Kuvendjiska Jasmina, Müller Felix, Bronsert Peter, Timme-Bronsert Sylvia, Fichtner-Feigl Stefan, Kulemann Birte
Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79110 Freiburg im Breisgau, Germany.
Department of General and Visceral Surgery, University Medical Center Freiburg, 79106 Freiburg im Breisgau, Germany.
Life (Basel). 2023 Jul 15;13(7):1570. doi: 10.3390/life13071570.
Intraductal papillary mucinous neoplasm (IPMN) is the most common pancreatic cyst and a precursor of pancreatic cancer (PDAC). Since PDAC has a devastatingly high mortality rate, the early diagnosis and treatment of any precursor lesion are rational. The safety of the existing guidelines on the clinical management of IPMN has been criticized due to unsatisfactory sensitivity and specificity, showing the need for further markers. Blood obtained from patients with IPMN was therefore subjected to size-based isolation of circulating epithelial cells (CECs). We isolated CECs and evaluated their cytological characteristics. Additionally, we compared Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations in CECs and the primary IPMN tissue, since KRAS mutations are very typical for PDAC. Samples from 27 IPMN patients were analyzed. In 10 (37%) patients, CECs were isolated and showed a hybrid pattern of surface markers involving both epithelial and mesenchymal markers, suggesting a possible EMT process of the cells. Especially, patients with high-grade dysplasia in the main specimen were all CEC-positive. KRAS mutations were also present in CECs but less common than in IPMN tissue. The existence of CEC in IPMN patients offers additional blood-based research possibilities for IMPN biology.
导管内乳头状黏液性肿瘤（IPMN）是最常见的胰腺囊肿，也是胰腺癌（PDAC）的癌前病变。由于PDAC的死亡率极高，对任何癌前病变进行早期诊断和治疗都是合理的。现有IPMN临床管理指南的安全性因其敏感性和特异性不尽人意而受到批评，这表明需要更多的标志物。因此，对IPMN患者的血液进行了基于大小的循环上皮细胞（CEC）分离。我们分离了CEC并评估了它们的细胞学特征。此外，我们比较了CEC和原发性IPMN组织中的 Kirsten 大鼠肉瘤病毒癌基因同源物（KRAS）突变，因为KRAS突变在PDAC中非常典型。对27例IPMN患者的样本进行了分析。在10例（37%）患者中分离出了CEC，这些CEC表现出涉及上皮和间充质标志物的表面标志物混合模式，提示细胞可能发生了上皮-间质转化（EMT）过程。特别是，主要标本中存在高级别异型增生的患者均为CEC阳性。CEC中也存在KRAS突变，但比IPMN组织中少见。IPMN患者中CEC的存在为IPMN生物学提供了更多基于血液的研究可能性。
