Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry

Pia Klausen; Bojan Kovacevic; Anders Toxværd; Evangelos Kalaitzakis; John Gásdal Karstensen; Charlotte Vestrup Rift; Carsten Palnæs Hansen; Jan Storkholm; Peter Vilmann; Jane Preuss Hasselby

doi:10.1111/apm.12900

Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry

Pia Klausen, Bojan Kovacevic, Anders Toxværd, Evangelos Kalaitzakis, John Gásdal Karstensen, Charlotte Vestrup Rift, Carsten Palnæs Hansen, Jan Storkholm, Peter Vilmann, Jane Preuss Hasselby

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

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.

Original language	English
Journal	A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica
Volume	127
Issue number	1
Pages (from-to)	27-32
Number of pages	6
ISSN	0903-4641
DOIs	https://doi.org/10.1111/apm.12900
Publication status	Published - Jan 2019

Keywords

Antigens, Neoplasm/analysis
Glycosylation
Humans
Immunohistochemistry/methods
Mucin-1/analysis
Pancreatic Intraductal Neoplasms/classification

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Klausen, P., Kovacevic, B., Toxværd, A., Kalaitzakis, E., Karstensen, J. G., Rift, C. V., Hansen, C. P., Storkholm, J., Vilmann, P., & Hasselby, J. P. (2019). Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry. A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica, 127(1), 27-32. https://doi.org/10.1111/apm.12900

Klausen, P, Kovacevic, B, Toxværd, A, Kalaitzakis, E, Karstensen, JG, Rift, CV, Hansen, CP, Storkholm, J, Vilmann, P & Hasselby, JP 2019, 'Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry', A P M I S. Acta Pathologica, Microbiologica et Immunologica Scandinavica, vol. 127, no. 1, pp. 27-32. https://doi.org/10.1111/apm.12900

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abstract = "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.",

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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.

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Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry

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