Jang Sung Ill, Lee See Young, Nahm Ji Hae, Cho Jae Hee, Jo Jung Hyun, Jung Chan Min, Lim Beom Jin, Lim Jin Hong, Kim Hyung Sun, Lee Su Yun, Hong In Young, Kim Sunghoon, Lee Dong Ki
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea.
Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea.
Diagnostics (Basel). 2025 Jul 15;15(14):1783. doi: 10.3390/diagnostics15141783.
: Accurate determination of malignancy in pancreatic masses through endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is crucial for appropriate clinical management and prognostic assessment. However, the diagnostic sensitivity of conventional cytology using Papanicolaou (Pap) staining remains limited, often leading to inconclusive results. In this study, we investigated the diagnostic utility of methionyl-tRNA synthetase 1 (MARS1) through immunohistochemical (IHC) and immunofluorescence (IF) staining as a potential biomarker for pancreatic cancer. IHC analysis was conducted on resected tissue samples from 10 patients, including both pancreatic ductal adenocarcinoma and corresponding non-neoplastic pancreatic tissue. Additionally, cytologic samples were obtained from 198 patients with pancreatic masses who underwent EUS-FNA for diagnostic evaluation. Pap staining and MARS1 IF staining were performed on liquid-based cytology slides derived from EUS-FNA specimens. : MARS1 was detected by IHC staining in the 10 surgical specimens diagnosed with pancreatic adenocarcinomas. After Pap staining, 37 patients were excluded because of unsuitable specimens, leaving 161 patients who underwent both Pap and MARS1 IF staining. EUS-FNA specimens from the 151 patients with pancreatic ductal adenocarcinoma were classified by Pap staining as atypia (n = 36), suspicious for malignancy (n = 55), or malignancy (n = 60). MARS1 IF staining was positive in 147 of these patients and negative in 4. MARS1 IF staining distinguished pancreatic cancer in specimens with atypia on Pap staining. The sensitivity for detecting pancreatic cancer was significantly higher for MARS1 IF staining than for conventional Pap staining (97.4% vs. 79.1%, < 0.0001). : The high sensitivity of MARS1 IF staining improved malignancy detection in pancreatic masses. Further prospective studies are required to validate our findings.
通过内镜超声引导下细针穿刺活检（EUS-FNA）准确判定胰腺肿块的恶性程度对于恰当的临床管理和预后评估至关重要。然而，采用巴氏（Pap）染色的传统细胞学诊断敏感性仍然有限，常常导致结果不确定。在本研究中，我们通过免疫组织化学（IHC）和免疫荧光（IF）染色研究了甲硫氨酰-tRNA合成酶1（MARS1）作为胰腺癌潜在生物标志物的诊断效用。对10例患者的切除组织样本进行了IHC分析，这些样本包括胰腺导管腺癌及相应的非肿瘤性胰腺组织。此外，从198例接受EUS-FNA进行诊断评估的胰腺肿块患者中获取了细胞学样本。对源自EUS-FNA标本的液基细胞学玻片进行了Pap染色和MARS1 IF染色。
在10例诊断为胰腺腺癌的手术标本中通过IHC染色检测到了MARS1。Pap染色后，37例患者因标本不合适被排除，剩下161例患者同时接受了Pap和MARS1 IF染色。151例胰腺导管腺癌患者的EUS-FNA标本经Pap染色分类为非典型（n = 36）、可疑恶性（n = 55）或恶性（n = 60）。这些患者中147例MARS1 IF染色呈阳性，4例呈阴性。MARS1 IF染色在Pap染色为非典型的标本中鉴别出了胰腺癌。MARS1 IF染色检测胰腺癌的敏感性显著高于传统Pap染色（97.4%对79.1%，<0.0001）。
MARS1 IF染色的高敏感性提高了胰腺肿块中恶性肿瘤的检测率。需要进一步的前瞻性研究来验证我们的发现。
