Intraductal papillary mucinous tumors of the pancreas

Schmitz-Winnenthal, Friedrich H.; Z’graggen, Kaspar; Volk, Christine; Schmied, Bruno M.; Büchler, Markus W.

doi:10.1007/s11894-003-0082-y

Cited by 14 publications

(14 citation statements)

References 49 publications

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“…For example, the K-ras mutation is found in 16.7% of normal epithelium samples of IPMN but in 57.1% of specimens of highgrade dysplasia, carcinoma in situ and malignant forms of IPMN are combined; p53 overexpression has shown the same pattern, with more invasive types of IPMNs showing a greater overexpression of p53 [13] .…”

Section: K-ras Mutations and P53 Overexpressionmentioning

confidence: 99%

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Intraductal Papillary Mucinous Neoplasms of the Pancreas

Al‐Refaie¹,

Choi²,

Tseng³

et al. 2006

Med Princ Pract

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The introduction of the exocrine pancreatic classification by the World Health Organization and improvements in pancreatic imaging have led to an improved understanding of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. As a result, IPMNs of the pancreas are increasingly being recognized as a separate disease entity. IPMNs are characterized by the cystic dilatation of the pancreatic duct and its branches, with papillary projections. There are three histological subtypes of IPMNs: main duct, branch duct, and mixed. The degree of atypia ranges from adenoma to frank invasive carcinoma. The lymph nodes are involved considerably less frequently than they are in pancreatic adenocarcinoma. Most patients are symptomatic at diagnosis and require a diagnostic workup similar to that for patients with pancreatic adenocarcinoma. Although some investigators continue to advocate total pancreatectomy, the evidence in support of this is decreasing. Partial pancreatectomy remains the treatment option. Intraoperative assessment of the resection surgical margins is an important component of surgical resection. Additionally, controversy also exists regarding the nature of the follow-up and the need for adjuvant chemoradiation therapy in the patient. Unlike ductal adenocarcinomas, IPMNs follow a relatively indolent course; the 5-year survival rate in patients with invasive IPMNs is 57%. A mural nodule and a main pancreatic duct diameter greater than 5 mm have been found to be predictors of malignancy.

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Section: K-ras Mutations and P53 Overexpressionmentioning

confidence: 99%

“…This mutation, resulting in the DPC4 inactivation, occurs due to one of two defects: a loss of heterozygosity (25%) or homozygous deletion (35%). On the other hand, in pancreatic adenocarcinomas, DPC4 is strongly expressed in all benign forms of IPMNs and in 84% of invasive IPMNs [7,13,15] .…”

Section: Dpc4 Genementioning

confidence: 99%

Intraductal Papillary Mucinous Neoplasms of the Pancreas

Al‐Refaie¹,

Choi²,

Tseng³

et al. 2006

Med Princ Pract

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“…1 Since the recognition of this entity by the World Health Organization in 1996, IPMNs have been identified with increased frequency and the unique clinical, radiological, and pathological features of IPMNs have been defined. [2][3][4][5] IPMNs are characterized as having grossly identifiable proliferations of mucin-producing neoplastic epithelium within dilated pancreatic ducts and ductules. 6 The intraductal components of IPMNs display a broad spectrum of dysplasia ranging from adenoma to borderline to carcinoma in situ, and ϳ30% of IPMNs are associated with an infiltrating adenocarcinoma.…”

mentioning

confidence: 99%

Gene Expression Profiling Identifies Genes Associated with Invasive Intraductal Papillary Mucinous Neoplasms of the Pancreas

Sato

Fukushima

Maitra

et al. 2004

The American Journal of Pathology

197

168

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The molecular pathology of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas has not been well characterized, and there are no reliable markers to predict the presence of an associated invasive carcinoma in IPMNs. Using oligonucleotide microarrays, we performed a large-scale gene expression profiling of 12 IPMNs with or without an associated invasive carcinoma. A subset of genes identified was validated for the gene expression patterns in a large panel of IPMNs by reverse-transcription polymerase chain reaction and/or immunohistochemistry. A total of 673 transcripts were identified as expressed at significantly higher levels (P < 0.05 and at fivefold or greater) in IPMNs relative to normal pancreatic ductal epithelial samples. Of interest, many of the genes identified as overexpressed in IPMNs have also been previously reported to be highly expressed in infiltrating ductal adenocarcinoma of the pancreas. By analyzing genes overexpressed selectively in IPMNs with an associated invasive carcinoma (n ‫؍‬ 7), we also identified a panel of genes potentially associated with the invasive phenotype of the neoplasms. Immunohistochemical validation revealed that claudin 4, CXCR4, S100A4, and mesothelin were expressed at significantly high frequency in invasive IPMNs than in noninvasive IPMNs. Notably, the expression of at least two of the four proteins was observed in 73% of 22 invasive IPMNs but in none of 16 noninvasive IPMNs (P < 0.0001). Our findings suggest that preoperative assessment of gene expression profiles may be able to differentiate invasive from noninvasive IPMNs.

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“…IPMNs are, by definition, larger than 1 cm and can be solitary or multifocal [70][71][72]. IPMNs can involve the main pancreatic duct or they may arise in a branch off from the main duct.…”

Section: Intraductal Papillary Mucinous Neoplasmsmentioning

confidence: 99%

The genetic classification of pancreatic neoplasia

2015

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Cancer is caused by the accumulation of inherited and/or acquired alterations in specific genes. The recent decline in the cost of DNA sequencing has allowed tumor sequencing to be conducted on a large scale, which, in turn, has led to an unprecedented understanding of the genetic events that drive neoplasia. This understanding, when integrated with meticulous histologic analyses and with clinical findings, has direct clinical implications. The recent sequencing of all of the major types of cystic and noncystic neoplasms of the pancreas has revealed opportunities for molecular diagnoses and for personalized treatment. This review summarizes the results from these recent studies focusing on the clinical relevance of genomic data.

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Intraductal papillary mucinous tumors of the pancreas

Cited by 14 publications

References 49 publications

Intraductal Papillary Mucinous Neoplasms of the Pancreas

Intraductal Papillary Mucinous Neoplasms of the Pancreas

Gene Expression Profiling Identifies Genes Associated with Invasive Intraductal Papillary Mucinous Neoplasms of the Pancreas

The genetic classification of pancreatic neoplasia

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