Abstract | BACKGROUND: DESIGN: We evaluated 35 pancreatectomy specimens diagnosed with type 2 AIP and potential mimics of this disease including type 1 AIP (n=14), chronic pancreatitis-not otherwise specified (n=10), groove pancreatitis (n=14), and PDAC (n=278). We scored inflammatory infiltrates, fibrosis and atrophy and performed immunohistochemical staining for PD-L1 and IDO1. We validated our findings on a series of endoscopic ultrasound-guided biopsies from patients with suspected type 2 AIP and inflammatory and neoplastic mimics of this disease (n=37). RESULTS: The mean age of patients with type 2 AIP was 50 years with a F:M ratio of 1.2:1. Patients with type 2 AIP showed pancreatic ductal staining for PD-L1 and IDO1 in 69% (24/35) and 60% (15/25) of cases, respectively. PD-L1 reactivity was noted in 3% of patients with other forms of chronic pancreatitis and 3% of PDACs; notably, peritumoral ducts and acini were negative. Eight of 9 endoscopic ultrasound-guided biopsies with pancreatic ductal epithelium from patients with type 2 AIP were positive for PD-L1, while the inflammatory and neoplastic mimics were negative. Collectively, the sensitivity and specificity of PD-L1 as a marker of type 2 AIP was 70% and 99%, respectively. CONCLUSIONS: Ductal PD-L1 reactivity has the potential to distinguish type 2 AIP from other forms of pancreatitis and PDAC.
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Authors | Rajib Gupta, Azfar Neyaz, Abhijit Chougule, Masayuki Akita, Yoh Zen, David Forcione, Carlos Fernandez-Del Castillo, Cristina R Ferrone, Vikram Deshpande |
Journal | The American journal of surgical pathology
(Am J Surg Pathol)
Vol. 43
Issue 7
Pg. 898-906
(07 2019)
ISSN: 1532-0979 [Electronic] United States |
PMID | 31135488
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- B7-H1 Antigen
- Biomarkers
- CD274 protein, human
- IDO1 protein, human
- Indoleamine-Pyrrole 2,3,-Dioxygenase
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Topics |
- Adult
- Aged
- Autoimmune Pancreatitis
(diagnosis, immunology, pathology, surgery)
- B7-H1 Antigen
(analysis)
- Biomarkers
(analysis)
- Carcinoma, Pancreatic Ductal
(diagnosis, immunology)
- Child
- Diagnosis, Differential
- Female
- Humans
- Immunohistochemistry
- Indoleamine-Pyrrole 2,3,-Dioxygenase
(analysis)
- Male
- Middle Aged
- Pancreas
(immunology, pathology, surgery)
- Pancreatectomy
- Pancreatic Neoplasms
(diagnosis, immunology)
- Predictive Value of Tests
- Reproducibility of Results
- Young Adult
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