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Relation of Epidermal Growth Factor Receptor and Estrogen Receptor-Independent pS2 Protein to the Malignant Transformation of Mucinous Cystic Neoplasms of the Pancreas

Robin E. Kirby, MD; Kent B. Lewandrowski, MD; James F. Southern, MD, PhD; Carolyn C. Compton, MD, PhD; Andrew L. Warshaw, MD
Arch Surg. 1995;130(1):69-72. doi:10.1001/archsurg.1995.01430010071014.
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Objective:  To evaluate the role of epidermal growth factor receptor (EGF-R) and pS2 protein in the evolution of malignancy in mucinous cystic tumors of the pancreas.

Background:  Mucinous cystic tumors of the pancreas include histologically benign but premalignant mucinous cystic neoplasms and mucinous cystadenocarcinoma. The molecular events leading to transformation from a benign to a malignant mucinous tumor are not known. Overexpression of EGF-R and detection of an estrogen-induced protein (pS2) has been demonstrated in ductal adenocarcinomas of the pancreas, but these factors have not been evaluated in mucinous cystic tumors.

Design:  Twenty-six mucinous tumors were examined for EGF-R, pS2 protein, and estrogen and progesterone receptors.

Results:  Eight (61.2%) of 13 malignant tumors exhibited increased expression of EGF-R, whereas EGF-R was not detected in any of the 13 benign tumors (P=.002). The pS2 protein was detected in nine of 11 malignant and 11 of 11 benign tumors (P=.480). Estrogen and progesterone receptors were not detected in the epithelium of either tumor type. The median survival time of the patients with EGF-R-negative tumors was 29.0 months compared with 14.5 months for those with EGF-R-postive tumors, but this difference did not reach significance owing to the small population size.

Conclusions:  Overexpression of EGF-R in mucinous cystic tumors, as in ductal adenocarcinomas, may be an important feature associated with malignancy and may have prognostic significance. Failure to detect EGF-R in histologically benign epithelium suggests that the upregulation of EGF-R may be important in the evolution of aggressive behavior. The expression of pS2 protein appears to be independent of estrogen and may play a role in the proliferative activity of mucinous tumors. However, pS2 expression is not a feature associated exclusively with malignancy.(Arch Surg. 1995;130:69-72)


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