Evaluation of MSX2 mRNA in brush cytology specimens distinguished pancreatic carcinoma from chronic pancreatitis
Evaluation of MSX2 mRNA in brush cytology specimens distinguished pancreatic carcinoma from chronic pancreatitis
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DOI：
10.1111/j.1349-7006.2010.01759.x
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发表时间：
2011-01
期刊：
影响因子：
5.7
通讯作者：
K. Satoh;S. Hamada;A. Kanno;K. Ishida;Hiromichi Ito;M. Hirota;A. Masamune;S. Egawa;M. Unno;T. Shimosegawa
中科院分区：
文献类型：
--
作者：
K. Satoh;S. Hamada;A. Kanno;K. Ishida;Hiromichi Ito;M. Hirota;A. Masamune;S. Egawa;M. Unno;T. Shimosegawa
当胰管存在狭窄时，很难区分胰腺导管腺癌（PDAC）和慢性胰腺炎（CP）。内窥镜刷检细胞学是检查胰管狭窄的一种方便方法，然而，据报道，该方法对PDAC的诊断灵敏度较低（40-70%）。最近，我们发现MSX 2经常在PDAC细胞中表达，但在正常培养的胰管或星状细胞中不表达。因此，我们分析了刷牙样本中的MSX 2表达水平，以检查这是否会区分PDAC和CP。对82例胰管狭窄患者行内镜逆行胰胆管造影术，采集胰管狭窄处的细胞刷检标本。对刷牙液进行细胞学诊断和RNA提取。通过一步真实的时间RT-PCR评价MSX 2的表达水平。MSX 2在PDAC中的表达水平显著高于CP（P = 0.000007），且表达水平与细胞学阳性相关（P = 0.013）。细胞学和MSX 2表达的PDAC诊断导管狭窄的敏感性、特异性和准确性分别为：47.4%、100%和63.4%; 73.7%、84.0%和79.3%。MSX 2表达水平诊断乳腺癌的敏感性和准确性明显高于细胞学检查。这表明评价内镜逆行胰胆管造影刷检样本中的MSX 2水平有助于区分PDAC和CP。（Cancer Sci 2011; 102：157-161）
It is difficult to distinguish pancreatic ductal adenocarcinoma (PDAC) from chronic pancreatitis (CP) when stricture is present in the pancreatic duct. Endoscopic brushing cytology is a convenient method for investigating strictures in the pancreatic duct, however, the diagnostic sensitivity of this method for PDAC is reported to be low (40–70%). Recently, we revealed that MSX2 is frequently expressed in PDAC cells but not in normal cultured pancreatic duct or stellate cells. Thus, we analyzed MSX2 expression levels in brushing samples to examine whether this would differentiate PDAC from CP. Cytologic brushing specimens were obtained from pancreatic duct strictures during endoscopic retrograde cholangiopancreaticography in 82 patients. The brushing fluid was subjected to cytological diagnosis and RNA extraction. The expression level of MSX2 was evaluated by one‐step real‐time RT‐PCR. MSX2 expression levels were significantly higher in PDAC than in CP (P = 0.0000007), and the expression level was associated with positive cytology (P = 0.013). The sensitivity, specificity, and diagnostic accuracy for PDAC of cytology and MSX2 expression in ductal strictures were: 47.4%, 100%, and 63.4%, and 73.7%, 84.0%, and 79.3%, respectively. The sensitivity and accuracy of MSX2 expression levels for diagnosis were much higher than those of cytology. This suggests that the evaluation of MSX2 levels in endoscopic retrograde cholangiopancreaticography brushing samples would be useful for distinguishing PDAC from CP. (Cancer Sci 2011; 102: 157–161)