Prognostic Significance of the Labeling of Adnab-9 in Pancreatic Intraductal Papillary Mucinous Neoplasms.
First described as a distinct entity in the early1980s (1), pancreatic ductal neoplasms with mucinhypersecretion have been increasingly recognized.This motivated the World Health Organization(WHO) reclassification proposal in 1996 (2), which separated them from mucinous cystic neoplasms.These tumors are now (3) termed intraductal papillarymucinous neoplasms (IPMN). Despite a burgeoningvolume of recent literature devoted to thiscondition, little is known of the pathogenesis ofIPMN,which is believed to constitute 10% of mucinproducingpancreatic tumors and 1% of pancreaticcancers (4). IPMN presents diagnostic and therapeuticchallenges to the clinician because it representsa histologic spectrum of morphology, from thebenign adenoma to invasive carcinoma. The initialhistological and morphological features of IPMN oftenunderestimate its invasive potential (5), and may notaccurately predict survival. Conversely, it may oftenbe difficult to differentiate benign from malignantlesions (5-7). In the most advanced stages, when aninvasive carcinoma is present, IPMN can be indistinguishablefrom common pancreatic ductal cancer(PC), yet with aggressive surgical management, theprognosis for patients with IPMN is far better (6,7).The availability of a prognostic indicator, independentfrom the pathological stage, may help to directtherapy.
Tobi
Martin
M
Gastroenterology Service, John D. Dingell VAMC, 111C1, 4646 John R St., Detroit, MI 48201.
Hatfield
James
J
Adsay
Volkan
V
Galagan
Katherine
K
Kozarek
Richard
R
Inagaki
Mitsuhiro
M
Kasai
Shinichi
S
Tokusashi
Yoshihiko
Y
Obara
Takeshi
T
Hruban
Ralph
R
Lough
John
J
Barkun
Alan
A
Jabbari
Mansour
M
Sheikh
Rafiq
R
Ruebner
Boris
B
Lawson
Michael
M
Ben-Josef
Edgar
E
Fligiel
Suzanne
S