Abstract :
Introduction: K-ras mutation is an early event and p53 mutation is a late event in the tumorigenesis pathway of carcinoma associated with Chronic Pancreatitis.
Aim: To identify the immunohistochemical expression of K-ras protein and p53 in surgical specimens of pancreas with chronic pancreatitis.
Materials and Methods : A 5 year study of chronic pancreatitis with associated pancreatic lesions received in the Histopathology Department, Government Medical College, Trivandrum. All cases of chronic pancreatitis, (n=60) were histopathologically examined along with the adjacent pancreatic tissue which showed precursor lesions. Immunohistochemical expression of K-ras protein and p53 in all cases were studied.
Results: In a total 60 cases of chronic pancreatitis, adjacent pancreatic tissue showed ductal adenocarcinoma in 20 cases (30%). Pancreatic Intraepithelial neoplasm (PanIN) was present in 6 cases accounting for 10%. 1 case was IPMN and one case was associated with serous cystadenoma.
Results: 7% of chronic pancreatitis showed K-ras mutations. Immunostaining for mutated p53 protein always was negative. p53 was positive in Pan IN 1A , Pan IN 1B, IPMN and carcinoma cells in 0 of 4(0%), 0 of 2(0%), 0 of 1(0%), and 18 of 20(90%), respectively, and K-ras was positive in 3 of 4 (75%), 2 of 2(100%), 1of 1(100%) and 12 of 20(60%), cases respectively.
Conclusion: Chronic pancreatitis and precursor lesions may progress to the development of pancreatic cancer. Further molecular studies for evaluation of oncogenes may be done in future for targeted therapy in pancreatic cancer.
Keyword :
Chronic pancreatitis, Pancreatic adenocarcinoma, IPMN, p53, Kras