoma, including a colloid carcinoma from an IN type epithelium. CONCLUSIONS: IN pattern IPMNs were the most common. Mixed histology was common. K-ras mutations were most common, but did not correlate with dysplasia. p53 mutations were seen in 6% of cases (only in GF and PB subtypes). A HER2 mutation was found in a GF IPMN. EGFR and BRAF mutations were restricted to IN IPMNs. These findings suggest the possibility of alternate pathways for carcinogenesis between epithelial subtypes of IPMNs.
BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas account for approximately 5% of pancreatic neoplasms. Prognosis is superior to that of pancreatic invasive ductal carcinoma. IPMNs reveal a variety of epithelial linings expressing different mucin staining patterns and may progress along different oncogenic pathways. MATERIALS AND METHODS: Fifty-two IPMNs were studied for expression of MUC1, MUC2, p16, p21, HER2, cyclin D1, and p53 protein and for mutations in K-ras, HER2, p53, EGFR, and BRAF genes. The cases were evaluated for dysplasia, presence of invasion, and morphology of lining epithelium. RESULTS: Twenty-six IPMNs appeared intestinal (IN). Five were low, 12 moderate, and 9 high grade. K-ras mutations were found in 15, EGFR mutations in 2, and BRAF mutation in 1. Seven cases were pancreaticobiliary (PB) and all showed moderate to high-grade dysplasia. Six K-ras mutations and 2 p53 mutations were found in PB tumors. p53 mutations were in cases with high-grade dysplasia. Nineteen IPMNs demonstrated a gastric foveolar (GF) pattern. The majority of GF cases had low or moderate dysplasia. Sixteen revealed K-ras mutations and 1 case each demonstrated a HER2 or p53 mutation. Five IPMNs revealed invasive adenocarcinoma, including a colloid carcinoma from an IN type epithelium. CONCLUSIONS: IN pattern IPMNs were the most common. Mixed histology was common. K-ras mutations were most common, but did not correlate with dysplasia. p53 mutations were seen in 6% of cases (only in GF and PB subtypes). A HER2 mutation was found in a GF IPMN. EGFR and BRAF mutations were restricted to IN IPMNs. These findings suggest the possibility of alternate pathways for carcinogenesis between epithelial subtypes of IPMNs.
Authors: Marcus C Tan; Olca Basturk; A Rose Brannon; Umesh Bhanot; Sasinya N Scott; Nancy Bouvier; Jennifer LaFemina; William R Jarnagin; Michael F Berger; David Klimstra; Peter J Allen Journal: J Am Coll Surg Date: 2015-02-11 Impact factor: 6.113
Authors: Chakshu Sharma; Karim M Eltawil; Paul D Renfrew; Mark J Walsh; Michele Molinari Journal: World J Gastroenterol Date: 2011-02-21 Impact factor: 5.742
Authors: Steven Lipkin; John Lee; David Imagawa; Stephen M Hewitt; Chris Tucker; Jason A Zell; Vanessa Wong; Angela Garcia; Rachel Gonzalez; Gary Della Zanna; Ellen Richmond; L M Rodriguez; M Bigg; F Schnoll-Sussmans; Frank Meyskens Journal: Cancer Prev Res (Phila) Date: 2011-04
Authors: Sujuan Yang; Sara P Y Che; Paul Kurywchak; Jena L Tavormina; Liv B Gansmo; Pedro Correa de Sampaio; Michael Tachezy; Maximilian Bockhorn; Florian Gebauer; Amanda R Haltom; Sonia A Melo; Valerie S LeBleu; Raghu Kalluri Journal: Cancer Biol Ther Date: 2017-01-25 Impact factor: 4.742