Mutations in IPMN Cases: A Potential Prognostic Factor.

An intraductal papillary mucinous neoplasm (IPMN) is a common pancreatic precursor lesion, and it often harbors mutations in , , and . To clarify the molecular profiles of IPMNs, we conducted mutation analysis of , , and in 61 IPMN formalin-fixed, paraffin-embedded (FFPE) specimens. The mutation rates of codons 12, 13, and 61 in and codon 201 in were detected by Sanger sequencing. Next-generation sequencing was performed on , and the results were further verified by Sanger sequencing. We identified and mutations in 35 (57%) and 40 (66%) IPMN cases, respectively. mutations were significantly correlated with the morphologic subtype ( < 0.001) and were more prevalent in the intestinal subtype (93%) than in the gastric (55%) and pancreatobiliary subtypes (44%) but were absent in the oncocytic subtype. mutations were found in 5 cases (8%), all of which occurred in high-grade dysplasia and invasive lesions (2/5 and 3/5). All 5 cases harboring RNF43 mutations also exhibited GNAS mutations. RNF43 mutations were associated with a worse prognosis in invasive IPMN patients ( = 0.002), while KRAS and GNAS mutations did not affect the prognosis of patients.