Department of Laboratory Medicine, Geisinger Medical Center, 100 N Academy Ave, Danville, PA 17822, USA.
Arch Pathol Lab Med. 2012 Jun;136(6):601-9. doi: 10.5858/arpa.2011-0326-OA.
Differentiation of ductal adenocarcinoma of the pancreas from nonneoplastic pancreatic tissues can be challenging, especially in small biopsy and fine-needle aspiration specimens.
To investigate the utility of 26 immunohistochemical markers (CAM 5.2, CK [cytokeratin] 7, CK20, CK17, CK19, MUC1, MUC2, MUC4, MUC5AC, MUC6, p53, DPC4/SMAD4, CDX2, pVHL [von Hippel-Lindau tumor suppressor gene protein], S100P, IMP-3 [insulin-like growth factor 2 messenger RNA binding protein 3], maspin, mesothelin, claudin 4, claudin 18, annexin A8, fascin, PSCA [prostate stem cell antigen], MOC31, CEA [carcinoembryonic antigen], and CA19-9 [cancer antigen 19-9]) in the diagnosis of ductal adenocarcinoma of the pancreas.
Immunohistochemical staining for these markers was performed in 60 cases of pancreatic ductal adenocarcinoma on routine and tissue microarray sections. In addition, immunohistochemical staining for maspin, S100P, IMP-3, and pVHL was performed on cell blocks from 67 pancreatic fine-needle aspiration cases, including 44 cases of pancreatic ductal adenocarcinoma.
The results demonstrated that (1) more than 90% of cases of ductal adenocarcinoma were positive for maspin, S100P, and IMP-3; (2) nearly all adenocarcinoma cases were negative for pVHL, whereas nonneoplastic ducts and acini were positive for pVHL in all cases; (3) normal/reactive pancreatic ducts were frequently positive for CK7, CK19, MUC1, MUC6, CA19-9, MOC31, PSCA, mesothelin, annexin A8, claudin 4, and claudin 18; (4) normal pancreatic ducts were usually negative for IMP-3, maspin, S100P, CK17, MUC2, MUC4, and MUC5AC; (5) 60% of adenocarcinomas were negative for DPC4/SMAD4; and (6) strong background staining was frequently seen with fascin, PSCA, and annexin A8.
pVHL, maspin, S100P, and IMP-3 constitute the best diagnostic panel of immunomarkers for confirming the diagnosis of pancreatic ductal adenocarcinoma in both surgical and fine-needle aspiration specimens.
胰腺导管腺癌与非肿瘤性胰腺组织的鉴别具有一定挑战性，尤其是在小活检和细针抽吸标本中。
研究 26 种免疫组织化学标志物（CAM5.2、CK[细胞角蛋白]7、CK20、CK17、CK19、MUC1、MUC2、MUC4、MUC5AC、MUC6、p53、DPC4/SMAD4、CDX2、pVHL[von Hippel-Lindau 肿瘤抑制基因蛋白]、S100P、IMP-3[胰岛素样生长因子 2 信使 RNA 结合蛋白 3]、maspin、mesothelin、claudin4、claudin18、annexin A8、fascin、PSCA[前列腺干细胞抗原]、MOC31、CEA[癌胚抗原]和 CA19-9[癌症抗原 19-9]）在胰腺导管腺癌诊断中的应用。
对 60 例胰腺导管腺癌常规和组织微阵列切片进行这些标志物的免疫组织化学染色。此外，对 67 例胰腺细针抽吸病例的细胞块进行了 maspin、S100P、IMP-3 和 pVHL 的免疫组织化学染色，包括 44 例胰腺导管腺癌。
结果表明：（1）>90%的导管腺癌病例对 maspin、S100P 和 IMP-3 呈阳性；（2）几乎所有腺癌病例均为 pVHL 阴性，而非肿瘤性导管和腺泡在所有病例中均为 pVHL 阳性；（3）正常/反应性胰腺导管常对 CK7、CK19、MUC1、MUC6、CA19-9、MOC31、PSCA、mesothelin、annexin A8、claudin4 和 claudin18 呈阳性；（4）正常胰腺导管通常对 IMP-3、maspin、S100P、CK17、MUC2、MUC4 和 MUC5AC 呈阴性；（5）60%的腺癌为 DPC4/SMAD4 阴性；（6）fascin、PSCA 和 annexin A8 常出现强烈的背景染色。
pVHL、maspin、S100P 和 IMP-3 构成了在手术和细针抽吸标本中确认胰腺导管腺癌诊断的最佳免疫标志物诊断组合。
