Pancreatic juice cytology in IPMN of the pancreas

Yamaguchi, Koji; Nakamura, Masafumi; Shirahane, Kengo; Kawamoto, Masahiko; Konomi, Hiroyuki; Ohta, Mutsuko; Tanaka, Masao

doi:10.1159/000086555

Cited by 50 publications

(30 citation statements)

References 15 publications

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“…Chronic pancreatitis or IPMN was diagnosed based on histologic examination of resected specimens or clinical findings at the time of the initial diagnosis and during a follow-up period of at least 12 months that included conventional diagnostic imaging. Cytologic examination was done by experienced cytologists according to the classification described previously (18). Class I comprised benign and nonneoplastic epithelium with no or only slight dysplasia.…”

Section: Methodsmentioning

confidence: 99%

S100A6 Is Increased in a Stepwise Manner during Pancreatic Carcinogenesis: Clinical Value of Expression Analysis in 98 Pancreatic Juice Samples

Ohuchida¹,

Mizumoto²,

Yu³

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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There are few reports describing the diagnostic significance of S100A6 expression in clinical samples obtained from patients with pancreatic disease. In the present study, we measured S100A6 expression in pancreatic tissues and juice to evaluate its involvement in pancreatic carcinogenesis. We did quantitative real-time reverse transcription-PCR to measure mRNA expression in microdissected cells and pancreatic juice samples. Microdissected invasive ductal carcinoma and intraductal papillary mucinous neoplasm (IPMN) cells expressed significantly higher levels of S100A6 than did microdissected pancreatitis-affected epithelial and normal cells (all comparison; P < 0.008). Median levels of S100A6 in invasive ductal carcinoma were higher than those in IPMN, and those in pancreatitis-affected epithelial cells tended to be higher than those in normal cells, although these differences were not statistically significant. In analyses of pancreatic juice, IPMN and pancreatic cancer samples expressed significantly higher levels of S100A6 than did chronic pancreatitis samples (both; P < 0.017), but levels in pancreatic cancer and IPMN samples did not differ form each other. Receiver operating characteristic (ROC) curve analysis revealed that measurement of S100A6 was useful for discriminating cancer (area under the ROC curve, 0.864) or IPMN (area under the ROC curve, 0.749) from chronic pancreatitis. The present data suggest that expression of S100A6 is increased in a stepwise manner during pancreatic carcinogenesis and may be a biomarker for evaluating malignant potential. Measurement of S100A6 in pancreatic juice may be useful to detect early pancreatic cancer or identify individuals with high-risk lesions that may progress to pancreatic cancer. (Cancer Epidemiol Biomarkers Prev 2007;16(4):649 -54)

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Section: Methodsmentioning

confidence: 99%

S100A6 Is Increased in a Stepwise Manner during Pancreatic Carcinogenesis: Clinical Value of Expression Analysis in 98 Pancreatic Juice Samples

Ohuchida¹,

Mizumoto²,

Yu³

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Therefore, it might be difficult to diagnose each subtype of IPMN preoperatively based solely on an imaging study. Recently, however, several investigations on pancreatic juice cytology in IPMN revealed that it can be subclassified not only histomorphologically but also based on cytological findings (11,24). Combining routine cytological findings with the subclassification of IPMNs by MUC immunocytochemistry will be useful for preoperative evaluation of the malignant potential of IPMNs.…”

Section: Clinicopathological Featuresmentioning

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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“…[12][13][14][15][16]25,26 We have recently reported that the combination of some factors augments the likelihood of malignancy in branch duct IPMNs, predicting malignancy at higher sensitivity (96%) and specificity (71%). 24 On the other hand, an approach from the viewpoint of subtypes also may contribute to the clinical management of IPMNs.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic significance of a dilated orifice of the duodenal papilla in intraductal papillary mucinous neoplasm of the pancreas

Aso

Ohtsuka

Ideno

et al. 2012

Gastrointestinal Endoscopy

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Pancreatic juice cytology in IPMN of the pancreas

Cited by 50 publications

References 15 publications

S100A6 Is Increased in a Stepwise Manner during Pancreatic Carcinogenesis: Clinical Value of Expression Analysis in 98 Pancreatic Juice Samples

S100A6 Is Increased in a Stepwise Manner during Pancreatic Carcinogenesis: Clinical Value of Expression Analysis in 98 Pancreatic Juice Samples

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

Diagnostic significance of a dilated orifice of the duodenal papilla in intraductal papillary mucinous neoplasm of the pancreas

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