title: Immunocytochemistry for Claudin-18 and Maspin in biliary brushing cytology increases the accuracy of diagnosing pancreatobiliary malignancies.
abstract: OBJECTIVE
  Biliary brush cytology is an important diagnostic tool in the evaluation of pancreatobiliary malignancies. However, it is difficult to distinguish between malignant and benign cells. The present study evaluated the utility of immunocytochemical expression of Claudin-18 and Maspin in brushing cytology specimens of pancreatobiliary lesions in the diagnosis of pancreatobiliary malignancies.
  
  
  METHODS
  The study retrospectively assessed biliary and pancreatic duct brushing cytology specimens of 43 patients whose pancreatobiliary lesions were histologically diagnosed at the University of Miyazaki Hospital. Scanty cellularity slides and cases with no histological confirmation were excluded. Alcohol-fixed and Papanicolaou-stained slides were immunostained with monoclonal antibodies to Claudin-18 and Maspin.
  
  
  RESULTS
  Of the 43 patients, 35 (81.4%) were finally histologically diagnosed with invasive adenocarcinomas. The sensitivity of routine cytology for the detection of malignancy was 63%, and the specificity was 100%. The sensitivity of cytology in combination with immunocytochemical expression of Claudin-18 (89%) or Claudin-18 and/or Maspin (97%) was significantly higher than that of cytology alone (P < 0.01).
  
  
  CONCLUSIONS
  Immunocytochemical staining for Claudin-18 and Maspin improved the diagnostic sensitivity for pancreatobiliary adenocarcinomas.
authors.affiliation: Division of Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tokumitsu
authors.affiliation: Division of Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.|Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Pathology, Faculty of Medicine, Miyazaki, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Yamashita
authors.affiliation: Division of Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.|Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Moriguchi-Goto
authors.affiliation: Community Medical Center, Faculty of Medicine, Miyazaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nanashima
authors.affiliation: Department of Pathology, Faculty of Medicine, Miyazaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Asada
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D057167:Claudins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015843:Serpins / Q000378:metabolism*
chemical_list: C486683:CLDN18 protein, human; D057167:Claudins; C085344:SERPIN-B5; D015843:Serpins
keywords: Claudin-18; Maspin; brush cytology; immunocytochemistry; pancreatobiliary adenocarcinomas