The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN) of the pancreas has evolved over the last decade. IPMN is a disease of the ductal epithelium and represent a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. As with villous adenomas of the colon, not all IPMNs will develop into adenocarcinoma. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. Growing controversy revolves around issues of natural history, management of small-branch-duct lesions, ability to predict malignancy and/or progression, and surveillance strategies. Given these controversies, novel methods are needed to help in detecting and classifying IPMNs’ malignant potential so that appropriate treatment can be administered. The authors review abstracts from the 2010 ASCO Gastrointestinal Cancers Symposium held in January 2010, including biomarkers helping to classify IPMNs: IL-8 and IL-1beta from IPMN cyst aspirates (Abstract #133), and Foxp3/CD4/CD25 cells (Abstract #148) in peripheral blood. Future studies will hopefully provide insight into the many unanswered questions.
Muhammad Wasif Saif, Scott Bussom