1. Tracking the Clonal Evolution of Adenosquamous Carcinoma, a Rare Variant of Intraductal Papillary Mucinous Neoplasm of the Pancreas
- Author
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Tomoki Yokochi, Hidenori Karasaki, Kensuke Oikawa, Shinichi Chiba, Kazuo Nagashima, Toru Kono, Yusuke Mizukami, Miho Muraki, Suguru Matsuzaka, Munehiko Ogata, Yusuke Ono, Hiroshi Funakoshi, and Susumu Tamakawa
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Pathology ,endocrine system diseases ,Adenosquamous carcinoma ,Endocrinology, Diabetes and Metabolism ,Adenocarcinoma ,Biology ,medicine.disease_cause ,Clonal Evolution ,Proto-Oncogene Proteins p21(ras) ,Carcinoma, Adenosquamous ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Gene Frequency ,Internal medicine ,Chromogranins ,GTP-Binding Protein alpha Subunits, Gs ,Internal Medicine ,GNAS complex locus ,medicine ,Carcinoma ,Humans ,Aged ,Hepatology ,Intraductal papillary mucinous neoplasm ,medicine.disease ,Adenocarcinoma, Mucinous ,Carcinoma, Papillary ,Squamous metaplasia ,Pancreatic Neoplasms ,stomatognathic diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Mutation ,Carcinoma, Squamous Cell ,Disease Progression ,biology.protein ,030211 gastroenterology & hepatology ,KRAS ,Pancreas ,Carcinoma, Pancreatic Ductal - Abstract
Adenosquamous carcinoma (ASC) is an uncommon variant of pancreatic neoplasm. We sought to trace the mode of tumor progression using specimens of ASC associated with intraductal papillary mucinous neoplasm (IPMN) of the pancreas. A resected specimen of the primary pancreatic ASC, developed in a 72-year-old man, was subjected to mutation profiling using amplicon-targeted sequencing and digital polymerase chain reaction. DNA was isolated from each histological compartment including noninvasive IPMN, squamous cell carcinoma (SCC), and adenocarcinoma (AC). Histologically, an IPMN with a large mural nodule was identified. The invasive tumor predominantly consisted of SCC, and a smaller AC was found around the lesion. Squamous metaplasias were sporadically distributed within benign IPMNs. Mutation alleles KRAS and GNAS were identified in all specimens of IPMN including the areas of squamous metaplasia. In addition, these mutations were found in SCC and AC. Clear transition from flat/low-papillary IPMN to SCC indicated a potent invasion front, and the SCC compartment was genetically unique, because the area has a higher frequency of mutation KRAS. The invasive tumors with distinct histological appearances shared the form of noninvasive IPMN as a common precursor, rather than de novo cancer, suggesting the significance of a genetic profiling scheme of tumors associated with IPMN.
- Published
- 2016
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