Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis

Background. Differentiating branch duct from mixed intraductal papillary mucinous neoplasm (BD-IPMN) is problematic, but clinically important as mixed IPMNs are managed surgically, while some BD-IPMN may be followed. Inflammatory mediator proteins (IMPs) have been implicated in acute and chronic inf...

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Main Authors: Linda S. Lee, Andrew M. Bellizzi, Peter A. Banks, Nisha I. Sainani, Vivek Kadiyala, Shadeah Suleiman, Darwin L. Conwell, Joao A. Paulo
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/247309
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author Linda S. Lee
Andrew M. Bellizzi
Peter A. Banks
Nisha I. Sainani
Vivek Kadiyala
Shadeah Suleiman
Darwin L. Conwell
Joao A. Paulo
author_facet Linda S. Lee
Andrew M. Bellizzi
Peter A. Banks
Nisha I. Sainani
Vivek Kadiyala
Shadeah Suleiman
Darwin L. Conwell
Joao A. Paulo
author_sort Linda S. Lee
collection DOAJ
description Background. Differentiating branch duct from mixed intraductal papillary mucinous neoplasm (BD-IPMN) is problematic, but clinically important as mixed IPMNs are managed surgically, while some BD-IPMN may be followed. Inflammatory mediator proteins (IMPs) have been implicated in acute and chronic inflammatory and malignant pancreatic diseases. Aim. To compare IMP profile of pancreatic cyst fluid collected endoscopically from BD-IPMN and mixed IPMN. Methods. Pancreatic cyst fluid from ten patients (5 BD-IPMN and 5 mixed IPMN) was collected by endoscopic ultrasound-guided fine needle aspiration or endoscopic retrograde cholangiopancreatography. Concentrations of 89 IMPs in these samples were determined using a multiplexed bead-based microarray protein assay and compared between BD-IPMN and mixed IPMN. Results. Eighty-six of 89 IMPs were detected in at least one of the 10 samples. Fourteen IMPs were detected only in mixed IPMN, while none were only in BD-IPMN. Of these, TGF-β1 was most prevalent, present in 3 of 5 mixed IPMNs. Seventy-two IMPs were detected in both BD-IPMN and mixed IPMNs. Of these, only G-CSF (P<0.05) was present in higher concentrations in mixed IPMNs. Conclusion. TGF-β1 and G-CSF detected in endoscopically collected pancreatic cyst fluid are potential diagnostic biomarkers capable of distinguishing mixed IPMN from BD-IPMN.
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spelling doaj-art-259d6bc8de044d498c020d3e68cb291a2025-08-20T02:04:27ZengWileyGastroenterology Research and Practice1687-61211687-630X2012-01-01201210.1155/2012/247309247309Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine AnalysisLinda S. Lee0Andrew M. Bellizzi1Peter A. Banks2Nisha I. Sainani3Vivek Kadiyala4Shadeah Suleiman5Darwin L. Conwell6Joao A. Paulo7Center for Pancreatic Disease and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USADepartment of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USACenter for Pancreatic Disease and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USADepartment of Radiology, Brigham and Women’s Hospital, Boston, MA 02115, USACenter for Pancreatic Disease and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USACenter for Pancreatic Disease and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USACenter for Pancreatic Disease and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USACenter for Pancreatic Disease and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USABackground. Differentiating branch duct from mixed intraductal papillary mucinous neoplasm (BD-IPMN) is problematic, but clinically important as mixed IPMNs are managed surgically, while some BD-IPMN may be followed. Inflammatory mediator proteins (IMPs) have been implicated in acute and chronic inflammatory and malignant pancreatic diseases. Aim. To compare IMP profile of pancreatic cyst fluid collected endoscopically from BD-IPMN and mixed IPMN. Methods. Pancreatic cyst fluid from ten patients (5 BD-IPMN and 5 mixed IPMN) was collected by endoscopic ultrasound-guided fine needle aspiration or endoscopic retrograde cholangiopancreatography. Concentrations of 89 IMPs in these samples were determined using a multiplexed bead-based microarray protein assay and compared between BD-IPMN and mixed IPMN. Results. Eighty-six of 89 IMPs were detected in at least one of the 10 samples. Fourteen IMPs were detected only in mixed IPMN, while none were only in BD-IPMN. Of these, TGF-β1 was most prevalent, present in 3 of 5 mixed IPMNs. Seventy-two IMPs were detected in both BD-IPMN and mixed IPMNs. Of these, only G-CSF (P<0.05) was present in higher concentrations in mixed IPMNs. Conclusion. TGF-β1 and G-CSF detected in endoscopically collected pancreatic cyst fluid are potential diagnostic biomarkers capable of distinguishing mixed IPMN from BD-IPMN.http://dx.doi.org/10.1155/2012/247309
spellingShingle Linda S. Lee
Andrew M. Bellizzi
Peter A. Banks
Nisha I. Sainani
Vivek Kadiyala
Shadeah Suleiman
Darwin L. Conwell
Joao A. Paulo
Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis
Gastroenterology Research and Practice
title Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis
title_full Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis
title_fullStr Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis
title_full_unstemmed Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis
title_short Differentiating Branch Duct and Mixed IPMN in Endoscopically Collected Pancreatic Cyst Fluid via Cytokine Analysis
title_sort differentiating branch duct and mixed ipmn in endoscopically collected pancreatic cyst fluid via cytokine analysis
url http://dx.doi.org/10.1155/2012/247309
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