Histologic, Immunohistochemical, and Molecular Classification of 52 IPMNs of the Pancreas

“…To our knowledge, this is the first report describing the relationship between invasiveness and TSP1 immunoreactivity in IPMN of the pancreas. Several investigators have reported clinicopathological and biological differences on comparing histologic subtypes of IPMN (5,12,13,17,20,25). Using the TSP1 expression pattern, we also analyzed differences in stromal invasion within histological subtypes of IPMN.…”

Section: References Discussionmentioning

confidence: 99%

“…Based on the results on an immunohistochemical study of TSP1, we investigated the therapeutic strategy according to the histological subtype of IPMN. Recently, there have been some reports on the relationship between the histological subtype and invasiveness in IPMN (5,12,13,17,20,25). We also analyzed the correlation between the subtype and stromal TSP1 expression in IPMNs to clarify which subtypes tended to achieve invasiveness fast and which tended to retain the status of adenoma in the pancreatic duct, and discussed the clinicopathological significance.…”

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confidence: 99%

Stromal thrombospondin-1 expression is a prognostic indicator and a new marker of invasiveness in intraductal papillary-mucinous neoplasm of the pancreas

et al. 2010

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The invasion of intraductal papillary-mucinous neoplasm (IPMN) is sometimes difficult to diagnose using only ordinary hematoxylin-eosin sections. The aim of this study was to evaluate the invasion of IPMN more precisely using thrombospondin-1 (TSP1) immunohistochemistry as a useful adjunct to morphological examination. Eighty patients that underwent primary resection for pancreatic IPMNs were retrospectively analyzed. The 80 IPMNs were studied for the expression of TSP1, MUC1-CORE, MUC2, and MUC5AC. The cases were evaluated for dysplasia, the presence of invasion, hisological subtypes, and survival. The 80 IPMNs were classified into 29 intraductal papillary-mucinous adenomas (IPMAs), 10 borderline IPMNs, 18 noninvasive intraductal papillary-mucinous carcinomas (IPMCs), and 23 invasive IPMCs according to the WHO classification. Invasive IPMCs were further divided into 12 minimally invasive IPMCs (MI-IPMCs) and 11 invasive carcinomas originating from IPMCs (IC-IPMCs) according to the Japan Pancreatic Society classification. The rate of strongly positive cases with more than 30% of the cancer stroma area expressing TSP1 was significantly higher in MI-IPMC and IC-IPMC than in noninvasive IPMC (P = 0.035, 0.005). Furthermore, patients in the strongly positive group had a significantly poorer prognosis compared to patients in the negative-weakly positive group (P = 0.008, log-rank test). Of the 80 tumors, 22 were classified into gastric-, 45 into intestinal-, 7 into pancreatobiliary-, and 6 into oncocytic-type IPMNs according to criteria described previously. The cases with a strongly positive expression of TSP1 were frequently detected in the pancreatobiliary and oncocytic types (P = 0.001). In conclusion, stromal TSP1 expression is a prognostic indicator and a new marker of invasiveness in IPMN.Intraductal papillary-mucinous neoplasms of the pancreas (IPMNs) are a well-characterized group of intraductal, mucin-producing, cystic neoplasms of the pancreas with a clear malignant potential (1, 2). A half of surgically resected IPMNs are intraductal papillary-mucinous adenoma (IPMA) or borderline IPMN even under current international criteria (21), and it is still unclear when they change to noninvasive intraductal papillary-mucinous carcinoma (IPMC), how long IPMC retains a status of "carcinoma in situ", and when IPMC achieves invasiveness. Particularly, invasive carcinoma originating from intraductal papillary-mucinous carcinoma (IC-IPMC) showed similar malignant behavior compared with conventional invasive ductal carcinoma both clinically and histologically (15). Minimally invasive IPMC (MI-IPMC) has been categorized within the classification of pancreatic carcinoma used by

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“…The commonest of these is a somatic mutation at the oncogenic hotspots in KRAS which is identified in approximately 80% of IPMNs if sensitive techniques are used [8]. These KRAS mutations occur in all grades of dysplasia as well as histologic subtypes, and are not a predictor of the presence of high-grade dysplasia [9]. In contrast, loss of tumor suppressor genes occurs later in IPMN development.…”

Section: Intraductal Papillary Mucinous Neoplasms and Mucinous Cysticmentioning

confidence: 99%

Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Raman

Lennon²

2018

Visc Med

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Pancreatic cysts are common, and are identified in 2-13% of individuals undergoing cross-sectional imaging. Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) are pancreatic cysts which are precursors to pancreatic adenocarcinoma. Currently available tools are imperfect at differentiating IPMNs and MCNs from other, benign types of pancreatic cysts. The role of molecular markers in the evaluation of pancreatic cysts and the identification of cysts with high-grade dysplasia or invasive adenocarcinoma is reviewed.

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Histologic, Immunohistochemical, and Molecular Classification of 52 IPMNs of the Pancreas

Cited by 59 publications

References 23 publications

Targeted next-generation sequencing of cancer genes dissects the molecular profiles of intraductal papillary neoplasms of the pancreas.

Targeted next-generation sequencing of cancer genes dissects the molecular profiles of intraductal papillary neoplasms of the pancreas.

Stromal thrombospondin-1 expression is a prognostic indicator and a new marker of invasiveness in intraductal papillary-mucinous neoplasm of the pancreas

Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

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