by Leigh MacMillan
Immature nerves and neural precursor cells accumulate in a type of premalignant tumor in the pancreas as it progresses to invasive disease, according to a recent study in the Journal of Pathology.
Marcus Tan, MBBS, and colleagues used detailed histologic analysis and multiplex immunohistochemistry, including machine learning methods, to analyze nerves in surgically removed specimens of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. IPMNs account for up to 25% of all cases of pancreatic adenocarcinoma.
The researchers found that the density of nerves within these tumors increased from low-grade to high-grade dysplasia but did not further increase once invasive disease (cancer) was present. They also showed, for the first time, the presence of neural precursor cells within premalignant tumors, and these precursors also increased in density during progression to cancer.
The findings show that neural infiltration is associated with malignant progression in IPMN. Novel therapeutics that block neural development in the tumor may arrest malignant progression, the researchers suggest.
Other authors of the study include Vincent Quoc-Huy Trinh, MD, Joseph Roland, PhD, Jahg Wong, MD, Frank Revetta, Krutika Patel, MBBS, Chanjuan Shi, MD, PhD, Kathleen DelGiorno, PhD, and Bruce Carter, PhD.
The research was supported by the National Institutes of Health (grants DK058404, CA068485, CA236733, GM142709, NS107456, NS102365), Nikki Mitchell Foundation and Pancreas Club, Vanderbilt Supporting Careers in Research for Interventional Physicians and Surgeons (SCRIPS) program, and American Gastroenterological Association.
