Bhardwaj Atul, Marsh William L, Nash Jason W, Barbacioru Catalin C, Jones Susie, Frankel Wendy L
Department of Pathology, Ohio State University, Columbus, USA.
Arch Pathol Lab Med. 2007 Apr;131(4):556-62. doi: 10.5858/2007-131-556-DISWPI.
Immunohistochemical stains have been used for the distinction of pancreatic adenocarcinoma from chronic pancreatitis.
To determine if a double stain for MUC/p53 improved specificity and sensitivity for distinction of pancreatic adenocarcinoma from chronic pancreatitis by comparing maspin, mucin 4 (MUC4), p53, Smad4, and the double stain MUC4/p53.
Seventy-four pancreatic adenocarcinomas and 19 chronic pancreatitis cases were retrieved from archival files. Tissue cores were arrayed to create a tissue microarray of 2-mm cores. Sections were stained with antibodies against maspin, MUC4, p53, and Smad4. Additionally, a 2-color, double stain for MUC4 and p53 was developed and evaluated. Five percent or greater staining in either of the cores was considered positive. Intensity (0, 1, 2) and extent (%) of tumor cells staining was also determined.
The sensitivity for distinction of pancreatic adenocarcinoma from chronic pancreatitis with maspin, MUC4, p53, and Smad4 was 90%, 77%, 60%, and 63%, respectively; the specificity was 67%, 78%, 88%, and 88%, respectively. When MUC4 and p53 were combined in a double stain, and positive staining for either considered a positive result, the sensitivity increased to 96% but specificity was 73%. When immunoreactivity for both antibodies was necessary for a positive result, sensitivity fell to 39% but specificity was 100%. No correlation was found between intensity or extent of staining with any of the individual stains and tumor differentiation.
The double immunohistochemical stain for MUC4/p53 can be a useful diagnostic tool in conjunction with the hematoxylin-eosin-stained section for pancreatic adenocarcinoma, particularly when limited tumor is available for multiple stains.
免疫组织化学染色已用于区分胰腺腺癌与慢性胰腺炎。
通过比较乳腺丝抑蛋白、黏蛋白4（MUC4）、p53、Smad4以及双染MUC4/p53，确定MUC/p53双染是否能提高区分胰腺腺癌与慢性胰腺炎的特异性和敏感性。
从存档文件中检索出74例胰腺腺癌和19例慢性胰腺炎病例。将组织芯排列以创建一个2毫米芯的组织微阵列。切片用抗乳腺丝抑蛋白、MUC4、p53和Smad4的抗体进行染色。此外，开发并评估了一种用于MUC4和p53的双色双染。任一芯中5%或更高的染色被视为阳性。还确定了肿瘤细胞染色的强度（0、1、2）和范围（%）。
用乳腺丝抑蛋白、MUC4、p53和Smad4区分胰腺腺癌与慢性胰腺炎的敏感性分别为90%、77%、60%和63%；特异性分别为67%、78%、88%和88%。当MUC4和p53进行双染，且任一抗体阳性染色即视为阳性结果时，敏感性提高到96%，但特异性为73%。当阳性结果需要两种抗体均有免疫反应性时，敏感性降至39%，但特异性为100%。未发现任何单个染色的强度或范围与肿瘤分化之间存在相关性。
MUC4/p53双免疫组织化学染色结合苏木精-伊红染色切片可成为诊断胰腺腺癌的有用工具，特别是在可供多种染色的肿瘤组织有限时。
