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Immunohistochemical distinction between intrahepatic cholangiocarcinoma and pancreatic ductal adenocarcinoma

Summary Distinction between primary intrahepatic cholangiocarcinoma (ICC) and metastatic pancreatic ductal adenocarcinoma (PDA) on a liver biopsy is essentially impossible histologically but has important clinical implications. In this study, 41 ICCs and 60 PDAs were immunohistochemically evaluated...

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Published in:Human pathology 2014-02, Vol.45 (2), p.394-400
Main Authors: Lok, Terry, BS, Chen, Lihong, MD, PhD, Lin, Fan, MD, PhD, Wang, Hanlin L., MD, PhD
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description Summary Distinction between primary intrahepatic cholangiocarcinoma (ICC) and metastatic pancreatic ductal adenocarcinoma (PDA) on a liver biopsy is essentially impossible histologically but has important clinical implications. In this study, 41 ICCs and 60 PDAs were immunohistochemically evaluated for the expression of S100P, pVHL, IMP3, maspin, MUC5AC, and CK17 proteins. The results showed pVHL expression in 29 (71%) ICCs but in only 3 (5%) PDAs. S100P, MUC5AC, and CK17 were frequently expressed in PDAs, seen in 57 (95%), 40 (67%), and 36 (60%) cases, respectively. In contrast, only 11 (27%), 5 (12%), and 5 (12%) ICC cases expressed these proteins. IMP3 was expressed in 37 (90%) ICC and 54 (90%) PDA cases with equal frequency. All 60 (100%) PDA and 30 (73%) ICC cases showed positive maspin immunoreactivity. A S100P−/pVHL+/MUC5AC−/CK17− staining pattern was essentially indicative of ICC, whereas the S100P+/pVHL−/MUC5AC+/CK17+ and S100P+/pVHL−/MUC5AC−/CK17+ staining patterns were suggestive of PDA. These observations demonstrate that S100P, pVHL, MUC5AC, and CK17 are a useful immunohistochemical panel that may help distinguish primary ICC from metastatic PDA.
doi_str_mv 10.1016/j.humpath.2013.10.004
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In this study, 41 ICCs and 60 PDAs were immunohistochemically evaluated for the expression of S100P, pVHL, IMP3, maspin, MUC5AC, and CK17 proteins. The results showed pVHL expression in 29 (71%) ICCs but in only 3 (5%) PDAs. S100P, MUC5AC, and CK17 were frequently expressed in PDAs, seen in 57 (95%), 40 (67%), and 36 (60%) cases, respectively. In contrast, only 11 (27%), 5 (12%), and 5 (12%) ICC cases expressed these proteins. IMP3 was expressed in 37 (90%) ICC and 54 (90%) PDA cases with equal frequency. All 60 (100%) PDA and 30 (73%) ICC cases showed positive maspin immunoreactivity. A S100P−/pVHL+/MUC5AC−/CK17− staining pattern was essentially indicative of ICC, whereas the S100P+/pVHL−/MUC5AC+/CK17+ and S100P+/pVHL−/MUC5AC−/CK17+ staining patterns were suggestive of PDA. These observations demonstrate that S100P, pVHL, MUC5AC, and CK17 are a useful immunohistochemical panel that may help distinguish primary ICC from metastatic PDA.</description><identifier>ISSN: 0046-8177</identifier><identifier>EISSN: 1532-8392</identifier><identifier>DOI: 10.1016/j.humpath.2013.10.004</identifier><identifier>PMID: 24439226</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; Bile Ducts, Intrahepatic ; Biomarkers ; Biomarkers, Tumor - metabolism ; Calcium-Binding Proteins - analysis ; Carcinoma, Pancreatic Ductal - diagnosis ; Carcinoma, Pancreatic Ductal - metabolism ; Carcinoma, Pancreatic Ductal - pathology ; Cholangiocarcinoma - diagnosis ; Cholangiocarcinoma - metabolism ; Cholangiocarcinoma - pathology ; CK17 ; Diagnosis, Differential ; Gallbladder ; Humans ; Immunohistochemistry ; IMP3 ; Intrahepatic cholangiocarcinoma ; Keratin-17 - analysis ; Liver Neoplasms - diagnosis ; Liver Neoplasms - metabolism ; Liver Neoplasms - pathology ; Maspin ; Medical research ; Metastasis ; Middle Aged ; MUC5AC ; Mucin 5AC - analysis ; Neoplasm Proteins - analysis ; Pancreatic cancer ; Pancreatic ductal adenocarcinoma ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - metabolism ; Pancreatic Neoplasms - pathology ; Pathology ; pVHL ; S100P ; Von Hippel-Lindau Tumor Suppressor Protein - analysis</subject><ispartof>Human pathology, 2014-02, Vol.45 (2), p.394-400</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>2014.</rights><rights>Copyright Elsevier Limited Feb 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c561t-dc970b807cc6c30d37e3910aed008558d09187db5b7e66ca3946d80f6bfecf723</citedby><cites>FETCH-LOGICAL-c561t-dc970b807cc6c30d37e3910aed008558d09187db5b7e66ca3946d80f6bfecf723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24439226$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lok, Terry, BS</creatorcontrib><creatorcontrib>Chen, Lihong, MD, PhD</creatorcontrib><creatorcontrib>Lin, Fan, MD, PhD</creatorcontrib><creatorcontrib>Wang, Hanlin L., MD, PhD</creatorcontrib><title>Immunohistochemical distinction between intrahepatic cholangiocarcinoma and pancreatic ductal adenocarcinoma</title><title>Human pathology</title><addtitle>Hum Pathol</addtitle><description>Summary Distinction between primary intrahepatic cholangiocarcinoma (ICC) and metastatic pancreatic ductal adenocarcinoma (PDA) on a liver biopsy is essentially impossible histologically but has important clinical implications. In this study, 41 ICCs and 60 PDAs were immunohistochemically evaluated for the expression of S100P, pVHL, IMP3, maspin, MUC5AC, and CK17 proteins. The results showed pVHL expression in 29 (71%) ICCs but in only 3 (5%) PDAs. S100P, MUC5AC, and CK17 were frequently expressed in PDAs, seen in 57 (95%), 40 (67%), and 36 (60%) cases, respectively. In contrast, only 11 (27%), 5 (12%), and 5 (12%) ICC cases expressed these proteins. IMP3 was expressed in 37 (90%) ICC and 54 (90%) PDA cases with equal frequency. All 60 (100%) PDA and 30 (73%) ICC cases showed positive maspin immunoreactivity. A S100P−/pVHL+/MUC5AC−/CK17− staining pattern was essentially indicative of ICC, whereas the S100P+/pVHL−/MUC5AC+/CK17+ and S100P+/pVHL−/MUC5AC−/CK17+ staining patterns were suggestive of PDA. 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Chen, Lihong, MD, PhD ; Lin, Fan, MD, PhD ; Wang, Hanlin L., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c561t-dc970b807cc6c30d37e3910aed008558d09187db5b7e66ca3946d80f6bfecf723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bile Duct Neoplasms</topic><topic>Bile Ducts, Intrahepatic</topic><topic>Biomarkers</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Calcium-Binding Proteins - analysis</topic><topic>Carcinoma, Pancreatic Ductal - diagnosis</topic><topic>Carcinoma, Pancreatic Ductal - metabolism</topic><topic>Carcinoma, Pancreatic Ductal - pathology</topic><topic>Cholangiocarcinoma - diagnosis</topic><topic>Cholangiocarcinoma - metabolism</topic><topic>Cholangiocarcinoma - pathology</topic><topic>CK17</topic><topic>Diagnosis, Differential</topic><topic>Gallbladder</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>IMP3</topic><topic>Intrahepatic cholangiocarcinoma</topic><topic>Keratin-17 - analysis</topic><topic>Liver Neoplasms - diagnosis</topic><topic>Liver Neoplasms - metabolism</topic><topic>Liver Neoplasms - pathology</topic><topic>Maspin</topic><topic>Medical research</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>MUC5AC</topic><topic>Mucin 5AC - analysis</topic><topic>Neoplasm Proteins - analysis</topic><topic>Pancreatic cancer</topic><topic>Pancreatic ductal adenocarcinoma</topic><topic>Pancreatic Neoplasms - diagnosis</topic><topic>Pancreatic Neoplasms - metabolism</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pathology</topic><topic>pVHL</topic><topic>S100P</topic><topic>Von Hippel-Lindau Tumor Suppressor Protein - analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lok, Terry, BS</creatorcontrib><creatorcontrib>Chen, Lihong, MD, PhD</creatorcontrib><creatorcontrib>Lin, Fan, MD, PhD</creatorcontrib><creatorcontrib>Wang, Hanlin L., MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Human pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lok, Terry, BS</au><au>Chen, Lihong, MD, PhD</au><au>Lin, Fan, MD, PhD</au><au>Wang, Hanlin L., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immunohistochemical distinction between intrahepatic cholangiocarcinoma and pancreatic ductal adenocarcinoma</atitle><jtitle>Human pathology</jtitle><addtitle>Hum Pathol</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>45</volume><issue>2</issue><spage>394</spage><epage>400</epage><pages>394-400</pages><issn>0046-8177</issn><eissn>1532-8392</eissn><abstract>Summary Distinction between primary intrahepatic cholangiocarcinoma (ICC) and metastatic pancreatic ductal adenocarcinoma (PDA) on a liver biopsy is essentially impossible histologically but has important clinical implications. In this study, 41 ICCs and 60 PDAs were immunohistochemically evaluated for the expression of S100P, pVHL, IMP3, maspin, MUC5AC, and CK17 proteins. The results showed pVHL expression in 29 (71%) ICCs but in only 3 (5%) PDAs. S100P, MUC5AC, and CK17 were frequently expressed in PDAs, seen in 57 (95%), 40 (67%), and 36 (60%) cases, respectively. In contrast, only 11 (27%), 5 (12%), and 5 (12%) ICC cases expressed these proteins. IMP3 was expressed in 37 (90%) ICC and 54 (90%) PDA cases with equal frequency. All 60 (100%) PDA and 30 (73%) ICC cases showed positive maspin immunoreactivity. A S100P−/pVHL+/MUC5AC−/CK17− staining pattern was essentially indicative of ICC, whereas the S100P+/pVHL−/MUC5AC+/CK17+ and S100P+/pVHL−/MUC5AC−/CK17+ staining patterns were suggestive of PDA. These observations demonstrate that S100P, pVHL, MUC5AC, and CK17 are a useful immunohistochemical panel that may help distinguish primary ICC from metastatic PDA.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24439226</pmid><doi>10.1016/j.humpath.2013.10.004</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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source Elsevier
subjects Aged
Aged, 80 and over
Bile Duct Neoplasms
Bile Ducts, Intrahepatic
Biomarkers
Biomarkers, Tumor - metabolism
Calcium-Binding Proteins - analysis
Carcinoma, Pancreatic Ductal - diagnosis
Carcinoma, Pancreatic Ductal - metabolism
Carcinoma, Pancreatic Ductal - pathology
Cholangiocarcinoma - diagnosis
Cholangiocarcinoma - metabolism
Cholangiocarcinoma - pathology
CK17
Diagnosis, Differential
Gallbladder
Humans
Immunohistochemistry
IMP3
Intrahepatic cholangiocarcinoma
Keratin-17 - analysis
Liver Neoplasms - diagnosis
Liver Neoplasms - metabolism
Liver Neoplasms - pathology
Maspin
Medical research
Metastasis
Middle Aged
MUC5AC
Mucin 5AC - analysis
Neoplasm Proteins - analysis
Pancreatic cancer
Pancreatic ductal adenocarcinoma
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - metabolism
Pancreatic Neoplasms - pathology
Pathology
pVHL
S100P
Von Hippel-Lindau Tumor Suppressor Protein - analysis
title Immunohistochemical distinction between intrahepatic cholangiocarcinoma and pancreatic ductal adenocarcinoma
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