Double immunohistochemical staining with MUC4/p53 is useful in the distinction of pancreatic adenocarcinoma from chronic pancreatitis: a tissue microarray-based study.

Abstract

CONTEXT:

Immunohistochemical stains have been used for the distinction of pancreatic adenocarcinoma from chronic pancreatitis.

OBJECTIVE:

To determine if a double stain for MUC/p53 improved specificity and sensitivity for distinction of pancreatic adenocarcinoma from chronic pancreatitis by comparing maspin, mucin 4 (MUC4), p53, Smad4, and the double stain MUC4/p53.

DESIGN:

Seventy-four pancreatic adenocarcinomas and 19 chronic pancreatitis cases were retrieved from archival files. Tissue cores were arrayed to create a tissue microarray of 2-mm cores. Sections were stained with antibodies against maspin, MUC4, p53, and Smad4. Additionally, a 2-color, double stain for MUC4 and p53 was developed and evaluated. Five percent or greater staining in either of the cores was considered positive. Intensity (0, 1, 2) and extent (%) of tumor cells staining was also determined.

RESULTS:

The sensitivity for distinction of pancreatic adenocarcinoma from chronic pancreatitis with maspin, MUC4, p53, and Smad4 was 90%, 77%, 60%, and 63%, respectively; the specificity was 67%, 78%, 88%, and 88%, respectively. When MUC4 and p53 were combined in a double stain, and positive staining for either considered a positive result, the sensitivity increased to 96% but specificity was 73%. When immunoreactivity for both antibodies was necessary for a positive result, sensitivity fell to 39% but specificity was 100%. No correlation was found between intensity or extent of staining with any of the individual stains and tumor differentiation.

CONCLUSION:

The double immunohistochemical stain for MUC4/p53 can be a useful diagnostic tool in conjunction with the hematoxylin-eosin-stained section for pancreatic adenocarcinoma, particularly when limited tumor is available for multiple stains.

• Authors: Atul Bhardwaj, William L Marsh Jr, Jason W Nash, Catalin C Barbacioru, Susie Jones, Wendy L Frankel
• Journal: Archives of pathology & laboratory medicine (Arch Pathol Lab Med) Vol. 131 Issue 4 Pg. 556-62 (Apr 2007) ISSN: 1543-2165 [Electronic] United States
• PMID: 17425384 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biomarkers, Tumor
• MUC4 protein, human
• Mucin-4
• Mucins
• SERPIN-B5
• Serpins
• Smad4 Protein
• Tumor Suppressor Protein p53

Topics

• Adenocarcinoma (diagnosis, metabolism)
• Biomarkers, Tumor (analysis)
• Diagnosis, Differential
• Humans
• Immunohistochemistry
• Mucin-4
• Mucins (metabolism)
• Pancreatic Neoplasms (diagnosis, metabolism)
• Pancreatitis, Chronic (diagnosis, metabolism)
• Sensitivity and Specificity
• Serpins (metabolism)
• Smad4 Protein (metabolism)
• Tissue Array Analysis
• Tumor Suppressor Protein p53 (metabolism)