Comprehensive characterization of intraductal oncocytic papillary neoplasm of the pancreas: A systematic and critical review Review
| Authors: | Paolino, G.; Basturk, O.; Esposito, I.; Hong, S. M.; Brosens, L. A.; Tarcan, Z.; Wood, L. D.; Gkountakos, A.; Omori, Y.; Mattiolo, P.; Ciulla, C.; Marchegiani, G.; Pea, A.; Bevere, M.; De Robertis, R.; D'Onofrio, M.; Salvia, R.; Cheng, L.; Furukawa, T.; Scarpa, A.; Adsay, V.; Luchini, C. |
| Review Title: | Comprehensive characterization of intraductal oncocytic papillary neoplasm of the pancreas: A systematic and critical review |
| Abstract: | Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a recently recognized pancreatic tumor. Here, we aimed to determine its most essential features with the systematic review tool. PubMed, Scopus, and Embase were searched for studies reporting data on pancreatic IOPN. The clinicopathologic, immunohistochemical, and molecular data were extracted and summarized. Then, a comparative analysis of the molecular alterations of IOPN with those of pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasm from reference cohorts (including The Cancer Genome Atlas) was conducted. The key findings from 414 IOPNs were as follows: 1) The male-to-female ratio was 1.5:1. Pancreatic head was the most common site (131/237; 55.3%), but a diffuse tumor extension involving more than one pancreatic segment was described in about 1 out of 5 cases (49/237; 20.6%). The mean size was 45.5 mm. An associated invasive carcinoma was present in 50% of cases (168/336). In those cases, most tumors were pT1 or pT2 and pN0 (>80%), and vascular invasion was uncommon (20.6%). Regarding survival, more than 90% of patients were alive after surgical resection. 2) Immunohistochemical and molecular features were as follows. The most commonly expressed mucins were MUC5AC (110/112; 98.2%) and MUC6 (78/84; 92.8%). Compared with pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasm, the classic pancreatic drivers KRAS, TP53, CDKN2A, SMAD4, and GNAS were less altered in IOPN (P < .01). Moreover, fusions involving PRKACA or PRKACB gene were detected in all of the 68 cases examined, with PRKACB::ATP1B1 being the most common (27/68 cases; 39.7%). These genomic events emerged as an entity-defining molecular alteration of IOPN (P < .01). Thus, such fusions represent a promising biomarker for diagnostic purposes. Recent evidence also suggests their role in influencing the acquisition of oncocytic morphology. IOPN is a distinct pancreatic neoplasm with specific clinicopathologic and molecular features. Considering the clinical or prognostic implications, its recognition is essential for pathologists and, ultimately, patients’ management © 2024 The Authors |
| Keywords: | immunohistochemistry; mitogen activated protein kinase; adult; cancer survival; aged; unclassified drug; clinical feature; histopathology; review; nuclear magnetic resonance imaging; follow up; lymph node metastasis; preoperative evaluation; biological marker; tumor localization; tumor volume; prevalence; epidermal growth factor receptor; intraductal papillary mucinous tumor; protein p53; tumor marker; distant metastasis; abdominal pain; systematic review; watchful waiting; carcinoma in situ; pancreatitis; gene fusion; fusion gene; invasive carcinoma; heterozygosity loss; pancreatic cancer; mucin 1; cyclin dependent kinase inhibitor 2a; k ras protein; colloid carcinoma; cancer morphology; perineural invasion; dysplasia; cyclic amp dependent protein kinase; mucin 5ac; mucin 2; surgical margin; fusion protein; solid pseudopapillary tumor; intraductal; intraductal papillary mucinous neoplasm; mucin 6; smad4 protein; pancreatic ductal carcinoma; tumor invasion; mortality rate; magnetic resonance cholangiopancreatography; intraductal oncocytic papillary neoplasm; gnas protein; oncocytic; human; male; female; rna sequencing; differential gene expression; oncogenomics; asymptomatic carrier; pancreatic intraductal neoplasia; oncocytic tumor; oxyphilic; prkaca; prkacb; prkaca atp1b1 fusion protein; prkaca protein; prkacb atp1b1 fusion protein; prkacb dnajb1 fusion protein; prkacb protein; cystadenocarcinoma of the pancreas; intraductal oncocytic papillary neoplasm of the pancreas; pancreatic mucinous cystadenoma |
| Journal Title: | Modern Pathology |
| Volume: | 37 |
| Issue: | 9 |
| ISSN: | 0893-3952 |
| Publisher: | Nature Research |
| Date Published: | 2024-09-01 |
| Start Page: | 100554 |
| Language: | English |
| DOI: | 10.1016/j.modpat.2024.100554 |
| PUBMED: | 38950698 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work