title: Double immunohistochemical staining with MUC4/p53 is useful in the distinction of pancreatic adenocarcinoma from chronic pancreatitis: a tissue microarray-based study.
abstract: BACKGROUND
  Immunohistochemical stains have been used for the distinction of pancreatic adenocarcinoma from chronic pancreatitis.
  
  
  OBJECTIVE
  To determine if a double stain for MUC/p53 improved specificity and sensitivity for distinction of pancreatic adenocarcinoma from chronic pancreatitis by comparing maspin, mucin 4 (MUC4), p53, Smad4, and the double stain MUC4/p53.
  
  
  METHODS
  Seventy-four pancreatic adenocarcinomas and 19 chronic pancreatitis cases were retrieved from archival files. Tissue cores were arrayed to create a tissue microarray of 2-mm cores. Sections were stained with antibodies against maspin, MUC4, p53, and Smad4. Additionally, a 2-color, double stain for MUC4 and p53 was developed and evaluated. Five percent or greater staining in either of the cores was considered positive. Intensity (0, 1, 2) and extent (%) of tumor cells staining was also determined.
  
  
  RESULTS
  The sensitivity for distinction of pancreatic adenocarcinoma from chronic pancreatitis with maspin, MUC4, p53, and Smad4 was 90%, 77%, 60%, and 63%, respectively; the specificity was 67%, 78%, 88%, and 88%, respectively. When MUC4 and p53 were combined in a double stain, and positive staining for either considered a positive result, the sensitivity increased to 96% but specificity was 73%. When immunoreactivity for both antibodies was necessary for a positive result, sensitivity fell to 39% but specificity was 100%. No correlation was found between intensity or extent of staining with any of the individual stains and tumor differentiation.
  
  
  CONCLUSIONS
  The double immunohistochemical stain for MUC4/p53 can be a useful diagnostic tool in conjunction with the hematoxylin-eosin-stained section for pancreatic adenocarcinoma, particularly when limited tumor is available for multiple stains.
authors.affiliation: Department of Pathology, Ohio State University, Columbus, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Bhardwaj
authors.forename: William L
authors.initials: WL
authors.lastname: Marsh
authors.forename: Jason W
authors.initials: JW
authors.lastname: Nash
authors.forename: Catalin C
authors.initials: CC
authors.lastname: Barbacioru
authors.forename: Susie
authors.initials: S
authors.lastname: Jones
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Frankel
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D055264:Mucin-4; D009077:Mucins / Q000378:metabolism*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000378:metabolism; D012680:Sensitivity and Specificity; D015843:Serpins / Q000378:metabolism; D051901:Smad4 Protein / Q000378:metabolism; D046888:Tissue Array Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C524658:MUC4 protein, human; D055264:Mucin-4; D009077:Mucins; C085344:SERPIN-B5; D015843:Serpins; D051901:Smad4 Protein; D016159:Tumor Suppressor Protein p53