title: An immunohistochemical marker panel including claudin-18, maspin, and p53 improves diagnostic accuracy of bile duct neoplasms in surgical and presurgical biopsy specimens.
abstract: Biliary tract cancers have an extremely poor outcome, and specific diagnostic markers and effective treatments are needed urgently. In this study, we assessed the capacity of panel of immunohistochemical markers including claudin-18, maspin, and p53 to distinguish biliary tract carcinoma and biliary intraepithelial neoplasia (BilIN) from non-neoplastic epithelium. We performed a retrospective study of 66 biliary tract cancer specimens and 63 specimens with non-neoplastic lesions. Of the surgical specimens, 96.7 % with adenocarcinoma/BilIN were detected as neoplastic, and all 63 specimens histologically diagnosed as non-neoplastic lesion were detected as non-neoplastic with high sensitivity (91.1 %) and specificity (100 %). Of presurgical endobiliary forceps biopsy specimens, all with adenocarcinoma/BilIN and only 1 of the 19 with a non-neoplastic lesion were distinguished as neoplastic with high sensitivity (100 %) and specificity (94.7 %). Moreover, this panel provided good separation of neoplasm from malignancy-undetermined atypical epithelium (18/21, 85.7 %). This panel achieves a more reliable distinction of biliary tract cancers and BilINs from non-neoplastic epithelia in both surgical and biopsy specimens than immunohistochemical analysis with single antibodies and is useful in supporting a diagnosis of adenocarcinoma and BilIN.
authors.affiliation: Departments of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Keira
authors.forename: Akira
authors.initials: A
authors.lastname: Takasawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Murata
authors.forename: Masanori
authors.initials: M
authors.lastname: Nojima
authors.forename: Kumi
authors.initials: K
authors.lastname: Takasawa
authors.forename: Jiro
authors.initials: J
authors.lastname: Ogino
authors.forename: Yukimura
authors.initials: Y
authors.lastname: Higashiura
authors.forename: Ayaka
authors.initials: A
authors.lastname: Sasaki
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Toru
authors.initials: T
authors.lastname: Mizuguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
authors.forename: Norimasa
authors.initials: N
authors.lastname: Sawada
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hasegawa
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D001652:Bile Ducts / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001706:Biopsy; D057167:Claudins / Q000378:metabolism*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015843:Serpins / Q000378:metabolism*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C486683:CLDN18 protein, human; D057167:Claudins; C085344:SERPIN-B5; D015843:Serpins; D016159:Tumor Suppressor Protein p53