Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun;83(6):1205-9.
doi: 10.1016/j.gie.2015.09.020. Epub 2015 Sep 25.

Pancreatic cyst fluid concentration of high-mobility group A2 protein acts as a differential biomarker of dysplasia in intraductal papillary mucinous neoplasm

Christopher J DiMaio  1 , Frances Weis-Garcia  2 , Emilia Bagiella  3 , Laura H Tang  4 , Peter J Allen  5
Affiliations

Pancreatic cyst fluid concentration of high-mobility group A2 protein acts as a differential biomarker of dysplasia in intraductal papillary mucinous neoplasm

Christopher J DiMaio et al. Gastrointest Endosc. 2016 Jun.

Abstract

Background and aims: No reliable cyst fluid biomarkers exist that allow preoperative identification of patients with intraductal papillary mucinous neoplasms (IPMNs) and high-risk pathology. High-mobility group (HMG) A2 protein has been demonstrated to be a biomarker of dysplasia in IPMNs. It is unknown whether HMGA2 protein is present in the cyst fluid from IPMNs. The aims of this study were to determine whether HMGA2 protein is present in the cyst fluid of IPMNs and demonstrate whether HMGA2 protein concentration correlates with the degree of dysplasia.

Methods: Patients with surgically resected IPMNs and banked pancreatic cyst fluid were identified. Low-risk IPMNs (low-grade [LGD] or moderate dysplasia [MD]) and high-risk IPMNs (high-grade dysplasia [HGD] or invasive cancer) were identified. Pancreatic cyst fluid concentrations of HMGA2 protein were measured via enzyme-linked immunosorbent assay.

Results: Samples from 31 patients were analyzed. HMGA2 protein was detected in the cyst fluid of 30 of 31 specimens (97%). Median cyst fluid HMGA2 protein concentration (ng/mL) was as follows: LGD, 0.6 (interquartile range [IQR] 0.35-0.6); MD, 1.55 (IQR 0.65-2.7); HGD, 4.2 (IQR 1.7-9.2) (P < .05). The median HMGA2 protein concentration was significantly higher in the HGD group (4.2 ng/mL, IQR 1.7-9.2) compared with the concentration in the low-risk group (1.1 ng/mL, IQR 0.6-2.7, P = .03).

Conclusion: HMGA2 protein is present in IPMN cyst fluid. Significantly higher concentrations of cyst fluid HMGA2 protein are found in IPMNs with HGD compared with lesions with LGD or MD. Cyst fluid concentrations of HMGA2 protein may thus serve as a biomarker to differentiate patients with high-risk IPMNs from those with low-risk IPMNs.

PubMed Disclaimer

Conflict of interest statement

Specific author contributions: Christopher J. DiMaio, Peter J. Allen: planning and conducting the study, collecting and interpreting the data, drafting the manuscript, and approval of final draft submission. Frances Weis-Garcia, Laura Tang: planning and conducting the study, collecting and interpreting the data, and approval of final draft submission. Emilia Bagiella: interpreting the data, and approval of final draft submission.

Figures

Figure 1
Figure 1
Median concentration of HMGA2 (ng/ml) in IPMN cyst fluid by grade of dysplasia.
Figure 2
Figure 2
Median concentration of HMGA2 (ng/ml) in IPMN cyst fluid, low-risk lesions vs high-risk lesions.
Figure 3
Figure 3
Immunohistochemistry staining for HMGA2 in pathology specimens: Negative staining in benign mucinous cystic neoplasm (A); positive staining in intraductal papillary mucinous neoplasm with invasive cancer (B) and pancreatic adenocarcinoma (C).
See this image and copyright information in PMC

References

    1. Adsay NV, Fukushima N, Furukawa T, et al. Intraductal neoplasm of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO classification of tumors of digestive system. Lyon: WHO Press; 2010. pp. 304–13.
    1. Hruban RH, Pitman MB, Klimstra DS. Tumors of the pancreas. In: Silverberg SG, editor. AFIP Atlas of tumor pathology series 4. Vol. 6. Washington: ARP Press; 2007. pp. 75–110.
    1. Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. Am J Roentgenol. 2008;191:802–7. - PMC - PubMed
    1. de Jong K, Nio CY, Hermans JJ, et al. High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations. Clin Gastroenterol Hepatol. 2010;8:806–11. - PubMed
    1. Klibansky DA, Reid-Lombardo KM, Gordon SR, et al. The clinical relevance of the increasing incidence of intraductal papillary mucinous neoplasm. Clin Gastroenterol Hepatol. 2012;10:555–8. - PMC - PubMed