The mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas

Am J Surg Pathol. 2002 Apr;26(4):466-71. doi: 10.1097/00000478-200204000-00008.

Abstract

Recently, it was shown that ductal adenocarcinomas and intraductal papillary-mucinous neoplasms of the pancreas differ in their expression of the mucin markers MUC1 and MUC2 while both tumors express MUC5AC. It is not known whether mucinous cystic neoplasms of the pancreas have their own mucin profile. To clarify this issue, 22 mucinous cystic neoplasms were examined immunohistologically for their expression of MUC1, MUC2, MUC5AC, and MUC6 and also for the protein products of the tumor suppressor genes p53 and DPC4 and the mismatch repair genes. Noninvasive mucinous cystic neoplasms, regardless of the degree of cellular atypia, were all positive for MUC5AC and negative for MUC1, with the exception of the cyst-lining epithelium of a single case with eosinophilic cytology (case no. 16). Only in cases with an invasive component was MUC1 expression observed. MUC2 expression was restricted to goblet cells scattered within the epithelium of the mucinous cystic neoplasms and was often accompanied by endocrine cells, a further indication of intestinal differentiation. DPC4 expression was maintained in all tumors, except for three invasive carcinomas. p53 nuclear reactivity was found in one borderline tumor and four invasive mucinous cystic carcinomas. The results suggest that the epithelium of noninvasive mucinous cystic neoplasms does not differ in its expression of MUC5AC from ductal adenocarcinomas, intraductal papillary-mucinous neoplasms, and metaplastic pancreatic duct epithelium. The fact that noninvasive mucinous cystic neoplasms lack MUC1 expression (except for an eosinophilic variant) but express it when they become invasive might be used as a marker indicating the step of progression from noninvasiveness to invasiveness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / chemistry*
  • Adenoma / pathology
  • Adult
  • Aged
  • Carcinoma / chemistry*
  • Carcinoma / pathology
  • Carcinoma, Squamous Cell / chemistry
  • Carcinoma, Squamous Cell / pathology
  • DNA-Binding Proteins
  • Female
  • Genes, p53
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Mucin 5AC
  • Mucin-1 / analysis
  • Mucin-2
  • Mucin-6
  • Mucins / analysis
  • Mucins / metabolism*
  • Pancreatic Neoplasms / chemistry*
  • Pancreatic Neoplasms / pathology
  • Smad4 Protein
  • Trans-Activators

Substances

  • DNA-Binding Proteins
  • MUC2 protein, human
  • MUC5AC protein, human
  • MUC6 protein, human
  • Mucin 5AC
  • Mucin-1
  • Mucin-2
  • Mucin-6
  • Mucins
  • SMAD4 protein, human
  • Smad4 Protein
  • Trans-Activators