Immunocytochemical detection of p53 protein from pancreatic duct brushings in patients with pancreatic carcinoma.
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.
Ishimaru
S
S
First Department of Internal Medicine, Hiroshima University School of Medicine. Japan
Itoh
M
M
Hanada
K
K
Tsuchida
A
A
Iwao
T
T
Kajiyama
G
G
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*
D004396:Coloring Agents; D009363:Neoplasm Proteins; D016159:Tumor Suppressor Protein p53