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MUC2 expression and prevalence of high-grade dysplasia and invasive carcinoma in mixed-type intraductal papillary mucinous neoplasm of the pancreas.
Pancreatology 2013 Nov-Dec; 13(6):583-8P

Abstract

BACKGROUND/OBJECTIVES

Morphological types and mucin protein expressions classify intraductal papillary mucinous neoplasms (IPMNs). Main duct (MD)-IPMN mostly consists of intestinal type (I-type), which expresses MUC2. Branch duct (BD)-IPMN mostly consists of gastric type (G-type), which does not express MUC2. However, the definition of mixed-type IPMN has yet to be clarified and it contains various histological types. The aim of this study was to investigate the relationship between MUC2 expression and the presence of high-grade dysplasia (HGD) and invasive carcinoma, especially in mixed-type IPMN.

METHODS

This retrospective study included 101 consecutive patients with surgically resected IPMNs between April 2001 and October 2012. All patients were morphologically classified into four distinct types (I-type, G-type, PB-type: pancreatobilliary, O-type: oncocytic) and immunohistochemical reactivity of various anti-mucin antibodies were investigated.

RESULTS

According to the classification of the 2012 international guidelines, the numbers (and histomorphological types: I/G/PB/O) of MD, mixed-type, and BD-IPMNs were 16 (12/4/0/0), 45 (16/28/1/0), and 40 (0/38/1/1). Prevalence of MUC2 expression in MD, mixed-type, and BD-IPMNs were 75% (12/16), 36% (16/45), and 0% (0/40). In mixed-type IPMN, the prevalence of HGD and/or invasive carcinoma in MUC2-positive IPMN was significantly higher than that of MUC2-negative IPMN (HGD + invasive carcinoma: 88% vs. 38%, p = 0.0017; invasive carcinoma: 50% vs. 21%, p = 0.042). Multivariate analysis showed that MUC2 expression is an independent predictive factor of HGD and invasive carcinoma in mixed IPMN (odds ratio 14.6, 95% CI 2.5-87.4, p = 0.003).

CONCLUSIONS

In mixed-type IPMN, MUC2 expression clearly identified HGD and invasive carcinoma and may provide most appropriate surgical indication.

Authors+Show Affiliations

Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24280573

Citation

Masuda, Atsuhiro, et al. "MUC2 Expression and Prevalence of High-grade Dysplasia and Invasive Carcinoma in Mixed-type Intraductal Papillary Mucinous Neoplasm of the Pancreas." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 13, no. 6, 2013, pp. 583-8.
Masuda A, Arisaka Y, Hara S, et al. MUC2 expression and prevalence of high-grade dysplasia and invasive carcinoma in mixed-type intraductal papillary mucinous neoplasm of the pancreas. Pancreatology. 2013;13(6):583-8.
Masuda, A., Arisaka, Y., Hara, S., Matsumoto, I., Takenaka, M., Sakai, A., ... Kutsumi, H. (2013). MUC2 expression and prevalence of high-grade dysplasia and invasive carcinoma in mixed-type intraductal papillary mucinous neoplasm of the pancreas. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 13(6), pp. 583-8. doi:10.1016/j.pan.2013.08.007.
Masuda A, et al. MUC2 Expression and Prevalence of High-grade Dysplasia and Invasive Carcinoma in Mixed-type Intraductal Papillary Mucinous Neoplasm of the Pancreas. Pancreatology. 2013;13(6):583-8. PubMed PMID: 24280573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - MUC2 expression and prevalence of high-grade dysplasia and invasive carcinoma in mixed-type intraductal papillary mucinous neoplasm of the pancreas. AU - Masuda,Atsuhiro, AU - Arisaka,Yoshifumi, AU - Hara,Shigeo, AU - Matsumoto,Ippei, AU - Takenaka,Mamoru, AU - Sakai,Arata, AU - Shiomi,Hideyuki, AU - Matsuki,Nobuyuki, AU - Sugimoto,Maki, AU - Fujita,Tsuyoshi, AU - Hayakumo,Takanobu, AU - Ku,Yonson, AU - Ogino,Shuji, AU - Azuma,Takeshi, AU - Kutsumi,Hiromu, Y1 - 2013/08/30/ PY - 2013/05/01/received PY - 2013/08/20/revised PY - 2013/08/21/accepted PY - 2013/11/28/entrez PY - 2013/11/28/pubmed PY - 2014/7/22/medline KW - BD-IPMN KW - CT KW - ERCP KW - EUS KW - EUS-FNA KW - HGD KW - High-grade dysplasia KW - IPMN KW - Invasive carcinoma KW - LGD KW - MCN KW - MD-IPMN KW - MPD KW - MRCP KW - MRI KW - MUC2 expression KW - Mixed-type IPMN KW - branch duct intraductal papillary mucinous neoplasm KW - computed tomography KW - endoscopic retrograde cholangiopancreatography KW - endoscopic ultrasonography KW - endoscopic ultrasound-guided fine needle aspiration KW - high-grade dysplasia KW - intraductal papillary mucinous neoplasm KW - low-grade dysplasia KW - magnetic resonance cholangiopancreatography KW - magnetic resonance imaging KW - main duct intraductal papillary mucinous neoplasm KW - main pancreatic duct KW - mucinous cystic neoplasm SP - 583 EP - 8 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 13 IS - 6 N2 - BACKGROUND/OBJECTIVES: Morphological types and mucin protein expressions classify intraductal papillary mucinous neoplasms (IPMNs). Main duct (MD)-IPMN mostly consists of intestinal type (I-type), which expresses MUC2. Branch duct (BD)-IPMN mostly consists of gastric type (G-type), which does not express MUC2. However, the definition of mixed-type IPMN has yet to be clarified and it contains various histological types. The aim of this study was to investigate the relationship between MUC2 expression and the presence of high-grade dysplasia (HGD) and invasive carcinoma, especially in mixed-type IPMN. METHODS: This retrospective study included 101 consecutive patients with surgically resected IPMNs between April 2001 and October 2012. All patients were morphologically classified into four distinct types (I-type, G-type, PB-type: pancreatobilliary, O-type: oncocytic) and immunohistochemical reactivity of various anti-mucin antibodies were investigated. RESULTS: According to the classification of the 2012 international guidelines, the numbers (and histomorphological types: I/G/PB/O) of MD, mixed-type, and BD-IPMNs were 16 (12/4/0/0), 45 (16/28/1/0), and 40 (0/38/1/1). Prevalence of MUC2 expression in MD, mixed-type, and BD-IPMNs were 75% (12/16), 36% (16/45), and 0% (0/40). In mixed-type IPMN, the prevalence of HGD and/or invasive carcinoma in MUC2-positive IPMN was significantly higher than that of MUC2-negative IPMN (HGD + invasive carcinoma: 88% vs. 38%, p = 0.0017; invasive carcinoma: 50% vs. 21%, p = 0.042). Multivariate analysis showed that MUC2 expression is an independent predictive factor of HGD and invasive carcinoma in mixed IPMN (odds ratio 14.6, 95% CI 2.5-87.4, p = 0.003). CONCLUSIONS: In mixed-type IPMN, MUC2 expression clearly identified HGD and invasive carcinoma and may provide most appropriate surgical indication. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/24280573/MUC2_expression_and_prevalence_of_high_grade_dysplasia_and_invasive_carcinoma_in_mixed_type_intraductal_papillary_mucinous_neoplasm_of_the_pancreas_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(13)00789-8 DB - PRIME DP - Unbound Medicine ER -