title: Potential usefulness of mucin immunohistochemical staining of preoperative pancreatic biopsy or juice cytology specimens in the determination of treatment strategies for intraductal papillary mucinous neoplasm.
abstract: We classified resected intraductal papillary mucinous neoplasms (IPMNs) into four subtypes (gastric, intestinal, pancreatobiliary and oncocytic) according to their morphological features and mucin expression, determined their clinicopathological characteristics and investigated the possibility of preoperatively diagnosing these subtypes. Sixty resected tumors, 4 preoperative tumor biopsies and 10 preoperative pancreatic juice cytology specimens were analyzed. The gastric and intestinal types accounted for the majority of IPMNs. Non-gastric type IPMNs were of high-grade malignancy. Many of the pancreatobiliary-type IPMNs were in an advanced stage and were associated with a poor prognosis. The results of mucin immunohistochemical staining of preoperative biopsy and surgically resected specimens were in agreement with each other, and in close agreement with those for pancreatic juice cytology specimens obtained from 10 patients during endoscopic retrograde cholangiopancreatography (ERCP). The immunostaining of preoperative biopsy specimens and ERCP-obtained pancreatic juice cytology specimens may be useful in the differential diagnosis of gastric and intestinal types of IPMN. If such techniques enable the preoperative diagnosis of IPMN subtypes, their use in combination with conventional preoperative imaging modalities may lead to surgical treatment best suited for the biological characteristics of the four subtypes.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Hisaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiuchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Uchida
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kawahara
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Masanori
authors.initials: M
authors.lastname: Akashi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mikagi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ishida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Okabe
authors.forename: Masamichi
authors.initials: M
authors.lastname: Nakayama
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Naito
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yano
authors.forename: Tomoki
authors.initials: T
authors.lastname: Taira
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawahara
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kage
authors.forename: Hisafumi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirozu
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D001706:Biopsy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D010180:Pancreatectomy; D010189:Pancreatic Juice / Q000378:metabolism; D057234:Preoperative Period
chemical_list: D009077:Mucins