Abstract
Precursor lesions of pancreatic cancer have been recognized about a century ago. The development of a consistent reproducible nomenclature and classification system for these lesions has been a major advance in the study of these noninvasive precursors. Pancreatic intraepithelial neoplasia (PanIN) as microscopic precursor lesions can be distinguished from mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMN) that are cystic and can often be recognized on imaging. Since precursor lesions harbor the unique chance to treat a patient before a fatal pancreatic cancer can arise a molecular characterization is essential to understand the biology and to find diagnostic and therapeutic targets to fight this disease of near uniform lethality. In order to study precursor lesions on a molecular level a meticulous isolation of the neoplastic cells is inevitable. We present the salient histopathologic and molecular features of precursor lesions of pancreatic cancer as well as methods that have proved to be useful within experimental studies.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Vincent A, Herman J, Schulick R, Hruban RH, Goggins M (2011) Pancreatic cancer. Lancet 378(9791):607–620 (in eng)
Yachida S et al (2010) Distant metastasis occurs late during the genetic evolution of pancreatic cancer. Nature 467(7319):1114–1117 (in eng)
Jones S et al (2008) Core signaling pathways in human pancreatic cancers revealed by global genomic analyses. Science 321(5897):1801–1806 (in eng)
Matthaei H, Schulick RD, Hruban RH, Maitra A (2011) Cystic precursors to invasive pancreatic cancer. Nat Rev Gastroenterol Hepatol 8(3):141–150 (in eng)
Klimstra DS, Longnecker DS (1994) K-ras mutations in pancreatic ductal proliferative lesions. Am J Pathol 145(6):1547–1550
Hruban RH et al (2001) Pancreatic intraepithelial neoplasia: a new nomenclature and classification system for pancreatic duct lesions. Am J Surg Pathol 25(5):579–586
Hruban RH et al (2004) An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol 28(8):977–987
Fernandez-del Castillo C, Adsay NV (2010) Intraductal papillary mucinous neoplasms of the pancreas. Gastroenterology 139(3):708–713, 713 e701–702
Longnecker DS et al (2005) Histopathological diagnosis of pancreatic intraepithelial neoplasia and intraductal papillary-mucinous neoplasms: interobserver agreement. Pancreas 31(4):344–349 (in eng)
Wu J et al (2011) Recurrent GNAS mutations define an unexpected pathway for pancreatic cyst development. Sci Transl Med 3(92):92ra66 (in eng)
Hruban RH, Klimstra DS, Pitman MB (2006) Tumors of the pancreas. American Registry of Pathology, Washington, DC
Basturk O, Coban I, Adsay NV (2009) Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med 133(3):423–438 (in eng)
Biankin AV et al (2001) Overexpression of p21(WAF1/CIP1) is an early event in the development of pancreatic intraepithelial neoplasia. Cancer Res 61(24):8830–8837
Luttges J et al (2001) Allelic loss is often the first hit in the biallelic inactivation of the p53 and DPC4 genes during pancreatic carcinogenesis. Am J Pathol 158(5):1677–1683
Jansen M et al (2002) Aberrant methylation of the 5′ CpG island of TSLC1 is common in pancreatic ductal adenocarcinoma and is first manifest in high-grade PanlNs. Cancer Biol Ther 1(3):293–296
Fukushima N et al (2002) Aberrant methylation of preproenkephalin and p16 genes in pancreatic intraepithelial neoplasia and pancreatic ductal adenocarcinoma. Am J Pathol 160(5):1573–1581
Maitra A et al (2002) Cyclooxygenase 2 expression in pancreatic adenocarcinoma and pancreatic intraepithelial neoplasia: an immunohistochemical analysis with automated cellular imaging. Am J Clin Pathol 118(2):194–201
Maitra A et al (2003) Multicomponent analysis of the pancreatic adenocarcinoma progression model using a pancreatic intraepithelial neoplasia tissue microarray. Mod Pathol 16(9):902–912
Takaori K, Kobashi Y, Matsusue S, Matsui K, Yamamoto T (2003) Clinicopathological features of pancreatic intraepithelial neoplasias and their relationship to intraductal papillary-mucinous tumors. J Hepatobiliary Pancreat Surg 10(2):125–136
Brat DJ, Lillemoe KD, Yeo CJ, Warfield PB, Hruban RH (1998) Progression of pancreatic intraductal neoplasias to infiltrating adenocarcinoma of the pancreas. Am J Surg Pathol 22(2):163–169
Moskaluk CA, Hruban RH, Kern SE (1997) p16 and K-ras gene mutations in the intraductal precursors of human pancreatic adenocarcinoma. Cancer Res 57(11):2140–2143
Maitra A, Wistuba II, Gazdar AF (2001) Microdissection and the study of cancer pathways. Curr Mol Med 1(1):153–162
Maitra A et al (1999) Enrichment of epithelial cells for molecular studies. Nat Med 5(4):459–463
Wilentz RE et al (2000) Immunohistochemical labeling for dpc4 mirrors genetic status in pancreatic adenocarcinomas: a new marker of DPC4 inactivation. Am J Pathol 156(1):37–43
Wilentz RE et al (2000) Loss of expression of Dpc4 in pancreatic intraepithelial neoplasia: evidence that DPC4 inactivation occurs late in neoplastic progression. Cancer Res 60(7):2002–2006
Iacobuzio-Donahue CA et al (2000) Dpc-4 protein is expressed in virtually all human intraductal papillary mucinous neoplasms of the pancreas: comparison with conventional ductal adenocarcinomas. Am J Pathol 157(3):755–761
Iacobuzio-Donahue CA et al (2000) Dpc4 protein in mucinous cystic neoplasms of the pancreas: frequent loss of expression in invasive carcinomas suggests a role in genetic progression. Am J Surg Pathol 24(11):1544–1548
Dhanasekaran SM et al (2001) Delineation of prognostic biomarkers in prostate cancer. Nature 412(6849):822–826
Rubin MA et al (2002) alpha-Methylacyl coenzyme A racemase as a tissue biomarker for prostate cancer. JAMA 287(13):1662–1670
van Heek NT et al (2002) Telomere shortening is nearly universal in pancreatic intraepithelial neoplasia. Am J Pathol 161(5):1541–1547
Rexhepaj E et al (2010) Validation of cytoplasmic-to-nuclear ratio of survivin as an indicator of improved prognosis in breast cancer. BMC Cancer 10:639 (in eng)
Acknowledgements
Anirban Maitra is supported by the Sol Goldman Pancreatic Cancer Research Center and the Michael Rolfe Foundation for Pancreatic Cancer Research. Hanno Matthaei is supported by a fellowship grant by Deutsche Krebshilfe (German Cancer Aid), Bonn, Germany. We are grateful to Dr. Ralph Hruban at Johns Hopkins for his contributions to an earlier edition of this chapter.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media, LLC
About this protocol
Cite this protocol
Matthaei, H., Molin, M.D., Maitra, A. (2013). Identification and Analysis of Precursors to Invasive Pancreatic Cancer. In: Su, G. (eds) Pancreatic Cancer. Methods in Molecular Biology, vol 980. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-287-2_1
Download citation
DOI: https://doi.org/10.1007/978-1-62703-287-2_1
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-62703-286-5
Online ISBN: 978-1-62703-287-2
eBook Packages: Springer Protocols