Plectin-1 as a Biomarker of Malignant Progression in Intraductal Papillary Mucinous Neoplasms: A Multicenter Study.
This study aimed to evaluate Plectin-1 expression as a biomarker of malignant risk for intraductal papillary mucinous neoplasms (IPMNs).



Plectin-1 immunohistochemistry (IHC) was performed retrospectively on surgical (n = 71) and cytological (n = 33) specimens from Mayo Clinic Jacksonville and UCLA Medical Center, including IPMNs with low-grade dysplasia, high-grade dysplasia (HGD), or an associated invasive adenocarcinoma.



Plectin-1 expression was increased in invasive adenocarcinoma compared with adjacent in situ IPMN (P = 0.005), as well as the in situ HGD component of IPMNs with invasive cancer compared with HGD of IPMNs without invasive cancer (P = 0.02). Plectin IHC discriminated IPMNs with invasive adenocarcinoma from noninvasive IPMN (area under the curve [AUC] of 0.79, 75% sensitivity, and 85% specificity) but was insufficient for discriminating HGD IPMN from low-grade dysplasia IPMNs in surgical resections (AUC of 0.67, 56% sensitivity, and 64% specificity) or fine-needle aspiration specimens (AUC of 0.45).



Although Plectin-1 IHC has insufficient accuracy to be used as a definitive biomarker for malignant risk in the evaluation of IPMN biopsy or cytological specimens, increased Plectin-1 expression observed in both invasive cancer and in situ HGD of malignant IPMNs suggests that it might be successfully leveraged as a cyst fluid biomarker or molecular imaging target.
From the *Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL; †Department of Pathology and Laboratory Medicine and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA; Departments of ‡Pathology and Laboratory Medicine, and §Cancer Biology, Mayo Clinic, Jacksonville, FL; ∥Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; and ¶Department of Bioengineering, School of Engineering and Applied Sciences, and #Robert M. Berne Cardiovasuclar Research Center, School of Medicine, University of Virginia, Charlottesville, VA.
Maria
M
Moris
David W
DW
Dawson
Jennifer
J
Jiang
Jason
J
Lewis
Aziza
A
Nassar
Kenneth K
KK
Takeuchi
Anna R
AR
Lay
Qihui
Q
Zhai
Timothy R
TR
Donahue
Kimberly A
KA
Kelly
Howard C
HC
Crawford
Michael
M
Wallace
D002288:Adenocarcinoma, Mucinous; D014408:Biomarkers, Tumor; D021441:Carcinoma, Pancreatic Ductal; D006801:Humans; D010190:Pancreatic Neoplasms; D051190:Plectin
D014408:Biomarkers, Tumor; D051190:Plectin