Cancerization of the Pancreatic Ducts
Cancerization of the Pancreatic Ducts
复制标题
胰管癌化
DOI：
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发表时间：
2018
影响因子：
5.6
通讯作者：
R. Hruban
中科院分区：
文献类型：
--
作者：
Danielle A. Hutchings;Kevin M. Waters;M. Weiss;elliot k fishman;M. Makary;Jin He;J. Cameron;L. Wood;R. Hruban
侵袭性胰腺导管腺癌（PDAC）可在称为导管癌变（COD）的过程中浸润回并沿着先前存在的胰腺导管和小管扩散。在组织学上，COD可以模拟高级别胰腺上皮内瘤变（HG-PanIN）。我们回顾了100例PDAC患者的胰腺切除术，以确定是否存在具有COD组织学特征的导管。支持COD的特征包括邻近的组织学相似的浸润性PDAC和明显非典型导管内上皮与正常导管上皮或导管周向受累之间的突然过渡。由于TP 53和SMAD 4基因在侵袭性PDAC中经常被靶向，而不是HG-PanIN，成对的PDAC和组织学上怀疑的COD病变用p53和Smad 4蛋白的抗体免疫标记。在89例（89%）病例中，在苏木精和伊红切片上发现疑似COD。89例中68例（76%）进行了p53和Smad 4的免疫标记。p53在55例中可解释，所有55例（100%）COD和侵袭性PDAC之间的标记一致。37例（67%）p53异常表达，其中30例（55%）p53过度表达，7例（13%）p53缺失表达。Smad 4免疫标记在61例中可解释，59例（97%）在COD和侵袭性PDAC之间显示一致的标记。28例（46%）Smad 4基因缺失。p53和Smad 4的侵袭性PDAC和COD的免疫标记支持在苏木精和伊红上观察到的COD的高患病率，并突出了p53和Smad 4免疫标记在区分COD和HG-PanIN中的效用。
Invasive pancreatic ductal adenocarcinoma (PDAC) can infiltrate back into and spread along preexisting pancreatic ducts and ductules in a process known as cancerization of ducts (COD). Histologically COD can mimic high-grade pancreatic intraepithelial neoplasia (HG-PanIN). We reviewed pancreatic resections from 100 patients with PDAC for the presence or absence of ducts with histologic features of COD. Features supporting COD included adjacent histologically similar invasive PDAC and an abrupt transition between markedly atypical intraductal epithelium and normal duct epithelium or circumferential involvement of a duct. As the TP53 and SMAD4 genes are frequently targeted in invasive PDAC but not HG-PanIN, paired PDAC and histologically suspected COD lesions were immunolabeled with antibodies to the p53 and Smad4 proteins. Suspected COD was identified on hematoxylin and eosin sections in 89 (89%) of the cases. Immunolabeling for p53 and Smad4 was performed in 68 (76%) of 89 cases. p53 was interpretable in 55 cases and all 55 (100%) cases showed concordant labeling between COD and invasive PDAC. There was matched aberrant p53 immunolabeling in 37 (67%) cases including overexpression in 30 (55%) cases and lack of expression in 7 (13%) cases. Smad4 immunolabeling was interpretable in 61 cases and 59 (97%) cases showed concordant labeling between COD and invasive PDAC. Matched loss of Smad4 was seen in 28 (46%) cases. The immunolabeling of invasive PDAC and COD for p53 and Smad4 supports the high prevalence of COD observed on hematoxylin and eosin and highlights the utility of p53 and Smad4 immunolabeling in differentiating COD and HG-PanIN.
影响因子：
29.4
作者：
Murphy SJ;Hart SN;Lima JF;Kipp BR;Klebig M;Winters JL;Szabo C;Zhang L;Eckloff BW;Petersen GM;Scherer SE;Gibbs RA;McWilliams RR;Vasmatzis G;Couch FJ
通讯作者：
Couch FJ