Expression of Ki-67, p53, and K-ras in chronic pancreatitis and pancreatic ductal adenocarcinoma.
OBJECTIVE
To examine surgical specimens of pancreas with either chronic pancreatitis or pancreatic cancer in order to study whether ductal hyperplasia and dysplasia in pancreas represent precursor lesions for pancreatic cancer.


METHODS
We examined expression of Ki-67, CEA, p53, and K-ras, in the surgical specimens of pancreas with adenocarcinomas (n=11) and chronic pancreatitis (n=12). Cellular proliferation was assessed by Ki-67 proliferation index using the proliferation marker Ki-67. In specimens with pancreas cancer, we divided pancreas epithelium into normal (n=7), ductal hyperplasia (n=3), dysplasia (n=4), and cancerous lesion (n=11) after hematoxylin and eosin staining, Ki-67, and CEA immunohistochemical staining. In cases with chronic pancreatitis, the specimen was pathologically examined as in cases with pancreas cancer, and they were also determined as normal (n=10), ductal hyperplasia (n=4), or dysplasia (n=5). p53 and K-ras expression were also studied by immunohistochemical staining.


RESULTS
In pancreatic cancer, the Ki-67 index was 3.73+/-3.58 in normal site, 6.62+/-4.39 in ductal hyperplasia, 13.47+/-4.02 in dysplasia and 37.03+/-10.05 in cancer tissue, respectively. Overall, p53 was positive in normal ducts, ductal hyperplasia, dysplasia, and carcinoma cells in 0 of 14 (0%), 0 of 7 (0%), 7 of 9 (78%), and 10 of 11 (91%), respectively, and K-ras was positive in 0 of 8 (0%), 1 of 3 (33%), 4 of 6 (67%), 4 of 5 (80%), respectively.


CONCLUSIONS
Our results favorably support the hypothesis that ductal hyperplasia and dysplasia of the pancreas might be precursor lesions for pancreas cancer. Further evaluation of oncogenes by the molecular study is needed.
Jeong
Seok
S
Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, Jung-Gu, Incheon 400-711, South Korea. ldh@inha.ac.kr
Lee
Don Haeng
DH
Lee
Jung Il
JI
Lee
Jin-Woo
JW
Kwon
Kye Sook
KS
Kim
Pum-Soo
PS
Kim
Hyung Gil
HG
Shin
Yong Woon
YW
Kim
Young Soo
YS
Kim
Young Bae
YB
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism* / Q000473:pathology; D049109:Cell Proliferation; D002908:Chronic Disease; D005260:Female; D011905:Genes, ras; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000378:metabolism* / Q000473:pathology; D011230:Precancerous Conditions; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
D015415:Biomarkers; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53