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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2013

01-11-2013 | Pancreatic Tumors

Clinicopathological Correlates of Activating GNAS Mutations in Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas

Authors: Marco Dal Molin, MD, Hanno Matthaei, MD, Jian Wu, PhD, Amanda Blackford, Sc.M., Marija Debeljak, B.S., Neda Rezaee, MD, Christopher L. Wolfgang, MD, PhD, Giovanni Butturini, MD, PhD, Roberto Salvia, MD, PhD, Claudio Bassi, MD, Michael G. Goggins, MD, Kenneth W. Kinzler, PhD, Bert Vogelstein, MD, James R. Eshleman, MD, PhD, Ralph H. Hruban, MD, Anirban Maitra, MBBS

Published in: Annals of Surgical Oncology | Issue 12/2013

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Abstract

Background

Intraductal papillary mucinous neoplasms (IPMNs) are the most common cystic precursor lesions of invasive pancreatic cancer. The recent identification of activating GNAS mutations at codon 201 in IPMNs is a promising target for early detection and therapy. The purpose of this study was to explore clinicopathological correlates of GNAS mutational status in resected IPMNs.

Methods

Clinical and pathologic characteristics were retrieved on 54 patients in whom GNAS codon 201 mutational status was previously reported (“historical group”, Wu et al. Sci Transl Med 3:92ra66, 2011). In addition, a separate cohort of 32 patients (validation group) was included. After microdissection and DNA extraction, GNAS status was determined in the validation group by pyrosequencing.

Results

GNAS activating mutations were found in 64 % of the 32 IPMNs included in the validation group, compared with a previously reported prevalence of 57 % in the historical group. Overall, 52 of 86 (61 %) of IPMNs demonstrated GNAS mutations in the two studies combined. Analysis of both groups confirmed that demographic characteristics, tumor location, ductal system involvement, focality, size, grade of dysplasia, presence of an associated cancer, and overall survival were not correlated with GNAS mutational status. Stratified by histological subtype, 100 % of intestinal type IPMNs demonstrated GNAS mutations compared to 51 % of gastric IPMN, 71 % of pancreatobiliary IPMNs, and 0 % of oncocytic IPMNs.

Conclusions

GNAS activating mutations can be reliably detected in IPMNs by pyrosequencing. In terms of clinicopathological parameters, only histological subtype was correlated with mutational frequency, with the intestinal phenotype always associated with GNAS mutations.
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Metadata
Title
Clinicopathological Correlates of Activating GNAS Mutations in Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas
Authors
Marco Dal Molin, MD
Hanno Matthaei, MD
Jian Wu, PhD
Amanda Blackford, Sc.M.
Marija Debeljak, B.S.
Neda Rezaee, MD
Christopher L. Wolfgang, MD, PhD
Giovanni Butturini, MD, PhD
Roberto Salvia, MD, PhD
Claudio Bassi, MD
Michael G. Goggins, MD
Kenneth W. Kinzler, PhD
Bert Vogelstein, MD
James R. Eshleman, MD, PhD
Ralph H. Hruban, MD
Anirban Maitra, MBBS
Publication date
01-11-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3096-1

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