胰腺导管内癌细胞乳头状瘤(IOPN)的综合特征:系统性和批判性综述。

IF 7.1 1区 医学 Q1 PATHOLOGY
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引用次数: 0

摘要

胰腺导管内癌细胞乳头状瘤(IOPN)是最近才被发现的一种胰腺肿瘤。在此,我们旨在利用系统综述工具确定其最基本的特征。我们在 PubMed、SCOPUS 和 Embase 中检索了报告胰腺 IOPN 数据的研究。提取并总结了临床病理、免疫组化和分子数据。然后,将 IOPN 的分子改变与参考队列(包括《癌症基因组图谱》)中胰腺导管腺癌和导管内乳头状粘液瘤的分子改变进行了比较分析。414 例 IOPN 的主要研究结果如下:1) 临床病理特征:男女比例为 1.5:1。胰头是最常见的部位(131/237,55.3%),但约 1/5 的病例(49/237,20.6%)描述了肿瘤的弥漫性扩展,涉及一个以上的胰腺节段。肿瘤平均大小为 45.5 毫米。50%的病例(168/336)伴有浸润癌。在这些病例中,大多数肿瘤为pT1/pT2和pN0(>80%),血管侵犯并不常见(20.6%)。在生存率方面,90%以上的患者在手术切除后仍存活。2) 免疫组化和分子特征:表达最多的粘蛋白是MUC5AC(110/112,98.2%)和MUC6(78/84,92.8%)。与胰腺导管腺癌和导管内乳头状粘液瘤相比,典型的胰腺驱动因子 KRAS、TP53、CDKN2A、SMAD4 和 GNAS 在 IOPN 中的改变较少(P<0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive Characterization of Intraductal Oncocytic Papillary Neoplasm of the Pancreas: A Systematic and Critical Review

Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a recently recognized pancreatic tumor. Here, we aimed to determine its most essential features with the systematic review tool. PubMed, Scopus, and Embase were searched for studies reporting data on pancreatic IOPN. The clinicopathologic, immunohistochemical, and molecular data were extracted and summarized. Then, a comparative analysis of the molecular alterations of IOPN with those of pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasm from reference cohorts (including The Cancer Genome Atlas) was conducted. The key findings from 414 IOPNs were as follows: 1) The male-to-female ratio was 1.5:1. Pancreatic head was the most common site (131/237; 55.3%), but a diffuse tumor extension involving more than one pancreatic segment was described in about 1 out of 5 cases (49/237; 20.6%). The mean size was 45.5 mm. An associated invasive carcinoma was present in 50% of cases (168/336). In those cases, most tumors were pT1 or pT2 and pN0 (>80%), and vascular invasion was uncommon (20.6%). Regarding survival, more than 90% of patients were alive after surgical resection. 2) Immunohistochemical and molecular features were as follows. The most commonly expressed mucins were MUC5AC (110/112; 98.2%) and MUC6 (78/84; 92.8%). Compared with pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasm, the classic pancreatic drivers KRAS, TP53, CDKN2A, SMAD4, and GNAS were less altered in IOPN (P < .01). Moreover, fusions involving PRKACA or PRKACB gene were detected in all of the 68 cases examined, with PRKACB::ATP1B1 being the most common (27/68 cases; 39.7%). These genomic events emerged as an entity-defining molecular alteration of IOPN (P < .01). Thus, such fusions represent a promising biomarker for diagnostic purposes. Recent evidence also suggests their role in influencing the acquisition of oncocytic morphology. IOPN is a distinct pancreatic neoplasm with specific clinicopathologic and molecular features. Considering the clinical or prognostic implications, its recognition is essential for pathologists and, ultimately, patients’ management

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来源期刊
Modern Pathology
Modern Pathology 医学-病理学
CiteScore
14.30
自引率
2.70%
发文量
174
审稿时长
18 days
期刊介绍: Modern Pathology, an international journal under the ownership of The United States & Canadian Academy of Pathology (USCAP), serves as an authoritative platform for publishing top-tier clinical and translational research studies in pathology. Original manuscripts are the primary focus of Modern Pathology, complemented by impactful editorials, reviews, and practice guidelines covering all facets of precision diagnostics in human pathology. The journal's scope includes advancements in molecular diagnostics and genomic classifications of diseases, breakthroughs in immune-oncology, computational science, applied bioinformatics, and digital pathology.
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