Immunohistochemical analysis of IMP3 and p53 expression in endoscopic ultrasound-guided fine needle aspiration and resected specimens of pancreatic diseases
Immunohistochemical analysis of IMP3 and p53 expression in endoscopic ultrasound-guided fine needle aspiration and resected specimens of pancreatic diseases
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DOI：
10.1016/j.pan.2017.12.010
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发表时间：
2018-03-01
期刊：
影响因子：
3.6
通讯作者：
Kato, Naoya
中科院分区：
文献类型：
--
作者：
Senoo, Junichi;Mikata, Rintaro;Kato, Naoya
背景：胰岛素样生长因子II信使核糖核酸结合蛋白3 （IMP3）是区分良恶性病变和预测预后的重要标志物。方法：首先，我们评估了77例胰腺导管腺癌（PDAC）、导管内乳头状粘液瘤（IPMN）和慢性胰腺炎（CP）切除标本中IMP3的表达。术前11例PDAC患者行超声内镜引导下细针穿刺（EUS-FNA）。进行IMP3和临床病理因素的生存分析。在另外127例实体胰腺肿块的EUS-FNA样本中评估IMP3和p53的表达，比较常规和免疫组织化学染色的诊断价值。结果：在PDAC、恶性IPMN、良性IPMN、CP中，分别有72.3%、50%、20%、0%的患者检测到IMP3的表达。11例EUS-FNA标本中有10例的IMP3表达与切除标本中的表达一致。单因素分析显示，PDAC样本中IMP3表达与肿瘤分化相关（p = 0.006），预后较差（p = 0.045）。通过多因素分析，肿瘤分化和淋巴结转移与预后不良有显著相关性。在EUS-FNA标本中，细胞组织学分析的敏感性为80.8%，特异性为100%，准确性为85.0%。恶性病变中分别有80.8%和44.9%、良性病变中分别有0%和5%检测到IMP3和p53的表达。结合IMP3免疫染色，细胞组织学分析的敏感性、特异性和准确性分别显著提高至87.9%、100%和90.8% （p = 0.016）。同时，p53染色对结果无影响。结论：IMP3免疫组化染色可提高EUS-FNA对胰腺恶性肿瘤的诊断准确性。（三）2018年IAP和EPC。Elsevier B.V.版权所有。
Background: Insulin-like growth factor II messenger ribonucleic acid-binding protein 3 (IMP3) is a valuable marker that distinguishes malignant from benign lesions and predicts prognosis.Methods: First, we evaluated IMP3 expression in 77 resected specimens of pancreatic ductal adenocarcinoma (PDAC), intraductal papillary mucinous neoplasm (IPMN), and chronic pancreatitis (CP). Eleven PDAC patients preoperatively underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Survival analysis of IMP3 and clinicopathological factors was performed. IMP3 and p53 expression was evaluated in another 127 EUS-FNA samples of solid pancreatic masses to compare the diagnostic value of routine and immunohistochemical staining.Results: IMP3 expression was detected in 72.3%, 50%, 20%, and 0% of PDAC, malignant IPMN, benign IPMN, and CP, respectively. Evaluation of IMP3 expression in EUS-FNA specimens coincided with that in resected specimens in 10 of 11. IMP3 expression correlated with tumor differentiation in PDAC samples (p = .006) and with poor prognosis through univariate analysis (p = .045). Tumor differentiation and lymph node metastasis were significantly associated with poor prognosis through multivariate analysis. In EUS-FNA specimens, the sensitivity, specificity, and accuracy of cytohistological analysis were 80.8%, 100%, and 85.0%, respectively. IMP3 and p53 expression were detected in 80.8% and 44.9% of malignant and 0% and 5% of benign lesions. Combined with IMP3 immunostaining, the sensitivity, specificity and accuracy of cytohistological analysis significantly increased to 87.9%, 100%, and 90.8% (p = .016), respectively. Meanwhile, p53 staining had no impact on the results.Conclusions: IMP3 immunohistochemical staining can improve the diagnostic accuracy of EUS-FNA for malignant pancreatic tumors. (C) 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.