title: Double immunostaining for maspin and p53 on cell blocks increases the diagnostic value of biliary brushing cytology.
abstract: Our objective is to elucidate the usefulness of maspin/p53 double immunostaining on biliary brushing cytology specimens. We first examined the expression of maspin in the biliary epithelium with variable degrees of dysplasia using surgically resected specimens (n = 56). Maspin appeared to be overexpressed in a stepwise manner from benign to malignant cholangiocytes: the reactive epithelium (20%), biliary intraepithelial neoplasia (~50%), and invasive cholangiocarcinomas (>90%). Next, an automated sequential double immunostaining protocol for maspin and p53 was applied to paraffin-embedded cell blocks of the biliary brushing cytology specimens obtained from 58 consecutive patients. Cell block preparation was successful in 44 cases (76%), which were morphologically diagnosed as adenocarcinoma (n = 16), atypical cells not diagnostic for malignancy (n = 10), and benign (n  = 18). Double positive cells were observed in 14/16 (88%) morphologically malignant, 6/10 (60%) borderline, and 0/18 benign cases. All 20 positive cases were proven to have pancreatobiliary malignancies by subsequent imaging or pathological analyses. A similar staining protocol for S100P and p53 was also applied to the same cohort; however, the positive frequency was slightly lower than those of maspin and p53 (36% vs. 45%). In conclusion, Maspin/p53 double immunostaining on cell blocks contributes to the detection of malignant cells in biliary brushing cytology specimens.
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Kanzawa
authors.affiliation: Department of Gastroenterology, Kitaharima Medical Center, Ono, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sanuki
authors.affiliation: Department of Gastroenterology, NTT East Sapporo Hospital, Sapporo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Onodera
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Fujikura
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
mesh_terms: D065311:Adenocarcinoma in Situ / Q000175:diagnosis; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D018281:Cholangiocarcinoma / Q000175:diagnosis*; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D015843:Serpins / Q000032:analysis / Q000096:biosynthesis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis / Q000096:biosynthesis
chemical_list: D014408:Biomarkers, Tumor; C085344:SERPIN-B5; D015843:Serpins; D016159:Tumor Suppressor Protein p53
keywords: S100P; cell block; cholangiocarcinoma; cytology; maspin