REG4 is associated with carcinogenesis in the 'intestinal' pathway of intraductal papillary mucinous neoplasms

Kohei Nakata, Eishi Nagai, Kenoki Ohuchida, Shinich Aishima, Akifumi Hayashi, Yoshihiro Miyasaka, Jun Yu, Kazuhiro Mizumoto, Masao Tanaka, Masazumi Tsuneyoshi

Research output: Contribution to journalArticle


Subclassification of intraductal papillary mucinous neoplasms of the pancreas (IPMNs), based on morphological features and immunohistochemical profiles, has been proposed. Intestinal-type IPMNs frequently show moderate to severe dysplasia. Regenerating islet-derived family, member 4 (REG4) is associated with the adenoma-carcinoma sequence in colon cancer and it is also associated with intestinal phenotype. Therefore, to identify REG4 expression in IPMNs may be helpful to detect high-grade IPMNs. We also investigated REG4 expression and CDX2 expression in IPMNs. To investigate the expressions of REG4 and CDX2 in IPMNs and in invasive ductal adenocarcinoma derived from IPMN, we used immunohistochemical staining and microdissection-based quantitative real-time reverse transcription-polymerase chain reaction. Among 125 IPMNs, 43 (34%) were positive for REG4 and most of the intestinal-type IPMNs showed its expression (35/38). The positive ratio of REG4 expression in colloid carcinoma (5/7) was significantly higher than that in tubular carcinoma (1/17; P=0.003). Most of CDX2-positive cases (31/33) expressed REG4 protein, whereas only 12 of 92 CDX2-negative cases did (P

Original languageEnglish (US)
Pages (from-to)460-468
Number of pages9
JournalModern Pathology
Issue number3
Publication statusPublished - 2009
Externally publishedYes



  • IPMN
  • Laser microdissection
  • Pancreatic cancer
  • PanIN
  • REG4

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Nakata, K., Nagai, E., Ohuchida, K., Aishima, S., Hayashi, A., Miyasaka, Y., ... Tsuneyoshi, M. (2009). REG4 is associated with carcinogenesis in the 'intestinal' pathway of intraductal papillary mucinous neoplasms. Modern Pathology, 22(3), 460-468.