Molecular genetics of ductal pancreatic neoplasia

The molecular genetic profiles that characterize pancreatic ductal neoplasi a have taken shape recently with the help of immunohistochemistry and the e stablishment of the nomenclature describing pancreatic ductal tumorigenesis . K-ras mutations frequently occur early, changes in the expression and gen etic integrity of the p16 gene appear in intermediate lesions, and the inac tivation of the p53, DPC4, and BRCA2 genes occur late in the neoplastic pro gression. Tumor-suppressor genes inactivated in pancreatic cancer such as A LK5, TGFBR2, MKK4, and STK11/LKB1 have been identified, although their role s in tumor progression are not yet well defined, Additional discoveries in this tumor system may be on the horizon, will further refine the molecular genetic profiles for the disease, and should suggest some clinical uses for this fund of knowledge. Curr Opin Gastro 2000, 16:419-425 (C) 2000 Lippinc ott Williams & Wilkins, Inc.