Surgical and molecular pathology of pancreatic neoplasms

Diagnostic Pathology

Table 2 Overview of pancreatic neoplasms with their key genetic alterations and several epigenetic alterations discussed in this review

	Average number of somatic mutations	Major genes involved	Methylation	MiRNA tumor expression compared to normal pancreatic tissue
Pancreatic ductal adenocarcinoma	20–80	KRAS, CDNK2A, SMAD4, TP53, MLL3, TGFBR2, ATM, ARID1A, ROBO2, KDM6A	Loss of function through promotor hypermethylation: CDNK2A, hMLH1,	Upregulation: miR-21, 23a, 31, 100, 143, 155, and 221
Pancreatic ductal adenocarcinoma	20–80			Downregulation: miR-148a, 217 and 375
Pancreatic Neuroendocrine tumor/carcinoma	16	MEN1, ATRX, DAXX, TSC2, PTEN ^#, Rb, TP53*	Hypomethylation of LINE1 and hypermethylation of RASSF1A promoting the accumulation of β-catenin	Upregulation: miR-193b, 103 and 107
Pancreatic Neuroendocrine tumor/carcinoma	16	MEN1, ATRX, DAXX, TSC2, PTEN ^#, Rb, TP53*		Downregulation: miR-155
Solid-pseudopapillary neoplasm	3	CTNNB1	u	MiRNAs possibly upregulating the Wnt, Hedgehog, and Androgen receptor pathway
Acinar cell carcinoma	131	SMAD4, JAK1, BRAF, RB1, TP53, APC, ARID1A, GNAS, MLL3, PTEN	Hypermethylation of RASSF1, MLH1 and APC	Upregulation: miR-17, 20, 21, 92–1, 103, 107
Acinar cell carcinoma	131		Hypermethylation of RASSF1, MLH1 and APC	Downregulation: miR-155
Pancreatoblastoma	18	Loss of chromosome 11p, CTNNB1	Hypermethylation of RASSF1A	u

u unknown. ^# MEN1, ATRX, DAXX, TSC2 and PTEN mutations are found in well-differentiated PanNET but not in PanNEC. * Rb and TP53 mutations are present in PanNEC, but not in well-differentiated PanNET

ISSN: 1746-1596