Inflammatory protein profiling of pancreatic cyst fluid using EUS-FNA in tandem with cytokine microarray differentiates between branch duct IPMN and inflammatory cysts
Inflammatory protein profiling of pancreatic cyst fluid using EUS-FNA in tandem with cytokine microarray differentiates between branch duct IPMN and inflammatory cysts
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DOI：
10.1016/j.jim.2012.05.018
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发表时间：
2012-08-31
影响因子：
2.2
通讯作者：
Paulo, Joao A.
中科院分区：
文献类型：
--
作者：
Lee, Linda S.;Banks, Peter A.;Paulo, Joao A.
背景：胰腺囊性肿瘤的诊断仍然存在问题。我们推测胰腺囊液中的炎性介质蛋白可以区分分支导管内乳头状黏液性肿瘤(BD-IPMN)和胰腺炎性囊肿。我们的目标是1)使用经内窥镜超声细针抽吸(EUS-FNA)获得的多路IMP靶向微阵列检测胰腺囊液中的炎性介质蛋白(IMP)，以及2)比较BD-IPMNS和炎性囊肿炎性囊液中的IMP谱。10例患者(5例BD-IPMN和5例炎性囊肿者)的胰腺囊液经EUS-FNA直接分析，以确定89种IMPS的浓度。结果：在89个被检测的IMP中，有83个至少在10个患者样本中的一个中被检测到。在BD-IPMN中检出7例IMP，但未检出炎性囊肿，在炎性囊肿中检出11例IMP，但未检出BD-IPMN。值得注意的是，粒细胞-巨噬细胞集落刺激因子(GM-CSF)在所有五个炎症性囊肿样本中都有表达。炎性囊肿组中肝细胞生长因子(HGF)浓度明显高于BD-IPMN组。结论：EUS-FNA采集的胰腺囊肿液中GM-CSF和HGF可作为BD-IPMN和炎性囊肿组的鉴别诊断指标。将微阵列分子技术与EUS-FNA相结合，可能代表着我们在理解复杂的胰腺疾病方面向前迈进了一大步。(C)2012爱思唯尔B.V.保留所有权利。
Background: Diagnosis of pancreatic cystic neoplasms remains problematic. We hypothesize that inflammatory mediator proteins in pancreatic cyst fluid can differentiate branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) and pancreatic inflammatory cysts. We aim to 1) detect inflammatory mediator proteins (IMPs) using a multiplexed IMP-targeted microarray in pancreatic cyst fluid obtained during endoscopic ultrasound fine needle aspiration (EUS-FNA) and 2) compare IMP profiles in pancreatic cyst fluid from BD-IPMNs and inflammatory cysts. Pancreatic cyst fluid from ten patients (5 BD-IPMN and 5 inflammatory cysts) was obtained by EUS-FNA and analyzed directly with a multiplexed microarray assay to determine concentrations of 89 IMPs. Statistical analysis was performed using non-parametric methods.Results: Eighty-three of the 89 assayed IMPs were detected in at least one of the 10 patient samples. Seven IMPs were detected in BD-IPMN but not inflammatory cysts, while eleven IMPs were identified in inflammatory cysts but not BD-IPMN. Notably, granulocyte-macrophage colony-stimulating factor (GM-CSF) expression was present in all five inflammatory cyst samples. Hepatocyte growth factor (HGF) was present in significantly higher concentrations in inflammatory cysts compared to BD-IPMN.Conclusion: Our exploratory analysis reveals that GM-CSF and HGF in EUS-FNA-collected pancreatic cyst fluid can distinguish between BD-IPMN and inflammatory cyst. Coupling microarray molecular techniques to EUS-FNA may represent a major step forward to our understanding complex pancreatic disease. (C) 2012 Elsevier B.V. All rights reserved.