title: Immunocytochemical detection of p53 protein from pancreatic duct brushings in patients with pancreatic carcinoma.
abstract: BACKGROUND
  It is often difficult to distinguish pancreatic carcinoma preoperatively from chronic pancreatitis. Therefore, we have developed a new method of detecting p53 immunoreactivity in cytologic material obtained by endoscopic retrograde pancreatic duct brushing (ERPDB).
  
  
  METHODS
  Twenty-eight patients with prominent strictures of the main pancreatic duct demonstrated by pancreatography including 20 ductal cell carcinoma and 8 chronic pancreatitis were studied. The ability to distinguish between these two groups preoperatively by conventional cytologic examination was compared with p53 immunocytochemistry using ERPDB:
  
  
  RESULTS
  The sensitivity, specificity, and overall accuracy of conventional cytologic examination in distinguishing ductal cell carcinoma from chronic pancreatitis were 60%, 100%, and 71% respectively. In comparison, the sensitivity, specificity, and overall accuracy of p53 immunocytochemistry in distinguishing were 90%, 100%, and 93%, respectively. The sensitivity of p53 staining of specimens from patients with carcinoma of the body or tail of the pancreas (90%) was the same for those with tumors of the head of the pancreas (90%).
  
  
  CONCLUSIONS
  These results suggest that p53 immunocytochemistry using ERPDB in conjunction with conventional cytologic examination can help differentiate ductal cell carcinoma from chronic pancreatitis preoperatively.
authors.affiliation: First Department of Internal Medicine, Hiroshima University School of Medicine. Japan
authors.forename: S
authors.initials: S
authors.lastname: Ishimaru
authors.forename: M
authors.initials: M
authors.lastname: Itoh
authors.forename: K
authors.initials: K
authors.lastname: Hanada
authors.forename: A
authors.initials: A
authors.lastname: Tsuchida
authors.forename: T
authors.initials: T
authors.lastname: Iwao
authors.forename: G
authors.initials: G
authors.lastname: Kajiyama
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000818:Animals; D002460:Cell Line; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D004396:Coloring Agents; D003251:Constriction, Pathologic; D003937:Diagnosis, Differential; D005260:Female; D005347:Fibroblasts; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D010183:Pancreatic Ducts / Q000737:chemistry*; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000175:diagnosis; D010195:Pancreatitis / Q000175:diagnosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: D004396:Coloring Agents; D009363:Neoplasm Proteins; D016159:Tumor Suppressor Protein p53