The Sol Goldman Pancreatic Cancer Research Center

Advances and Discoveries Made at Johns Hopkins

Follow-up After Intraductal Papillary Mucinous Neoplasm
More and more patients are undergoing surgery for an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. IPMNs are curable lesions, but if left untreated, some will progress to invasive cancer. They therefore represent an opportunity for early detection and early treatment. He and colleagues from Johns Hopkins followed 130 patients who had an IPMN resected to see if they were at risk for a second tumor. Remarkably, 17% of the patients developed progressive disease in their remnant pancreas, and five of them developed an invasive pancreatic cancer. What does this mean? This study, and others like it, suggest that patients who have an IPMN surgically resected should be followed clinically after their surgery.

He J, Cameron JL, Ahuja N, Makary MA, Hirose K, Choti MA, Schulick RD, Hruban RH, Pawlik TM, Wolfgang CL. Is it necessary to follow patients after resection of a benign pancreatic intraductal papillary mucinous neoplasm? J Am Coll Surg. 216:657-65, 2013.

A Genetic Approach to Detecting Intraductal Papillary Mucinous Neoplasms
Intraductal papillary mucinous neoplasms (IPMNs) can be precursors to invasive pancreatic cancer. The challenge can be detecting these precursor lesions. Dr. Kanda and colleagues report, in the journal Gut, a novel approach to detecting IPMNs. Patientrs undergoing upper endoscopy were given an injection of a drug called secretin. Secretin causes the pancreas to secrete fluid ("pancreatic juice"). This fluid was collected endoscopically and submitted to sequencing. Dr. Kanda and colleagues found that a DNA signature (GNAS mutations) can be detected in pancreatic juice samples from patients with an IPMN. This study suggests a new approach to developing a test for IPMNs- sequencing secretin stimulated pancreatic juice samples.

Kanda M, Knight S, Topazian MD, Syngal S, Farrell J, Lee JH, Kamel I, Lennon AM, Borges M, Young A, Jujiwara S, Seike J, Eshleman J, Hruban RH, Canto M, Goggins M. Mutant GNAS detected in duodenal collections of secretin-stimulated pancreatic juice indicates the presence or emergency of pancreatic cysts. Gut. 62:1024-33, 2013.