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
. 2024 Nov 10;13(22):6759.
doi: 10.3390/jcm13226759.

Histological Subtypes Might Help Risk Stratification in Different Morphological Types of IPMNs: Back to the Future?

Giuseppe Anzillotti  1   2   3 , Francesca Vespasiano  1   4 , Chiara Maria Scandavini  1   5 , Marco Del Chiaro  6 , Asif Halimi  1   5 , Alessandro Anselmo  7 , Giuseppe Tisone  7 , Carlos Fernández Moro  8 , Zeeshan Ateeb  1   9 , Urban Arnelo  1   5 , J-Matthias Löhr  1   9 , Ernesto Sparrelid  1   9 , Roberto Valente  1   5   6
Affiliations

Histological Subtypes Might Help Risk Stratification in Different Morphological Types of IPMNs: Back to the Future?

Giuseppe Anzillotti et al. J Clin Med. .

Abstract

Background: Intraductal papillary mucinous neoplasms (IPMNs) display four histological subtypes: gastric foveolar, pancreaticobiliary, intestinal, and oncocytic. All of these subtypes harbor a different risk of cancer development. The clinical impact of these subtypes concerning the occurrence of high-grade dysplasia (HGD)/cancer (C) in specific morphological types, such as branch-duct (BD), main-duct (MD), and mixed-type (MT) IPMNs, has been less investigated. Hence, our aim was to investigate the prevalence of histological subtypes and their possible association with HGD/C concerning morphologically different IPMNs. Methods: This was a retrospective review of demographics, risk factors, and histological features in a surgical cohort of patients having undergone resection for suspect malignant IPMNs at a high-volume tertiary center from 2007 to 2017. Results: A total of 273 patients were resected for IPMNs from during the study period, of which 188 were included in the final analysis. With sex- and age-adjusted multivariable logistic regression analysis across the entire cohort, gastric foveolar subtypes were associated with a reduced prevalence of HGD/C (OR = 0.30; 0.11-0.81, 95% CI, 95%CI; p = 0.01). With univariable logistic regression analysis, in the BD-IPMN subgroup, the pancreaticobiliary subtype was associated with an increased prevalence of HGD/C (OR = 18.50, 1.03-329.65, 95% CI; p = 0.04). In MD- and MT-IPMNs, the gastric foveolar subtype was associated with a decreased prevalence of HGD/cancer (OR = 0.30, 0.13-0.69, 95% CI; p = 0.004). Conclusions: In MD and MT-IPMNs, the gastric-foveolar subtype is associated with a lower prevalence of HGD/C, possibly identifying in such a high-risk group, a subgroup with more indolent behavior. In BD-IPMNs, the pancreaticobiliary subtype is associated with a higher prevalence of HGD/C, conversely identifying among those patients, a subgroup deserving special attention.

Keywords: branch duct; cyst; histology; intraductal papillary mucinous neoplasm (IPMN); main duct; pancreatic cancer; pancreatic ductal adenocarcinoma.

PubMed Disclaimer

Conflict of interest statement

Dr. Del Chiaro received a research grant from Haemonetics, Inc. and is a co-PI of a Boston Scientific-sponsored study on the use of intra-operative pancreatoscopy in IPMN patients. Dr. Arnelo is a co-PI of a Boston Scientific-sponsored study on the use of intra-operative pancreatoscopy in IPMN patients. Dr. Arnelo is a consultant for Boston Scientific and Ambu. Dr. Valente is a consultant for Boston Scientific.

Figures

Figure 1
Figure 1
Inclusion flow-chart according to CONSORT.
Figure 2
Figure 2
Prevalence of histological subtypes in the entire cohort (in %).
Figure 3
Figure 3
Prevalence of histological subtypes in BD-IPMNs.
Figure 4
Figure 4
Prevalence of histological subtypes in MD/MT-IPMNs.
See this image and copyright information in PMC

References

    1. Löhr J.-M. Pancreatic Cancer Should Be Treated as a Medical Emergency. BMJ. 2014;349:g5261. doi: 10.1136/bmj.g5261. - DOI - PubMed
    1. Rahib L., Smith B.D., Aizenberg R., Rosenzweig A.B., Fleshman J.M., Matrisian L.M. Projecting Cancer Incidence and Deaths to 2030: The Unexpected Burden of Thyroid, Liver, and Pancreas Cancers in the United States. Cancer Res. 2014;74:2913–2921. doi: 10.1158/0008-5472.CAN-14-0155. - DOI - PubMed
    1. Yoon W.J., Lee J.K., Lee K.H., Ryu J.K., Kim Y.-T., Yoon Y.B. Cystic Neoplasms of the Exocrine Pancreas: An Update of a Nationwide Survey in Korea. Pancreas. 2008;37:254–258. doi: 10.1097/MPA.0b013e3181676ba4. - DOI - PubMed
    1. Sohn T.A., Yeo C.J., Cameron J.L., Hruban R.H., Fukushima N., Campbell K.A., Lillemoe K.D. Intraductal Papillary Mucinous Neoplasms of the Pancreas: An Updated Experience. Ann. Surg. 2004;239:788–797; discussion 797–799. doi: 10.1097/01.sla.0000128306.90650.aa. - DOI - PMC - PubMed
    1. Omori Y., Ono Y., Tanino M., Karasaki H., Yamaguchi H., Furukawa T., Enomoto K., Ueda J., Sumi A., Katayama J., et al. Pathways of Progression From Intraductal Papillary Mucinous Neoplasm to Pancreatic Ductal Adenocarcinoma Based on Molecular Features. Gastroenterology. 2019;156:647–661.e2. doi: 10.1053/j.gastro.2018.10.029. - DOI - PubMed

LinkOut - more resources