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. 2017 Jun;470(6):647-653.
doi: 10.1007/s00428-017-2105-3. Epub 2017 Mar 13.

Fhit down-regulation is an early event in pancreatic carcinogenesis

Affiliations

Fhit down-regulation is an early event in pancreatic carcinogenesis

Matteo Fassan et al. Virchows Arch. 2017 Jun.

Abstract

Aberrant Fhit expression characterizes a large proportion of primary pancreatic ductal adenocarcinomas (PDACs), but fragmentary information is available on Fhit expression during the phenotypic changes of pancreatic ductal epithelium during multistep transformation. We assessed Fhit expression by immunohistochemistry in two different multistep pancreatic carcinogenic processes: pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasia (IPMN). We considered 105 surgically treated PDACs/IPMNs and selected 30 samples of non-neoplastic pancreatic parenchyma, 50 PanIN lesions, 30 IPMNs, 15 IPMNs with associated invasive carcinoma, and 60 adenocarcinomas. Normal pancreatic ducts and surrounding acinar cells consistently showed moderate to strong Fhit immunoreactivity. Significant down-regulation of Fhit expression was observed in association with increasing severity of dysplastia/neoplastia in both carcinogenic processes. This was further confirmed by studying multiple lesions obtained from the same surgical specimen. Of 60 PDACs, only 14 showed Fhit expression comparable to normal pancreatic ductal epithelium, while the remainder (77%) showed clearly negative or reduced Fhit expression. This study demonstrates that Fhit down-regulation is an early event in both multistep carcinogenic processes leading to PDAC.

Keywords: Biomarkers; Carcinogenesis; FHIT; Pancreatic cancer.

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Conflict of interest statement

Conflict of interests: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Fhit expression is down-regulated early in pancreatic carcinogenesis
Immunohistochemical expression is represented as H-score values. PanIN= Pancreatic intraepithelial neoplasia; LG= low grade; HG= high grade. (A) Fhit expression distribution in the series of samples examined. (B) Fhit expression according to dysplasia grade of PanIN. (C) Matched PanIN-PDAC. (D&E) Distribution of Fhit H-score according to histotype and grade of IPMNs, respectively. (F) Fhit expression in matched dysplastic and invasive epithelia in 15 IPMNs with an associated invasive carcinoma. Boxplots are with wiskers from minimum to maximum of all data.
Figure 2
Figure 2. Fhit expression is significantly down-regulated in pancreatic ductal adenocarcinoma (PDAC) and in PDAC-associated pancreatic intraepithelial neoplastic (PanIN) lesions
(A) A low-grade PanIN lesion (asterisk) showing Fhit expression comparable to expression in normal surrounding pancreatic parenchyma. (B) A representative Fhit-negative adenocarcinoma intermingled with Fhit-positive pancreatic ductal epithelia. (C) A high-grade PanIN lesion (arrow heads) and coexisting PDAC, both showing negative/low Fhit expression. (Original magnifications, 4×, 10, and 20×).
Figure 3
Figure 3. Down-regulation of Fhit expression in IPMNs
(A and B) IPMNs (asterisks) with low-grade dysplasia showing negative/low Fhit expression in comparison to Fhit-positive adjacent pancreatic parenchyma. (C) A Fhit positive IPMN (arrow heads), showing down-regulation of Fhit expression in higher grade epithelia. (D) IPMN with low-grade dysplasia showing negative (arrow heads)/low Fhit expression in comparison to Fhit positive adjacent pancreatic parenchyma (asterisk). (E) Fhit-negative IPMN with high-grade dysplasia. (F) Mild to moderate Fhit expression in an IPMN with high-grade dysplasia and a coexisting Fhit-negative colloid adenocarcinoma (arrow heads). (Original magnifications, 4×, 10, and 20×).

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