Immunocytochemistry for MUC4 and MUC16 is a useful adjunct in the diagnosis of pancreatic adenocarcinoma on fine-needle aspiration cytology.
Immunocytochemistry for MUC4 and MUC16 is a useful adjunct in the diagnosis of pancreatic adenocarcinoma on fine-needle aspiration cytology.
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DOI：
10.5858/arpa.2011-0229-oa
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发表时间：
2013-04
影响因子：
4.6
通讯作者：
Lele SM
中科院分区：
文献类型：
--
作者：
Horn A;Chakraborty S;Dey P;Haridas D;Souchek J;Batra SK;Lele SM
在不同的研究中，胰腺肿块的细针穿刺（FNA）诊断为非典型/可疑恶性肿瘤的范围为2%至29%。我们已经确定了3个基因MUC4、MUC16和NGAL的表达在胰腺腺癌中高度上调。在本研究中，我们分析了这些标记物在FNA样本中的表达，以确定它们是否可以提高敏感性和特异性。评价MUC4、MUC16和NGAL在胰腺FNA标本评价中的应用价值。回顾了连续10年进行胰腺FNAs的记录。对相应细胞块的未染色切片进行MUC4、MUC16和NGAL（多克隆）免疫染色。免疫染色采用h评分（范围0-3）进行评估。h值为bb0.5的病例均为阳性。病例根据细胞形态学标准分为腺癌（31 / 64,48.4%）、良性（17 / 64,26.6%）和非典型/可疑（16 / 64,25%）。在随访中，所有细胞学诊断为癌的病例（100%;31 / 31）均通过活检/切除样本或临床随访（如不可切除的疾病）得到证实。在诊断为非典型/可疑的病例中，69%（16例中的11例）的腺癌阳性，31%（16例中的5例）的后续随访为良性。各种标志物检测胰腺腺癌的总体敏感性和特异性分别为MUC4（74%和100%）、MUC16（62.9%和100%）和NGAL（61.3%和58.8%）。在细胞学不典型/可疑的病例中，MUC4和MUC16的表达对肿瘤的特异性为100%，敏感性分别为63.6%和66.7%。MUC4和MUC16的免疫细胞化学似乎是胰腺FNA样本分类的有用辅助手段，特别是在细胞形态学评估不明确（非典型/可疑）腺癌的病例中。
Diagnoses rendered as atypical/suspicious for malignancy on fine-needle aspiration (FNA) of pancreatic mass lesions range from 2% to 29% in various studies. We have identified the expression of 3 genes, MUC4, MUC16, and NGAL that are highly upregulated in pancreatic adenocarcinoma. In this study, we analyzed the expression of these markers in FNA samples to determine whether they could improve sensitivity and specificity. To evaluate the utility of MUC4, MUC16, and NGAL in the evaluation of pancreatic FNA specimens. Records of pancreatic FNAs performed during 10 consecutive years were reviewed. Unstained sections from corresponding cell blocks were immunostained for MUC4, MUC16, and NGAL (polyclonal). Immunostaining was assessed using the H-score (range, 0–3). Any case with an H-score of >0.5 was considered positive. Cases were classified using cytomorphologic criteria as adenocarcinoma (31 of 64; 48.4%), benign (17 of 64; 26.6%), and atypical/suspicious (16 of 64; 25%). On follow-up, all cases (100%; 31 of 31) diagnosed as carcinoma on cytology were confirmed on biopsy/resection samples or by clinical follow-up (such as unresectable disease). Of the cases diagnosed as atypical/suspicious, 69% (11 of 16) were found to be positive for adenocarcinoma and 31% (5 of 16) were benign on subsequent follow-up. Overall sensitivity and specificity, respectively, for the various markers for the detection of pancreatic adenocarcinoma were as follows: MUC4 (74% and 100%), MUC16 (62.9% and 100%), and NGAL (61.3% and 58.8%). In cases that were atypical/suspicious on cytology, expression of MUC4 and MUC16 was 100% specific for carcinoma with sensitivities of 63.6% and 66.7%, respectively. Immunocytochemistry for MUC4 and MUC16 appears to be a useful adjunct in the classification of pancreatic FNA samples, especially in cases that are equivocal (atypical/suspicious) for adenocarcinoma on cytomorphologic assessment.