Nishikawa Noriko, Kimura Yasutoshi, Okita Kenji, Zembutsu Hitoshi, Furuhata Tomohisa, Katsuramaki Tadashi, Kimura Sachiko, Asanuma Hiroko, Hirata Koichi
First Department of Surgery, Sapporo Medical University School of Medicine, S-1, W-16, Sapporo, Hokkaido 060-8543, Japan.
J Hepatobiliary Pancreat Surg. 2006;13(4):327-35. doi: 10.1007/s00534-005-1073-1.
BACKGROUND/PURPOSE: The molecular pathology of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas has not been well characterized, and there are no reliable markers to predict the presence of associated invasive carcinoma in patients with IPMNs. We investigated the clinicopathologic characteristics of 37 IPMNs and the immunohistochemical findings of these tumors to investigate the malignancy of IPMNs.
Between May 1992 and September 2003, 37 patients with IPMNs, 24 with adenoma and 13 with carcinoma, underwent pancreatic resections at Sapporo Medical University Hospital, Japan. In tumor specimens from these patients, we immunohistochemically analyzed the expression of p53 protein, proliferating-cell nuclear antigen (PCNA), vascular endothelial growth factor (VEGF), matrix metalloproteinase-7 (MMP-7), and E-cadherin. Clinical features and follow-up after resection were recorded.
Aberrant expression of the proteins examined was frequently observed. Namely, there were significant differences in the expression of MMP-7 according to clinicopathological characteristics. Positive expression of MMP-7 was found in all of nine patients with infiltrating ductal pancreatic adenocarcinoma (IDC) and in all of seven patients with invasive intraductal papillary mucinous adenocarcinoma (IC-IPMC); however, 33.3% of patients with noninvasive IPMA, 58.3% of patients with intraductal papillary mucinous adenoma (IPMA), and all normal pancreatic tissues were negative for MMP-7; differences which were statistically significant (P < 0.05).
Our current results indicate that MMP-7 may play a significant role in the progression of noninvasive to invasive IPMC.
背景/目的:胰腺导管内乳头状黏液性肿瘤(IPMNs)的分子病理学特征尚未完全明确,且尚无可靠标志物来预测IPMNs患者是否存在相关浸润性癌。我们研究了37例IPMNs的临床病理特征以及这些肿瘤的免疫组化结果,以探讨IPMNs的恶性程度。
1992年5月至2003年9月期间,37例IPMNs患者(24例为腺瘤,13例为癌)在日本札幌医科大学医院接受了胰腺切除术。在这些患者的肿瘤标本中,我们对p53蛋白、增殖细胞核抗原(PCNA)、血管内皮生长因子(VEGF)、基质金属蛋白酶-7(MMP-7)和E-钙黏蛋白的表达进行了免疫组化分析。记录了临床特征及切除术后的随访情况。
经常观察到所检测蛋白的异常表达。具体而言,根据临床病理特征,MMP-7的表达存在显著差异。在所有9例浸润性导管腺癌(IDC)患者和所有7例浸润性导管内乳头状黏液腺癌(IC-IPMC)患者中均发现MMP-7呈阳性表达;然而,33.3%的非浸润性IPMA患者、58.3%的导管内乳头状黏液腺瘤(IPMA)患者以及所有正常胰腺组织的MMP-7均为阴性;这些差异具有统计学意义(P<0.05)。
我们目前的结果表明,MMP-7可能在非浸润性IPMC向浸润性IPMC的进展中起重要作用。