title: Utility of immunohistochemistry in the pancreatobiliary tract.
abstract: BACKGROUND
  Immunohistochemistry has become a useful ancillary study in the identification and classification of pancreatic neoplasms. The diagnostic accuracy has been significantly improved because of the continuous discoveries of tumor-associated biomarkers and the development of effective immunohistochemical panels.
  
  
  OBJECTIVE
  To identify and classify pancreatic neoplasms by immunohistochemistry.
  
  
  METHODS
  Literature review and authors' research data and personal practice experience were used.
  
  
  CONCLUSIONS
  To better guide therapeutic decisions and predict the prognostic outcome, it is crucial to make an accurate diagnosis of a pancreatic neoplasm. Application of appropriate immunohistochemical panels enables pathologists to differentiate pancreaticobiliary adenocarcinomas from reactive conditions and to identify rare types of pancreatic neoplasms. Knowing the utilities and pitfalls of each tumor-associated biomarker is essential to avoiding a potential diagnostic error because an absolutely cancer-specific biomarker does not exist. This article reviews frequently used tumor-associated biomarkers, provides lists of effective immunohistochemical panels, and recommends a diagnostic algorithm as a standard approach to pancreatic neoplasms.
authors.affiliation: From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania (Drs Lin and Chen); and the Department of Pathology, University of California, Los Angeles (Dr Wang).
authors.forename: Fan
authors.initials: F
authors.lastname: Lin
authors.forename: Zongming Eric
authors.initials: ZE
authors.lastname: Chen
authors.forename: Hanlin L
authors.initials: HL
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000378:metabolism*; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor