title: Stromal Fibrosis and Expression of Matricellular Proteins Correlate With Histological Grade of Intraductal Papillary Mucinous Neoplasm of the Pancreas.
abstract: The aim of the study was to clarify the correlation between the microenvironmental factors and histological grade in intraductal papillary mucinous neoplasm (IPMN).
  
  
  
  We investigated 65 IPMNs resected at Yamagata University Hospital between 2000 and 2011, and all cases were categorized to low-inter (including low- and intermediate-grade dysplasia) and high-inv (including high-grade dysplasia and IPMN with an associated invasive carcinoma) groups. We compared between the 2 groups pathologically with regard to fibrosis and the expression of alpha-smooth muscle actin (α-SMA), periostin, and galectin-1 in the periductal stroma of IPMN.
  
  
  
  There were 41 low-inter and 24 high-inv. The subtype was categorized as 22 main duct type (MD-IPMN) and 43 branch duct type (BD-IPMN). The degree of fibrosis and the expression of α-SMA, periostin, and galectin-1 were significantly higher in high-inv than in low-inter within BD-IPMNs. Multivariate logistic regression analysis indicated that high expression of α-SMA (odds ratio, 13.802; 95% confidence interval, 1.108-171.893; P = 0.0414) was a significant independent related factor of high-inv in BD-IPMN.
  
  
  
  Stromal fibrosis and expression of α-SMA, periostin, and galectin-1 are more marked in high-inv than in low-inter within BD-IPMNs, and they could become new markers for determining the indications for surgery in BD-IPMN.
authors.affiliation: From the Departments of *Gastroenterology and †Gastroenterological, General, Breast, and Thyroid Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Kakizaki
authors.forename: Naohiko
authors.initials: N
authors.lastname: Makino
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tozawa
authors.forename: Teiichiro
authors.initials: T
authors.lastname: Honda
authors.forename: Akiko
authors.initials: A
authors.lastname: Matsuda
authors.forename: Yushi
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Miho
authors.initials: M
authors.lastname: Ito
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
authors.forename: Wataru
authors.initials: W
authors.lastname: Kimura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
mesh_terms: D002288:Adenocarcinoma, Mucinous; D021441:Carcinoma, Pancreatic Ductal; D005770:Gastrointestinal Neoplasms; D006801:Humans; D010179:Pancreas; D010190:Pancreatic Neoplasms