Intraductal Papillary Mucinous Neoplasms of the Pancreas With Distinct Pancreatic Ductal Adenocarcinomas Are Frequently of Gastric Subtype

• DOI: 10.1097/sla.0b013e31828cd008
• Publication Date: 2013-03-26T12:49:32Z
• Authors: Noboru Ideno; Takao Ohtsuka; Hiroshi Kono; Kenji Fujiwara; Yasunori Oda; Shinichi Aishima; Tetsuhide Ito; Kousei Ishigami; Shoji Tokunaga; Kenoki Ohuchida; Shunichi Takahata; Masafumi Nakamura; Kazuhiro Mizumoto; Masao Tanaka
• Keywords: GNAS complex locus; CDX2; Mucin 2; Mucinous carcinoma; MUC1

To identify a high-risk group of patients with pancreatic ductal adenocarcinoma (PDAC), independently arising in the pancreas intraductal papillary mucinous neoplasm (IPMN), using histopathologic subtypes.Pathologic features IPMN distinct PDAC, including subtypes and PDAC phenotypes, have not been well characterized. Mucin expression patterns mutational status GNAS KRAS are useful to explore relationship between these 2 lesion types.Clinicopathologic data 179 resected IPMNs 180 PDACs without as control were reviewed. classified into 4 grades (low-grade, intermediate-grade, high-grade dysplasia, an associated invasive carcinoma) (gastric, intestinal, pancreatobiliary, oncocytic). The MUC1, MUC2, MUC5AC, MUC6, CDX2 was investigated by immunohistochemistry IPMNs. evaluated cycle sequencing pre-/coexisting IPMNs.Twenty-six synchronous or metachronous identified 20 (11.2%) Occurrence concomitant more frequently observed gastric-type (18/110, 16.4%) compared intestinal (1/49, 2.0%), pancreatobiliary (1/17, 5.9%), oncocytic-type (0/3, 0%) (P = 0.047). Both positive for MUC6 expression, assessed immunohistochemistry, but negative MUC2 CDX2. mucin-staining similar those tubular from Mutation within codon 201 detected IPMNs, whereas most exhibited mutations. However, R201H mutation 1 intestinal-type PDAC.Mucin demonstrate that mutations aggressive phenotype arise benign absence