title: Distinction of Invasive Carcinoma Derived From Intraductal Papillary Mucinous Neoplasms From Concomitant Ductal Adenocarcinoma of the Pancreas Using Molecular Biomarkers.
abstract: To clarify the usefulness of molecular biomarkers for distinguishing invasive carcinoma derived from intraductal papillary mucinous neoplasms (IPMNs [Inv-IPMN]) from concomitant pancreatic ductal adenocarcinoma (PDAC).
  
  
  
  Data from 19 patients with resected concomitant PDAC were retrospectively reviewed. KRAS/GNAS mutations and immunohistochemical (IHC) expression of p53 and p16/CDKN2A were assessed in both IPMN and distinct PDAC. As controls, KRAS/GNAS mutations and IHC labeling were assessed between invasive and noninvasive components in 1 lesion of 22 independent patients.
  
  
  
  KRAS/GNAS mutation status of invasive and noninvasive components in Inv-IPMN was consistent in 18 (86%) of 21 patients. Conversely, mutational patterns in IPMN and distinct PDAC in the same pancreas differed from each other in 17 (89%) of 19. There were 10 (53%) and 8 (42%) of 19 patients who showed the same p53 and p16/CDKN2A staining between concomitant PDAC and distinct IPMN. In the Inv-IPMN cohort, 19 (86%) of 22 patients showed the same IHC expression pattern between the noninvasive and invasive components.
  
  
  
  It may be possible to distinguish Inv-IPMN from concomitant PDAC by assessing these molecular biomarkers. More precise distinction of Inv-IPMN and concomitant PDAC will lead to adequate recognition of the natural history of IPMNs and hence optimal management.
authors.affiliation: From the Departments of *Surgery and Oncology, †Anatomic Pathology, and ‡Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tamura
authors.forename: Takao
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Date
authors.forename: Takaaki
authors.initials: T
authors.lastname: Fujimoto
authors.forename: Taketo
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Hideyo
authors.initials: H
authors.lastname: Kimura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Tetsuyuki
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Kenoki
authors.initials: K
authors.lastname: Ohuchida
authors.forename: Shunichi
authors.initials: S
authors.lastname: Takahata
authors.forename: Kousei
authors.initials: K
authors.lastname: Ishigami
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mizumoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakamura
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D002864:Chromogranins / Q000235:genetics / Q000378:metabolism; D019941:Cyclin-Dependent Kinase Inhibitor p16; D050763:Cyclin-Dependent Kinase Inhibitor p18 / Q000235:genetics / Q000378:metabolism; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D019205:GTP-Binding Protein alpha Subunits, Gs / Q000235:genetics / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D009154:Mutation; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010183:Pancreatic Ducts / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics / Q000378:metabolism; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; C000614131:CDKN2A protein, human; D002864:Chromogranins; D019941:Cyclin-Dependent Kinase Inhibitor p16; D050763:Cyclin-Dependent Kinase Inhibitor p18; C117307:KRAS protein, human; D016159:Tumor Suppressor Protein p53; C406732:GNAS protein, human; D019205:GTP-Binding Protein alpha Subunits, Gs; D016283:Proto-Oncogene Proteins p21(ras)