Mizumoto Masaki, Honjo Gen, Kobashi Yoichiro, Awane Masaaki, Matsusue Satoru
Department of Abdominal Surgery, Tenri Hospital, Nara, Japan.
Hepatogastroenterology. 2011 Sep-Oct;58(110-111):1791-5. doi: 10.5754/hge09195.
BACKGROUND/AIMS: Invasive intraductal papillary mucinous neoplasms (IPMNs) of the pancreas show poor prognosis similar to ductal adenocarcinomas. The aim of this study was to evaluate the molecular indicators of invasion and risk factors of recurrence of IPMNs.
For 46 curative resections of IPMNs, we analyzed the expression of apomucin antigens (MUC1, MUC2 and MUC5AC), p53 and Ki67 using resected specimens.
All 46 IPMNs were classified into 4 groups; MUC1+/p53+, MUC1+/p53-, MUC2+ and MUC1-/MUC2-. The incidence of MUC1 expression increased according to the grade of dysplasia and all of 5 invasive carcinomas expressed MUC1. None of the invasive carcinoma, but almost half of IPMNs of non-invasive carcinoma and sever dysplasia expressed MUC2. Additionally, p53 expression was limited to invasive IPMNs and a non-invasive IPMN which recurred after the operation. The Ki67 labeling index was increased according to the grade of dysplasia and was highest in the MUC1+/p53+ group. In the MUC2+ cases, Ki67 labeling index was significantly higher than that in the MUC1-/MUC2- cases. MUC5AC was expressed in all IPMNs.
The expression of MUC1, MUC2 and p53 might be indicators of malignancy and the expressions of MUC1 and p53 were the predictors of tumor invasion and recurrence.
背景/目的：胰腺浸润性导管内乳头状黏液性肿瘤（IPMNs）的预后与导管腺癌相似，较差。本研究旨在评估IPMNs的侵袭分子指标和复发危险因素。
对46例IPMNs根治性切除术的标本，分析脱辅基黏蛋白抗原（MUC1、MUC2和MUC5AC）、p53和Ki67的表达。
46例IPMNs分为4组：MUC1+/p53+、MUC1+/p53-、MUC2+和MUC1-/MUC2-。MUC1表达的发生率随发育异常程度增加，5例浸润性癌均表达MUC1。浸润性癌均未表达MUC2，但几乎一半的非浸润性癌和重度发育异常的IPMNs表达MUC2。此外，p53表达仅限于浸润性IPMNs和1例术后复发的非浸润性IPMN。Ki67标记指数随发育异常程度增加，在MUC1+/p53+组最高。在MUC2+病例中，Ki67标记指数显著高于MUC1-/MUC2-病例。所有IPMNs均表达MUC5AC。
MUC1、MUC2和p53的表达可能是恶性肿瘤的指标，MUC1和p53的表达是肿瘤侵袭和复发的预测指标。
