Intraductal papillary mucinous neoplasms of the pancreas: an analysis of protein expression and clinical features.
OBJECTIVE
The molecular pathology of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas has not been well characterized, and there are no reliable markers to predict the presence of associated invasive carcinoma in patients with IPMNs. We investigated the clinicopathologic characteristics of 37 IPMNs and the immunohistochemical findings of these tumors to investigate the malignancy of IPMNs.


METHODS
Between May 1992 and September 2003, 37 patients with IPMNs, 24 with adenoma and 13 with carcinoma, underwent pancreatic resections at Sapporo Medical University Hospital, Japan. In tumor specimens from these patients, we immunohistochemically analyzed the expression of p53 protein, proliferating-cell nuclear antigen (PCNA), vascular endothelial growth factor (VEGF), matrix metalloproteinase-7 (MMP-7), and E-cadherin. Clinical features and follow-up after resection were recorded.


RESULTS
Aberrant expression of the proteins examined was frequently observed. Namely, there were significant differences in the expression of MMP-7 according to clinicopathological characteristics. Positive expression of MMP-7 was found in all of nine patients with infiltrating ductal pancreatic adenocarcinoma (IDC) and in all of seven patients with invasive intraductal papillary mucinous adenocarcinoma (IC-IPMC); however, 33.3% of patients with noninvasive IPMA, 58.3% of patients with intraductal papillary mucinous adenoma (IPMA), and all normal pancreatic tissues were negative for MMP-7; differences which were statistically significant (P < 0.05).


CONCLUSIONS
Our current results indicate that MMP-7 may play a significant role in the progression of noninvasive to invasive IPMC.
Nishikawa
Noriko
N
First Department of Surgery, Sapporo Medical University School of Medicine, S-1, W-16, Sapporo, Hokkaido 060-8543, Japan.
Kimura
Yasutoshi
Y
Okita
Kenji
K
Zembutsu
Hitoshi
H
Furuhata
Tomohisa
T
Katsuramaki
Tadashi
T
Kimura
Sachiko
S
Asanuma
Hiroko
H
Hirata
Koichi
K
D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000378:metabolism / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015820:Cadherins / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020783:Matrix Metalloproteinase 7 / Q000378:metabolism*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D015820:Cadherins; D018809:Proliferating Cell Nuclear Antigen; D016159:Tumor Suppressor Protein p53; D042461:Vascular Endothelial Growth Factor A; C060932:MMP7 protein, human; D020783:Matrix Metalloproteinase 7