Significance of High-Mobility Group A Protein 2 Expression in Pancreatic Ductal Adenocarcinoma and Ampullary Adenocarcinoma

• Published in: The Turkish Journal of Gastroenterology Vol. 34; no. 10; pp. 1014 - 1024
• Main Authors: Oflas, Damla, Canaz, Funda, Özer, İlter, Demir, Lütfiye, Çolak, Ertuğrul
• Format: Journal Article
• Language: English
• Published: Turkey AVES 01-10-2023; Turkish Society of Gastroenterology
• Subjects: Adenocarcinoma; Ampulla of Vater; Cadherins; Cancer; Carcinoma, Pancreatic Ductal; Chemotherapy; Chromosomal proteins; Common Bile Duct Neoplasms; Diagnosis; Duodenal Neoplasms; Gastrointestinal Tract; Gene expression; Genetic aspects; Health aspects; Humans; Metastasis; Oncology, Experimental; Original; Pancreatic cancer; Pancreatic Neoplasms; Pancreatitis; Pancreatitis, Chronic; Stem cells; Vimentin; Turkey
• ISSN: 1300-4948; 2148-5607
• DOI: 10.5152/tjg.2023.22881

Pancreatic and ampullary adenocarcinoma (AAC) are quite resistant to chemotherapy with high metastasis potential. Our study aimed to interpret high-mobility group A protein 2 (HMGA2) expression in benign and precursor pancreatic lesions and pancreatic and ampullary carcinoma and to evaluate its relationship with epithelial-mesenchymal transition (EMT) and clinicopathological parameters.
In this study, normal-appearing pancreas, chronic pancreatitis (CP), low- (L) and high (H)-grade pancreatic intraepithelial neoplasia (PanIN), pancreatic ductal adenocarcinoma (PDAC), and AAC were evaluated with the immunohistochemical marker of HMGA2. Vimentin and E-cadherin immunohistochemical stains were applied in PDAC and AAC.
The HMGA2 expression was not detected in normal-appearing pancreas, CP, and L-PanIN. A statistically significant expression was observed in PDAC and H-PanIN (P < .001). A statistically significant correlation was found between loss of membranous E-cadherin expression and vimentin positivity and HMGA2 expression (P > .05). The HMGA2 expression was observed to increase the risk of diseaserelated death and decrease overall survival (OS) in AAC and the neoplasia group (P = .002 and P = .016, respectively). There was no significant difference in OS and risk of death in PDAC (P > .05) with respect to HMGA2 positivity.
High-mobility group A protein 2 is a helpful immunohistochemical marker in differentiating CP from PDAC. It also plays a role in EMT and may serve as a potential new prognostic agent and therapeutic target in tumors of the periampullary region, especially AAC.