Intraductal Papillary Mucinous Neoplasms: Clinical Characters And MicroRNA Differential Express

Intraductal papillary mucinous neoplasms (IPMNs) are intraductal mucin-producing neoplasms of the pancreas that cause cystic dilatation of the main and/or branch pancreatic ducts. Although IPMNs have been increasingly detected over the last decade, the natural history of this neoplasm is not fully understood, and its management remains controversial.IPMNs are thought to have malignant potential and to undergo transformation from adenoma to borderline neoplasms, followed by carcinoma in situ (CIS), and finally invasive carcinoma, which is the classic adenoma-carci-noma sequence. Complete resection of noninvasive IPMNs (CIS or earlier disease) has been reported to achieve excellent survival. On the other hand, the survival rate after resection of invasive IPMNs has been reported to be markedly worse than that of patients without invasive components.The aim of the present study was to define the clinicopathologic characteristics, imaging findings, and long-term outcome of patients with IPMNs our institution. Another purpose was to determine the factors correlated with malignancy and invasive carcinoma of IPMNs, that we could utilize to determne the indications for surgical resection of these neoplasms. Finally, we try to identified the patterns of miRNA abnormalities in the IPMN.1.Intraductal Papillary Mucinous Neoplasms of the Pancreas: Clinic CharacteristicsAims:The aim of the present study was to define the clinicopathologic characteristics, imaging findings, and long-term outcome of patients with IPMNs at our institution. Predictive factors for malignancy and invasiveness in IPMN were analysed.Methods:78 patients with IPMN underwent surgical treatment, with histological confirmation of adenoma in 23, borderline in 14, carcinoma in situ in 30 and invasive carcinoma in 11. Both of Univariate and multivariate analysis of potential predictive factors of malignancy and invasiveness, including preoperative clinical and imaging findings, was conducted.Results:Univariate analysis identified 5 independent predictive factors for malignancy:jaundice, duct disease type, tumor size and mural nodules; and 5 independent predictive factors for invasiveness:mural nodules, pancreatitis, CA-19-9 level,CEA level and Boundary not clear. Multivariate analysis identified the CA-19-9 level is only independent predictive factors for malignancy and no predictive factor for invasiveness.Conclusion:The above factors should be considered in the diagnosis of IPMN to facilitate appropriate management.2. microRNAs expression in intraductal papillary mucinous neoplasms of the pancreasAims:Intraductal papillary mucinous neoplasms (IPMNs) are non-invasive precursor lesions of pancreatic cancer. Misexpression of microRNAs (miRNAs) is commonly observed in pancreatic adenocarcinoma. In contrast, miRNA abnormalities in pancreatic cancer precursor lesions have not been documented.Methods:Relative expression levels of a panel of twelve miRNAs upregulated in pancreatic cancers were assessed in 15 non-invasive IPMNs, using quantitative reverse transcription PCR (qRT-PCR).Results:Significant overexpression by qRT-PCR of 9 of the 15miRNAs was observed in the 21 IPMNs versus matched controls (p<0.05). Aberrant expression of miR-178 is demonstrating in the IPMN,CP,NP and PDAC (p<0.05), it could be specific miRNA of IPMN.Conclusions:Aberrant expression of miR-178 is demonstrating in the IPMN,CP,NP and PDAC (p<0.05), it could be specific miRNA of IPMN.In summary,the final conclusions were just as following:The independent predictive factors for invasiveness:mural nodules, pancreatitis, CA-19-9 level,CEA level and these independent predictive factors for malignancy: jaundice, duct disease type, tumor size should be considered in the diagnosis of IPMN to facilitate appropriate management.we demonstrate that aberrant expression of miR-178 is demonstrating in the IPMN,NP,CP and PDAC (p<0.05), it could be specific miRNA of IPMN.