Diagnostic value of IMP3 and p53 immunohistochemical staining in EUS-guided fine-needle aspiration for solid pancreatic tumors

Abstract

We previously identified insulin-like growth factor-II messenger ribonucleic acid-binding protein 3 (IMP3) as a valuable marker to distinguish malignant from benign lesions in pancreatic solid masses. The aim of this prospective study was to evaluate the usefulness of IMP3 and p53 immunohistochemical staining in endoscopic ultrasound-guided fine-needle aspiration (EUS–FNA) samples for pancreatic solid masses. The study recruited 90 consecutive patients with pancreatic masses, including 62 pancreatic ductal adenocarcinomas (PDACs), 11 benign tumors, and 17 other tumors, who underwent EUS–FNA, and conducted IMP3 and p53 immunohistochemical staining. The main outcome measurement was improved diagnostic utility using IMP3 and p53 immunohistochemical staining. IMP3 and p53 expressions were detected in 60.8% and 49.4% of malignant lesions, 69.4% and 58.1% of PDACs, and 0% of benign lesions, respectively. In PDAC and benign tumors, the use of IMP3 and/or p53 immunostaining increased the sensitivity of cytohistological analysis from 88.7 to 93.5%, although the difference was not statistically significant. The sensitivity of histological analysis combined with that of IMP3 staining was 91.9%, which was significantly greater than that of histology alone (80.6%). The use of IMP3 and p53 immunohistochemical staining did not significantly improve the sensitivity of cytohistological analysis; however, IMP3 staining may be helpful for the histological analysis of malignant pancreatic tumors.

Sensitivity of endoscopic ultrasound‐guided fine‐needle aspiration cytology and biopsy for a diagnosis of pancreatic ductal adenocarcinoma: A comparative analysis

“…We found diagnostic sensitivity to be lower than that previously reported, probably because we did not perform ROSE or macroscopic on-site evaluation (MOSE). 10,11,[25][26][27][28] However, the majority of reported studies have been conducted by clinicians, and there exists little detailed information regarding PDAC as diagnosed by pathologists on the basis of EUS-FNAC and EUS-FNAB.…”

Research advances of N6‐methyladenosine in diagnosis and therapy of pancreatic cancer

“…Compared with cytohistology alone, cytohistological analysis combined with IMP3 staining had substantially higher diagnostic sensitivity, specificity, and accuracy in endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) samples 85 . Tadic et al and Mikata et al also confirmed these findings 90,91 …”

“…In EUS‐FNA samples, IMP3 staining remarkably improves diagnostic sensitivity, specificity, and accuracy of cytohistological analysis of PDAC, facilitating the distinction between PDAC and benign pancreatic diseases. 91 Moreover, rs9939609 and rs7495G are FTO polymorphism and hnRNP polymorphism, respectively. Both rs9939609 and rs7495G are linked to PC risk, manifesting their potential in PC early diagnosis.…”

“…However, due to small specimens obtained by EUS–FNA, it is challenging in differentiating PC from benign pancreatic diseases. In EUS‐FNA samples, IMP3 staining remarkably improves diagnostic sensitivity, specificity, and accuracy of cytohistological analysis of PDAC, facilitating the distinction between PDAC and benign pancreatic diseases 91 . Moreover, rs9939609 and rs7495G are FTO polymorphism and hnRNP polymorphism, respectively.…”

Usefulness of Adding Maspin Staining to p53 Staining for EUS-FNA Specimens of Pancreatic Ductal Adenocarcinoma

“…Positive classification was inferred when the nucleus or cytoplasm of tumor cells above the cut off value (%) was stained ( Figure 2 ). With reference to past literature [ 21 , 22 , 23 ], p53 staining was inferred as positive when 60% or more of the tumor cell nuclei was stained. Sensitivity and specificity were analyzed for (1) the samples with only p53 staining, (2) only maspin staining, and (3) p53 staining + maspin staining (the test was considered positive if any marker was positive).…”