Baruch Amy C, Wang Huamin, Staerkel Gregg A, Evans Douglas B, Hwang Rosa Frances, Krishnamurthy Savitri
Department of Cytopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Diagn Cytopathol. 2007 Mar;35(3):143-7. doi: 10.1002/dc.20594.
Mesothelin is a potential marker of pancreatic adenocarcinoma that was recently identified by serial analysis of gene expression. We evaluated the sensitivity and specificity of mesothelin as a marker of pancreatic adenocarcinoma on destained Papanicolaou (Pap) smears and unstained cellblocks from 28 patients using a monoclonal antibody to mesothelin. Intensity and proportion of staining was semiquantitatively graded on a scale of 1-3, and as 0%, 1 to <10%, 10-50%, or >50%. Positive staining for mesothelin was seen in 64% of the direct smears and in 36% of cell block sections. Focal positivity for mesothelin was noted in benign pancreatic tissue in one of 10 cases. Staining was most often focal (<50% of cells) in both direct smears and cell block sections. The overall sensitivity and specificity of mesothelin as a marker for pancreatic adenocarcinoma were 68% and 90%, respectively. Sensitivity was higher in Pap smears than in cell block sections (64% versus 36%). The presence of occasional mesothelin expression in benign tissue, its very focal expression in malignant tissue may limit the utility of mesothelin as a marker of pancreatic adenocarcinomas in fine-needle aspiration (FNA) specimens.
间皮素是一种胰腺腺癌的潜在标志物，最近通过基因表达序列分析得以鉴定。我们使用抗间皮素单克隆抗体，对28例患者经苏木精-伊红（Pap）染色涂片脱色后以及未染色细胞块进行评估，以确定间皮素作为胰腺腺癌标志物的敏感性和特异性。染色强度和比例采用1 - 3级半定量分级，以及0%、1%至<10%、10% - 50%或>50%进行分级。在64%的直接涂片和36%的细胞块切片中可见间皮素阳性染色。10例中有1例在良性胰腺组织中发现间皮素局灶阳性。在直接涂片和细胞块切片中，染色大多为局灶性（<50%的细胞）。间皮素作为胰腺腺癌标志物的总体敏感性和特异性分别为68%和90%。Pap涂片的敏感性高于细胞块切片（64%对36%）。良性组织中偶尔存在间皮素表达，其在恶性组织中表达非常局灶，这可能会限制间皮素作为细针穿刺（FNA）标本中胰腺腺癌标志物的应用。
