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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2021; 27(21): 2710-2726
Published online Jun 7, 2021. doi: 10.3748/wjg.v27.i21.2710
Molecular alterations in pancreatic tumors
Michela Visani, Giorgia Acquaviva, Antonio De Leo, Viviana Sanza, Lidia Merlo, Thais Maloberti, Alba A Brandes, Enrico Franceschi, Monica Di Battista, Michele Masetti, Elio Jovine, Sirio Fiorino, Annalisa Pession, Giovanni Tallini, Dario de Biase
Michela Visani, Giorgia Acquaviva, Antonio De Leo, Viviana Sanza, Lidia Merlo, Thais Maloberti, Giovanni Tallini, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna–Molecular Diagnostic Unit, Azienda USL di Bologna, Bologna 40138, Italy
Antonio De Leo, Annalisa Pession, Giovanni Tallini, Dario de Biase, Division of Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
Alba A Brandes, Enrico Franceschi, Monica Di Battista, Medical Oncology Department, Azienda USL/IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna 40139, Italy
Michele Masetti, Elio Jovine, Division of Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40133, Italy
Sirio Fiorino, Internal Medicine Unit, Budrio Hospital Azienda USL, Bologna 40133, Italy
Annalisa Pession, Dario de Biase, Department of Pharmacy and Biotechnology, University of Bologna, Bologna 40138, Italy
Author contributions: de Biase D conceived and designed the study; Visani M, Acquaviva G, De Leo A, Sanza V, Merlo L, Maloberti T, Franceschi E, Di Battista M, Masetti M, Fiorino S and de Biase D performed the literature search and acquisition of the data; Brandes AA, Jovine E, Pession A and Tallini G performed the interpretation and the critical revision of the data; Visani M and de Biase D wrote the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: Authors have nothing to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dario de Biase, MSc, PhD, Assistant Professor, Department of Pharmacy and Biotechnology, University of Bologna, viale Ercolani 4/2, Bologna 40138, Italy. dario.debiase@unibo.it
Received: January 17, 2021
Peer-review started: January 17, 2021
First decision: February 9, 2021
Revised: February 25, 2021
Accepted: April 14, 2021
Article in press: April 14, 2021
Published online: June 7, 2021
Processing time: 129 Days and 16.4 Hours
Abstract

Genetic alterations in pancreatic tumors can usually be classified in: (1) Mutational activation of oncogenes; (2) Inactivation of tumor suppressor genes; and (3) Inactivation of genome maintenance genes controlling the repair of DNA damage. Endoscopic ultrasound-guided fine-needle aspiration has improved pre-operative diagnosis, but the management of patients with a pancreatic lesion is still challenging. Molecular testing could help mainly in solving these “inconclusive” specimens. The introduction of multi-gene analysis approaches, such as next-generation sequencing, has provided a lot of useful information on the molecular characterization of pancreatic tumors. Different types of pancreatic tumors (e.g., pancreatic ductal adenocarcinomas, intraductal papillary mucinous neoplasms, solid pseudopapillary tumors) are characterized by specific molecular alterations. The aim of this review is to summarize the main molecular alterations found in pancreatic tumors.

Keywords: Pancreatic tumors; Molecular alterations; Pancreatic ductal adenocarcinomas; Intraductal papillary mucinous neoplasm; Mutations; Molecular markers

Core Tip: To date, in patients with pancreatic cancer there are no targetable molecules for personalized treatment in clinical practice. The introduction of multi-gene analysis approaches, such as massive parallel sequencing, has provided a lot of useful information regarding the molecular characterization of pancreatic tumors. However, a huge amount of data needs to be properly managed to determine the information that is useful and correct. A deeper knowledge of the molecular alterations characterizing pancreatic neoplasms may lead to new potential therapeutic targets for these tumors.