ORIGINAL ARTICLE
Expression of SOX9 in Intraductal Papillary Mucinous Neoplasms of the Pancreas Fanbin Meng, MD,*Þ Kyoichi Takaori, MD, PhD,* Tatsuo Ito, MD, PhD,* Toshihiko Masui, MD, PhD,* Michiya Kawaguchi, MD, PhD,* Yoshiya Kawaguchi, MD, PhD,þ and Shinji Uemoto, MD, PhD* Objectives: SRY (sex determining region Y) box 9 (SOX9) plays a key role in the embryologic development, differentiation, and maintenance of organs in the pancreas as well as progression of several kinds of tumors. The aim of the present study was to evaluate the expression and potential role of SOX9 in intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. Methods: The authors selected 27 pathological tissues from 19 IPMN cases to assess the expression of SOX9 by means of immunohistochemistry and analyzed the expression pattern of SOX9 with 78 lesions obtained from these tissues stained by SOX9. Results: SOX9 was expressed in the normal pancreas, IPMN, and pancreatic ductal adenocarcinoma. SOX9-positive cells were confined to the lower portions of the papillary structures of IPMN. However, SOX9 was expressed in the entire epithelium once the neoplasms advanced to high-grade dysplasia and invasive carcinoma. The expression pattern of SOX9 was similar to that of CD44 in the normal pancreas and IPMN. Double staining of SOX9 and CD44 detected colocalization of SOX9 and CD44 in IPMN. Conclusions: Changes in the SOX9 expression pattern may be involved in the mechanisms of the malignant progression of IPMN. Key Words: intraductal papillary mucinous neoplasm, IPMN, SOX9, pancreas (Pancreas 2014;43: 7Y14)
T
he intraductal papillary mucinous neoplasm (IPMN) is an intraductal, grossly visible epithelial neoplasm of mucinproducing cells arising in the main pancreatic duct or its branches.1 Intraductal papillary mucinous neoplasm usually has a better prognosis than pancreatic ductal adenocarcinoma (PDAC) even when associated with high-grade dysplasia.2 However, when advanced to invasive carcinoma with metastasis to the lymph nodes or other organs, like PDAC, it shows a poor prognosis.3,4 Understanding of the molecular biological mechanisms during the development of IPMN and identification of potential factors that can predict the tendency toward malignancy will help in treating this kind of disease.
From the *Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; †Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China; and ‡Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan. Received for publication October 17, 2012; accepted July 26, 2013. Reprints: Kyoichi Takaori, MD, PhD, Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-5807, Japan (e
Expression of SOX9 in Intraductal Papillary Mucinous Neoplasms of the Pancreas Fanbin Meng, MD,*Þ Kyoichi Takaori, MD, PhD,* Tatsuo Ito, MD, PhD,* Toshihiko Masui, MD, PhD,* Michiya Kawaguchi, MD, PhD,* Yoshiya Kawaguchi, MD, PhD,þ and Shinji Uemoto, MD, PhD* Objectives: SRY (sex determining region Y) box 9 (SOX9) plays a key role in the embryologic development, differentiation, and maintenance of organs in the pancreas as well as progression of several kinds of tumors. The aim of the present study was to evaluate the expression and potential role of SOX9 in intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. Methods: The authors selected 27 pathological tissues from 19 IPMN cases to assess the expression of SOX9 by means of immunohistochemistry and analyzed the expression pattern of SOX9 with 78 lesions obtained from these tissues stained by SOX9. Results: SOX9 was expressed in the normal pancreas, IPMN, and pancreatic ductal adenocarcinoma. SOX9-positive cells were confined to the lower portions of the papillary structures of IPMN. However, SOX9 was expressed in the entire epithelium once the neoplasms advanced to high-grade dysplasia and invasive carcinoma. The expression pattern of SOX9 was similar to that of CD44 in the normal pancreas and IPMN. Double staining of SOX9 and CD44 detected colocalization of SOX9 and CD44 in IPMN. Conclusions: Changes in the SOX9 expression pattern may be involved in the mechanisms of the malignant progression of IPMN. Key Words: intraductal papillary mucinous neoplasm, IPMN, SOX9, pancreas (Pancreas 2014;43: 7Y14)
T
he intraductal papillary mucinous neoplasm (IPMN) is an intraductal, grossly visible epithelial neoplasm of mucinproducing cells arising in the main pancreatic duct or its branches.1 Intraductal papillary mucinous neoplasm usually has a better prognosis than pancreatic ductal adenocarcinoma (PDAC) even when associated with high-grade dysplasia.2 However, when advanced to invasive carcinoma with metastasis to the lymph nodes or other organs, like PDAC, it shows a poor prognosis.3,4 Understanding of the molecular biological mechanisms during the development of IPMN and identification of potential factors that can predict the tendency toward malignancy will help in treating this kind of disease.
From the *Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; †Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China; and ‡Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan. Received for publication October 17, 2012; accepted July 26, 2013. Reprints: Kyoichi Takaori, MD, PhD, Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-5807, Japan (e
