title: Usefulness of human telomerase reverse transcriptase in pancreatic juice as a biomarker of pancreatic malignancy.
abstract: OBJECTIVE
  Human telomerase reverse transcriptase (hTERT), one of the subunits of telomerase, is a promising diagnostic marker for pancreatic cancer. In the present study, we did a large-scale analysis of 115 preoperative pancreatic juice specimens to evaluate the feasibility of detection of hTERT expression by immunohistochemistry for preoperative diagnosis of pancreatic malignancy.
  
  
  METHODS
  The expression of hTERT was examined by immunohistochemistry in preoperative pancreatic juice samples.
  
  
  RESULTS
  In pancreatic juice samples, hTERT expression was detectable in 84% of pancreatic ductal adenocarcinomas (PDACs), whereas 62% of PDACs were positive by cytology. In intraductal papillary mucinous neoplasms (IPMNs), hTERT expression was detectable in 88% of malignant IPMNs, whereas only 22% were positive by cytology. The sensitivity, specificity, and overall accuracy of hTERT expression for differentiation between carcinoma and other benign diseases were 85.1%, 82.1%, and 84.3%, respectively, whereas the same values for cytologic accuracy were 47.1%, 89.3%, and 57.4%, respectively. When the results of cytology and hTERT expression were combined, the sensitivity and overall accuracy increased to 92.0% and 87.8%, respectively.
  
  
  CONCLUSIONS
  Our results suggested that the assessment of hTERT expression in preoperative pancreatic juice increased the sensitivity and accuracy of diagnosis of PDACs and malignant IPMNs without using special techniques.
authors.affiliation: Division of Clinical Medical Science, Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Minami-Ku, Hiroshima, Japan. anakashima@hiroshima-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Nakashima
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hayashidani
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sudo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
authors.forename: Miyo
authors.initials: M
authors.lastname: Oda
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
authors.forename: Eiso
authors.initials: E
authors.lastname: Hiyama