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. 2018 Mar;18(2):176-183.
doi: 10.1016/j.pan.2017.12.010. Epub 2017 Dec 26.

Immunohistochemical analysis of IMP3 and p53 expression in endoscopic ultrasound-guided fine needle aspiration and resected specimens of pancreatic diseases

Junichi Senoo  1 , Rintaro Mikata  2 , Takashi Kishimoto  3 , Masahiro Hayashi  1 , Yuko Kusakabe  1 , Shin Yasui  1 , Mutsumi Yamato  1 , Hiroshi Ohyama  1 , Harutoshi Sugiyama  1 , Toshio Tsuyuguchi  1 , Hideyuki Yoshitomi  4 , Masayuki Ohtsuka  4 , Juri Maeda  5 , Satoshi Ota  5 , Yukio Nakatani  5 , Naoya Kato  1
Affiliations

Immunohistochemical analysis of IMP3 and p53 expression in endoscopic ultrasound-guided fine needle aspiration and resected specimens of pancreatic diseases

Junichi Senoo et al. Pancreatology. 2018 Mar.

Abstract

Background: Insulin-like growth factor II messenger ribonucleic acid-binding protein 3 (IMP3) is a valuable marker that distinguishes malignant from benign lesions and predicts prognosis.

Methods: First, we evaluated IMP3 expression in 77 resected specimens of pancreatic ductal adenocarcinoma (PDAC), intraductal papillary mucinous neoplasm (IPMN), and chronic pancreatitis (CP). Eleven PDAC patients preoperatively underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Survival analysis of IMP3 and clinicopathological factors was performed. IMP3 and p53 expression was evaluated in another 127 EUS-FNA samples of solid pancreatic masses to compare the diagnostic value of routine and immunohistochemical staining.

Results: IMP3 expression was detected in 72.3%, 50%, 20%, and 0% of PDAC, malignant IPMN, benign IPMN, and CP, respectively. Evaluation of IMP3 expression in EUS-FNA specimens coincided with that in resected specimens in 10 of 11. IMP3 expression correlated with tumor differentiation in PDAC samples (p = .006) and with poor prognosis through univariate analysis (p = .045). Tumor differentiation and lymph node metastasis were significantly associated with poor prognosis through multivariate analysis. In EUS-FNA specimens, the sensitivity, specificity, and accuracy of cytohistological analysis were 80.8%, 100%, and 85.0%, respectively. IMP3 and p53 expression were detected in 80.8% and 44.9% of malignant and 0% and 5% of benign lesions. Combined with IMP3 immunostaining, the sensitivity, specificity and accuracy of cytohistological analysis significantly increased to 87.9%, 100%, and 90.8% (p = .016), respectively. Meanwhile, p53 staining had no impact on the results.

Conclusions: IMP3 immunohistochemical staining can improve the diagnostic accuracy of EUS-FNA for malignant pancreatic tumors.

Keywords: EUS-FNA; IMP3; Immunohistochemical analysis; Pancreatic cancer; p53.

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