Detection of B7-H4 and p53 in pancreatic cancer: potential role as a cytological diagnostic adjunct.
OBJECTIVE
This study compared p53 expression with B7-H4, a novel cancer biomarker, in pancreatic ductal adenocarcinoma (PDA) resection specimens and in a pilot series of endoscopic ultrasound-guided fine-needle aspirations (EUS-FNAs).


METHODS
B7-H4 and p53 expression were evaluated by immunoperoxidase methods in 36 PDA and 15 EUS-FNA specimens and were scored for intensity and proportion of positive cells; cases were then assigned a final sum score.


RESULTS
B7-H4 was detected in 33 (92%) of 36 PDA sections, 8 (89%) of 9 cytologically positive EUS-FNAs, and 1 (20%) of 5 cytologically negative EUS-FNAs. p53 was detected in 30 (83%) of 36 PDA sections, 4 (44%) of 9 cytologically positive EUS-FNAs, and 1 (20%) of 5 cytologically negative cases. One EUS-FNA case that was cytologically atypical but not diagnostic of malignancy expressed B7-H4 and p53. Some benign tissue components (intercalated cells/ducts, main pancreatic ducts, and acinar cells) were also positive for B7-H4 and/or p53. Overall expression of B7-H4 in benign tissues, however, was relatively low compared with that seen in most carcinoma cases.


CONCLUSIONS
B7-H4 was expressed more often in PDA than was p53. Despite potentially problematic expression in benign/normal cells, the 2 markers target different cellular components and demonstrate potential diagnostic use for detection of PDA in resected and EUS-FNA specimens.
Awadallah
Nida S
NS
Division of Gastroenterology, Department of Internal Medicine, University of Colorado at Denver and Health Science Center, Aurora, CO 80045, USA.
Shroyer
Kenneth R
KR
Langer
Daniel A
DA
Torkko
Kathleen C
KC
Chen
Yang K
YK
Bentz
Joel S
JS
Papkoff
Jackie
J
Liu
Wenhui
W
Nash
S Russell
SR
Shah
Raj J
RJ
D000328:Adult; D000368:Aged; D018122:B7-1 Antigen / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D044963:Biopsy, Fine-Needle / Q000379:methods; D021441:Carcinoma, Pancreatic Ductal / Q000737:chemistry* / Q000473:pathology; D019160:Endosonography; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010179:Pancreas / Q000737:chemistry; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000473:pathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D016707:Tissue Fixation; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1
D018122:B7-1 Antigen; D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1; C475826:VTCN1 protein, human