CRABP-II is a highly sensitive and specific diagnostic molecular marker for pancreatic ductal adenocarcinoma in distinguishing from benign pancreatic conditions.
CRABP-II, a retinoic acid binding protein, shuffles retinoic acid from cytoplasm into nucleus and forms a complex with nuclear retinoic acid receptor to facilitate transcriptional activities of retinoic acid. In this study, we studied the expression patterns of CRABP-II in pancreatic ductal adenocarcinoma (PDAC) compared with those in normal pancreas, chronic pancreatitis, and precancerous lesions. We showed no detectable expressions of CRABP-II in normal pancreatic parenchyma, normal ductal epithelium, and chronic pancreatitis. In contrast, the expression of CRABP-II was readily detected in all PDACs including metastatic PDACs. CRABP-II staining was also observed and progressively increased from pancreatic intraepithelial neoplasia 1 to 3. In addition, when fine needle aspiration specimens were evaluated from patients with PDAC, CRABP-II was positive in 55.6% cases if cytology diagnosis was "atypia," and in 87.5% cases, if "malignancy." Our study suggests that CRABP-II is highly and specifically expressed in PDAC and is more commonly expressed in high-grade precursor cancerous lesions than in low-grade lesions. Therefore, overexpression of CRABP-II is a late event of pancreatic carcinogenesis, and it could be used as a diagnostic marker to distinguish PDAC from other benign pancreatic conditions in both resection and cytology specimens.
Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH 44106.
Wenbin
W
Xiao
Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH 44106.
Hong
H
Hong
Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH 44106.
Amad
A
Awadallah
Case Western Reserve University, Cleveland, OH 44106.
Shuiliang
S
Yu
Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH 44106; Case Western Reserve University, Cleveland, OH 44106.
Lan
L
Zhou
Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH 44106; Case Western Reserve University, Cleveland, OH 44106. Electronic address: wei.xin@case.edu.
Wei
W
Xin
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D018168:Receptors, Retinoic Acid / Q000032:analysis*; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D018168:Receptors, Retinoic Acid; C082928:retinoic acid binding protein II, cellular
CRABP-II; Cytology; Immunohistochemistry; Pancreatic duct adenocarcinoma; Pancreatic intraepithelial neoplasm; Pathology; Retinoic acid