Novel Insights Into Immunohistochemical Analysis For Acinar Cell Neoplasm of The Pancreas: Carboxypeptidase A2, Carboxypeptidase A1, and Glycoprotein 2.
Novel Insights Into Immunohistochemical Analysis For Acinar Cell Neoplasm of The Pancreas: Carboxypeptidase A2, Carboxypeptidase A1, and Glycoprotein 2.
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胰腺腺泡细胞肿瘤免疫组织化学分析的新见解：羧肽酶 A2、羧肽酶 A1 和糖蛋白 2。
DOI：
10.1097/pas.0000000000002024
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hiraoka N.
中科院分区：
文献类型：
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作者：
Ishimoto-Namiki U;Ino Y;Esaki M;Shimada K;Saruta M;Hiraoka N.
腺泡细胞癌是一种罕见的高度恶性胰腺肿瘤。由于组织学的相似性，ACC通常很难与其他胰腺实性髓样肿瘤，特别是神经内分泌肿瘤（NEN）和导管内小管乳头状肿瘤（ITPN）区分开来。我们的目的是鉴定新的免疫组织化学标记物，这些标记物通常在具有腺泡细胞分化的肿瘤细胞中表达，并且对手术和小型活检标本都有用。选择在胰腺组织中的肿瘤性或非肿瘤性腺泡细胞中特异性表达的候选分子，其具有适用于免疫组织化学的特异性和可用抗体。我们选择了羧肽酶A1（CPA 1）、羧肽酶A2（CPA 2）和糖蛋白2（GP 2），它们分别在ACC（n= 27）或腺泡细胞分化的肿瘤中表达100%、100%和96%，包括混合性腺泡-神经内分泌癌（n= 9）、混合性腺泡-导管癌（n= 3）、胰腺母细胞瘤（n= 4）、腺泡囊变（n= 2），肿瘤细胞胞浆内呈颗粒状。CPA 2和CPA 1在任何其他无腺泡细胞分化的肿瘤中均不表达，包括NEN（n= 44）、胰腺导管腺癌（n= 44）和ITPN（n= 4）。GP 2在这些肿瘤中不表达，除了在罕见的情况下，包括14%的NEN，15%的导管内乳头状粘液性肿瘤，25%的导管内嗜酸性乳头状肿瘤，25%的ITPN和7%的胰腺导管腺癌，其中一小部分肿瘤细胞在其顶端细胞膜中表达GP 2。NEN病例也有胞浆GP 2表达。因此，CPA 2、CPA 1和潜在的GP 2可以作为ACC标志物。
Acinar cell carcinoma (ACC) is a rare and highly malignant pancreatic tumor. Owing to histologic similarity, ACC is often difficult to distinguish from other solid medullary pancreatic tumors, particularly neuroendocrine neoplasm (NEN) and intraductal tubulopapillary neoplasm (ITPN). We aimed to identify new immunohistochemical markers commonly expressed in tumor cells with acinar cell differentiation and useful for both surgical and small biopsy specimens. Candidate molecules exclusively expressed in neoplastic or non-neoplastic acinar cells in pancreatic tissues with specific and available antibodies suitable for immunohistochemistry were selected. We selected carboxypeptidase A1 (CPA1), carboxypeptidase A2 (CPA2), and glycoprotein 2 (GP2), which were expressed in 100%, 100%, and 96% of cases, respectively, in ACC (n= 27) or neoplasia with acinar cell differentiation, including mixed acinar-neuroendocrine carcinoma (n= 9), mixed acinar-ductal carcinoma (n= 3), pancreatoblastoma (n= 4), and acinar cystic transformation (n= 2), in the cytoplasm of tumor cells with a granular pattern. Both CPA2 and CPA1 were not expressed in any other tumors without acinar cell differentiation, including NEN (n= 44), pancreatic ductal adenocarcinoma (n= 44), and ITPN (n= 4). GP2 was not expressed in these tumors except in rare cases, including 14% of NEN, 15% of intraductal papillary-mucinous neoplasm, 25% of intraductal oncocytic papillary neoplasm, 25% of ITPN, and 7% of pancreatic ductal adenocarcinoma, wherein a small proportion of tumor cells expressed GP2 in their apical cell membrane. NEN cases also showed cytoplasmic GP2 expression. Therefore, CPA2, CPA1, and potentially GP2 may act as ACC markers.