Immunohistochemical distinction between intrahepatic cholangiocarcinoma and pancreatic ductal adenocarcinoma.
Distinction between primary intrahepatic cholangiocarcinoma (ICC) and metastatic pancreatic ductal adenocarcinoma (PDA) on a liver biopsy is essentially impossible histologically but has important clinical implications. In this study, 41 ICCs and 60 PDAs were immunohistochemically evaluated for the expression of S100P, pVHL, IMP3, maspin, MUC5AC, and CK17 proteins. The results showed pVHL expression in 29 (71%) ICCs but in only 3 (5%) PDAs. S100P, MUC5AC, and CK17 were frequently expressed in PDAs, seen in 57 (95%), 40 (67%), and 36 (60%) cases, respectively. In contrast, only 11 (27%), 5 (12%), and 5 (12%) ICC cases expressed these proteins. IMP3 was expressed in 37 (90%) ICC and 54 (90%) PDA cases with equal frequency. All 60 (100%) PDA and 30 (73%) ICC cases showed positive maspin immunoreactivity. A S100P-/pVHL+/MUC5AC-/CK17- staining pattern was essentially indicative of ICC, whereas the S100P+/pVHL-/MUC5AC+/CK17+ and S100P+/pVHL-/MUC5AC-/CK17+ staining patterns were suggestive of PDA. These observations demonstrate that S100P, pVHL, MUC5AC, and CK17 are a useful immunohistochemical panel that may help distinguish primary ICC from metastatic PDA.
Department of Pathology and Laboratory Medicine, University of California at Los Angeles, Los Angeles, CA 90095.
Terry
T
Lok
Department of Pathology and Laboratory Medicine, University of California at Los Angeles, Los Angeles, CA 90095; Department of Pathology, School of Basic Medical Sciences of Fujian Medical University, Fuzhou, Fujian 350004, China.
Lihong
L
Chen
Department of Laboratory Medicine, Geisinger Medical Center, Danville, PA 17822.
Fan
F
Lin
Department of Pathology and Laboratory Medicine, University of California at Los Angeles, Los Angeles, CA 90095. Electronic address: hanlinwang@mednet.ucla.edu.
Hanlin L
HL
Wang
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000378:metabolism; D002135:Calcium-Binding Proteins / Q000032:analysis; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D053537:Keratin-17 / Q000032:analysis; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D055271:Mucin 5AC / Q000032:analysis; D009363:Neoplasm Proteins / Q000032:analysis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D051794:Von Hippel-Lindau Tumor Suppressor Protein / Q000032:analysis
D014408:Biomarkers, Tumor; D002135:Calcium-Binding Proteins; D053537:Keratin-17; C524678:MUC5AC protein, human; D055271:Mucin 5AC; D009363:Neoplasm Proteins; C103003:S100P protein, human; D051794:Von Hippel-Lindau Tumor Suppressor Protein; C497446:VHL protein, human
CK17; IMP3; Intrahepatic cholangiocarcinoma; MUC5AC; Maspin; Pancreatic ductal adenocarcinoma; S100P; pVHL