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Abnormal immunolabelling of SMAD 4 in cell block specimens to distinguish malignant and benign pancreatic cells
Author(s) -
Matsuda Yoko,
Esaka Shikine,
Suzuki Akemi,
Hamashima Yuri,
Imaizumi Masayuki,
Matsukawa Miho,
Fujii Yuko,
Aida Junko,
Takubo Kaiyo,
Ishiwata Toshiyuki,
Nishimura Makoto,
Arai Tomio
Publication year - 2019
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12653
Subject(s) - medicine , smad , cell , pathology , cancer research , transforming growth factor , biology , biochemistry
Background Accurate diagnosis of malignant and benign pancreatic lesions can be challenging, especially with endoscopic ultrasound‐guided fine needle aspiration ( EUS ‐ FNA ) samples that are small and/or degraded. In the present study, we determined how to best evaluate abnormal SMAD 4 expression by immunohistochemical staining on cell block specimens from EUS ‐ FNA samples. Results In surgically resected pancreas, when abnormal SMAD 4 immunolabelling was evaluated as negative SMAD 4 expression, the sensitivity was low (33%), but when it was evaluated as decreased SMAD 4 expression, the sensitivity improved (53%). Specificity and positive predictive value were high for both evaluations. There were no false‐positive cases. In cell block specimens, decreased SMAD 4 expression showed 47% sensitivity and 72% specificity, while negative SMAD 4 expression showed lower sensitivity (20%) and higher specificity (100%). Both evaluations in cell block specimens showed lower sensitivity and specificity compared to resected specimens. False‐positive and ‐negative rates were higher for cell blocks than for resected specimens. Conclusions Decreased SMAD 4 immunolabelling provided improved sensitivity as compared to negative SMAD 4 immunolabelling; therefore, it is important to compare SMAD 4 expression in a sample to its expression in normal cells. Abnormal SMAD 4 labelling showed low sensitivity and high specificity; therefore, SMAD 4 staining using EUS ‐ FNA samples might be helpful to detect malignancies that possess SMAD 4 gene abnormalities.