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High expression of intestinal-type mucin (MUC2) in intraductal papillary mucinous neoplasms coexisting with extrapancreatic gastrointestinal cancers.

OBJECTIVES: It is known that intraductal papillary mucinous neoplasm (IPMN) is associated with a high incidence of extrapancreatic neoplasms. We tried to uncover the characteristics and gene expressions of IPMNs that coexist with other extrapancreatic gastrointestinal cancers. METHODS: We retrieved the surgical specimens from 54 IPMN patients, including 7 cases of IPMNs that coexisted with extrapancreatic gastrointestinal cancers. The immunohistochemical staining (p21, Bcl-2, p53, intestinal-type secretory mucin [MUC2], and MUC5AC) and the pathological subtypes of the tumor papillae (the intestinal type, pancreaticobiliary type, null type, or unclassified type) were analyzed. RESULTS: MUC2 expression was noticed more frequently in the IPMN coexisting with extrapancreatic cancers (6/7) than in the IPMN without extrapancreatic cancers (18/47; P = 0.04). There were no differences in p21 (P = 0.12), p53 (P = 0.25), and MUC5AC (P = 1.0) expressions between the 2 groups. IPMN with extrapancreatic cancers was noticed in all subtypes of papillae. CONCLUSIONS: Regardless of the subtypes of papillae, transcription of the MUC2 might be related with the synchronous extrapancreatic gastrointestinal cancer development that is seen with IPMN. Therefore, careful systemic surveillance is needed to detect coexisting gastrointestinal cancer for all the subtypes of IPMN with MUC2 expression.

Carcinoma, Pancreatic Ductal↗

Anti-angiogenic strategies in gastrointestinal malignancies.

Advances in our understanding of the mechanisms underlying tumor progression suggest that angiogenesis plays a key role in gastrointestinal malignancies. Vascular endothelial growth factor (VEGF) has emerged as an important therapeutic target, and a variety of strategies to inhibit VEGF are under investigation. The approval of bevacizumab for use in patients with previously untreated metastatic colorectal cancer was based on clinical data suggesting that VEGF is a valid therapeutic target in this disease. As the data mature from ongoing trials, the role of angiogenesis inhibitors in the treatment of colon cancer and other gastrointestinal malignancies will be more clearly defined. Additional information is needed to identify the diseases and stages most likely to benefit from anti-angiogenic agents and the optimal sequences and therapeutic combinations that should be studied.

Angiogenesis Inhibitors↗