TY - JOUR
T1 - Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry
AU - Klausen, Pia
AU - Kovacevic, Bojan
AU - Toxværd, Anders
AU - Kalaitzakis, Evangelos
AU - Karstensen, John Gásdal
AU - Rift, Charlotte Vestrup
AU - Hansen, Carsten Palnæs
AU - Storkholm, Jan
AU - Vilmann, Peter
AU - Hasselby, Jane Preuss
PY - 2019/1
Y1 - 2019/1
N2 - Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions of pancreatic ductal adenocarcinoma (PDAC). Current edition of WHO Classification of Tumors of the Digestive System recognizes four different subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) and recommends analysis of mucin expression (MUC1, MUC2, MUC5AC, MUC6) as well as evaluation of architectural and cell differentiation patterns for correct classification. However, there is no consensus on MUC1 expression of IPMN-lesions in the literature. Current recommendations are based on studies where antibodies against the core MUC1 protein or sialylated MUC1 (tumor associated MUC1), not the fully glycosylated MUC1 were used. We have recently reported that MUC1 is strongly expressed in both gastric and intestinal types IPMN specimens from the cystic wall, obtained by endoscopic ultrasound guided microbiopsy procedure. We have used a commercial MUC1 antibody, validated and recommended for diagnostic use, which recognizes fully glycosylated MUC1. Based on the above, we propose a revision of the WHO Classification, specifying that antibodies against tumor associated MUC1 should be used for IPMN subtyping.
AB - Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions of pancreatic ductal adenocarcinoma (PDAC). Current edition of WHO Classification of Tumors of the Digestive System recognizes four different subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) and recommends analysis of mucin expression (MUC1, MUC2, MUC5AC, MUC6) as well as evaluation of architectural and cell differentiation patterns for correct classification. However, there is no consensus on MUC1 expression of IPMN-lesions in the literature. Current recommendations are based on studies where antibodies against the core MUC1 protein or sialylated MUC1 (tumor associated MUC1), not the fully glycosylated MUC1 were used. We have recently reported that MUC1 is strongly expressed in both gastric and intestinal types IPMN specimens from the cystic wall, obtained by endoscopic ultrasound guided microbiopsy procedure. We have used a commercial MUC1 antibody, validated and recommended for diagnostic use, which recognizes fully glycosylated MUC1. Based on the above, we propose a revision of the WHO Classification, specifying that antibodies against tumor associated MUC1 should be used for IPMN subtyping.
KW - Antigens, Neoplasm/analysis
KW - Glycosylation
KW - Humans
KW - Immunohistochemistry/methods
KW - Mucin-1/analysis
KW - Pancreatic Intraductal Neoplasms/classification
U2 - 10.1111/apm.12900
DO - 10.1111/apm.12900
M3 - Journal article
C2 - 30549137
SN - 0903-4641
VL - 127
SP - 27
EP - 32
JO - A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica
JF - A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica
IS - 1
ER -