Intraductal papillary-mucinous tumours represent a distinct group of pancreatic neoplasms: an investigation of tumour cell differentiation and K-ras, p53 and c-erbB-2 abnormalities in 26 patients
Intraductal papillary-mucinous tumours represent a distinct group of pancreatic neoplasms: an investigation of tumour cell differentiation and K-ras, p53 and c-erbB-2 abnormalities in 26 patients
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导管内乳头状粘液肿瘤代表一组独特的胰腺肿瘤：对 26 名患者的肿瘤细胞分化和 K-ras、p53 和 c-erbB-2 异常的研究
DOI：
10.1007/bf00189573
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发表时间：
2004
期刊：
影响因子：
3.5
通讯作者：
G. Klöppel
中科院分区：
文献类型：
--
作者：
F. Sessa;E. Solcia;C. Capella;M. Bonato;A. Scarpa;G. Zamboni;N. Pellegata;G. Ranzani;F. Rickaert;G. Klöppel
导管内乳头状生长的粘液分泌分泌，柱状细胞的特点是一组罕见的胰腺外分泌肿瘤，我们建议称之为导管内乳头状粘液瘤（IPMT）。我们分析了26例IPMT的组织病理学与胃肠胰腺标志物表达、遗传变化和生物学的关系。4例仅显示轻度发育不良的IPMT被认为是腺瘤。9个肿瘤表现为中度发育不良，被认为是边缘性的。在13例IPMT中发现严重的发育不良-原位癌改变，因此归类为导管内癌。其中6个癌是侵袭性的其中2个有淋巴结转移。除一例肿瘤呈导管浸润外，其余肿瘤的浸润成分与粘液性非囊性癌相似。免疫组织化学结果显示，在大多数癌中发现肠标记型，而在腺瘤或交界性肿瘤中发现胃型分化。在31%的IPMT（2例腺瘤，1例交界性癌，5例癌）中发现K-ras突变（密码子12处有7个，密码子13处有1个）。在31%的IPMT（6例癌和2例交界性IPMT）中检测到核p53过表达，并与两种癌中p53突变（一个在外显子8，另一个在外显子5）相关。p53异常与K-ras突变无关。65%的IPMT患者c-erbB-2过表达，伴有不同程度的不典型增生。24例患者中有22例在术后平均随访41个月后存活。只有两名患者在手术时都患有侵袭性癌症，死于肿瘤疾病。结论是胰腺IPMT包括肿瘤，通常具有良好的预后，但在不典型增生的程度和标记物表达方面是异质的。腺瘤、交界性肿瘤、导管内癌和浸润性癌可以区分。p53的改变与恶性肿瘤的分级无关，而K-ras突变或c-erbB-2过表达与恶性肿瘤的分级无关。大多数IPMT在组织学结构、标志物表达和行为上与导管腺癌不同。
Intraductal papillary growth of mucin producting hypersecreting, columnar cells characterizes a group of rare pancreatic exocrine neoplasms which we propose to call intraductal papillary-mucinous tumors (IPMT). We analysed the histopathology of 26 IPMT in relation to gastro-enteropancreatic marker expression, genetic changes and biology. Four IPMT showing only mild dysplasia were considered to be adenomas. Nine tumours displayed moderate dysplasia and were regarded as borderline. Severe dysplasia-carcinoma in situ changes were found in 13 IPMT which were therefore classified as intraductal carcinomas. Six of these carcinomas were frankly invasive and two of these had lymph node metastases. The invasive component resembled mucinous noncystic carcinoma in all but one tumour which showed a ductal invasion pattern. Immunohistochemically, an intestinal marker type was found in most carcinomas, while gastric type differentiation prevailed among adenomas or borderline tumours. K-ras mutations (seven at codon 12 and one at codon 13) were found in 31% of IPMT (2 adenomas, 1 borderline, 5 carcinomas). Nuclear p53 overexpression was detected in 31% of IPMT (6 carcinomas and 2 borderline IPMT) and correlated with p53 mutations (one at exon 8 and the other at exon 5) in two carcinomas. p53 abnormalities were unrelated to K-ras mutation. c-erbB-2 overexpression was observed in 65% of IPMT, with various grades of dysplasia. Twenty-two of 24 patients are alive and well after a mean post-operative follow-up of 41 months. Only two patients, both with invasive cancer at the time of surgery, died of tumour disease. It is concluded that pancreatic IPMT encompass neoplasms which, in general, have a favorable prognosis, but are heterogeneous in regard to grade of dysplasia and marker expression. Adenoma, borderline tumour, intraductal carcinoma and invasive carcinoma can be differentiated. p53 changes but not K-ras mutation or c-erbB-2 overexpression are related to the grade of malignancy. Most IPMT differ in histological structure, marker expression and behaviour from ductal adenocarcinoma.
胃癌的中心凹细胞成分。
影响因子：
3.3
作者：
Fiocca,R;Villani,L;Tenti,P;Cornaggia,M;Finzi,G;Riva,C;Capella,C;Bara,J;Samloff,IM;Solcia,E
通讯作者：
Solcia,E
影响因子：
3.3
作者：
YAMANAKA, Y;FRIESS, H;KORC, M
通讯作者：
KORC, M