title: Immunohistochemical Antibody Panel for the Differential Diagnosis of Pancreatic Ductal Carcinoma From Gastrointestinal Contamination and Benign Pancreatic Duct Epithelium in Endoscopic Ultrasound-Guided Fine-Needle Aspiration.
abstract: The diagnosis of pancreatic ductal adenocarcinoma (PDAC) by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) can be challenging to distinguish tumor cells from benign epithelium (BE). The aim of the present study was to set a minimal antibody panel to differentiate PDAC from contaminated BE in EUS-FNA specimens.
  
  
  
  Immunohistochemistry using claudin 4, EZH2, Ki-67, maspin, p53, and S100P was performed on tissue microarray sections containing 53 PDACs and 33 BE as well as cell blocks of EUS-FNA including 53 PDACs and 22 BE. The positive rate was scored as 0 to 4+. The receiver operating characteristic curve was applied to determine a cutoff point, and the Classification And Regression Trees method was used to obtain a classification tree of the best panel.
  
  
  
  The cutoff point was 1+ for claudin 4, EZH2, Ki-67, p53, and S100P and 2+ for maspin. All BE scored 0 for p53. The classification tree revealed using p53, S100P, and claudin 4 was the most powerful. The sensitivity and specificity of the tree were 96.2% and 100% in tissue microarrays and 100% and 95.5% in EUS-FNA, respectively.
  
  
  
  The classification tree using p53, S100P, and claudin 4 seems to successfully distinguish PDAC from the accompanying BE.
authors.affiliation: From the *Department of Diagnostic Pathology, †Human Health Sciences, and ‡Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Furuhata
authors.forename: Sachiko
authors.initials: S
authors.lastname: Minamiguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shirahase
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Kodama
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
authors.forename: Takaki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
mesh_terms: D000906:Antibodies / Q000276:immunology; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000276:immunology; D002135:Calcium-Binding Proteins / Q000032:analysis / Q000276:immunology; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism* / Q000473:pathology; D062506:Claudin-4 / Q000032:analysis / Q000276:immunology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D000071221:Enhancer of Zeste Homolog 2 Protein / Q000032:analysis / Q000276:immunology; D004848:Epithelium / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D019394:Ki-67 Antigen / Q000032:analysis / Q000276:immunology; D009363:Neoplasm Proteins / Q000032:analysis / Q000276:immunology; D010183:Pancreatic Ducts / Q000378:metabolism* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015843:Serpins / Q000032:analysis / Q000276:immunology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis / Q000276:immunology
chemical_list: D000906:Antibodies; D014408:Biomarkers, Tumor; D002135:Calcium-Binding Proteins; D062506:Claudin-4; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; C103003:S100P protein, human; C085344:SERPIN-B5; D015843:Serpins; D016159:Tumor Suppressor Protein p53; C498409:EZH2 protein, human; D000071221:Enhancer of Zeste Homolog 2 Protein