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Immunocytochemical study of the expression of mesothelin in fine-needle aspiration biopsy specimens of pancreatic adenocarcinoma.

Abstract
Mesothelin is a potential marker of pancreatic adenocarcinoma that was recently identified by serial analysis of gene expression. We evaluated the sensitivity and specificity of mesothelin as a marker of pancreatic adenocarcinoma on destained Papanicolaou (Pap) smears and unstained cellblocks from 28 patients using a monoclonal antibody to mesothelin. Intensity and proportion of staining was semiquantitatively graded on a scale of 1-3, and as 0%, 1 to <10%, 10-50%, or >50%. Positive staining for mesothelin was seen in 64% of the direct smears and in 36% of cell block sections. Focal positivity for mesothelin was noted in benign pancreatic tissue in one of 10 cases. Staining was most often focal (<50% of cells) in both direct smears and cell block sections. The overall sensitivity and specificity of mesothelin as a marker for pancreatic adenocarcinoma were 68% and 90%, respectively. Sensitivity was higher in Pap smears than in cell block sections (64% versus 36%). The presence of occasional mesothelin expression in benign tissue, its very focal expression in malignant tissue may limit the utility of mesothelin as a marker of pancreatic adenocarcinomas in fine-needle aspiration (FNA) specimens.
AuthorsAmy C Baruch, Huamin Wang, Gregg A Staerkel, Douglas B Evans, Rosa Frances Hwang, Savitri Krishnamurthy
JournalDiagnostic cytopathology (Diagn Cytopathol) Vol. 35 Issue 3 Pg. 143-7 (Mar 2007) ISSN: 8755-1039 [Print] United States
PMID17304533 (Publication Type: Journal Article)
Chemical References
  • GPI-Linked Proteins
  • Membrane Glycoproteins
  • Mesothelin
Topics
  • Adenocarcinoma (diagnosis, pathology)
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle
  • Female
  • GPI-Linked Proteins
  • Humans
  • Immunohistochemistry
  • Male
  • Membrane Glycoproteins (metabolism)
  • Mesothelin
  • Middle Aged
  • Pancreas (pathology)
  • Pancreatic Neoplasms (diagnosis, pathology)
  • Papanicolaou Test
  • Vaginal Smears

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