福士耕先生の論文が、Journal of Clinical Medicine誌(Journal Citation Reports Impact Factor 2021 = 4.964)にpublishされました。
J Clin Med. 2022 Oct 16;11(20):6097. doi: 10.3390/jcm11206097.
Usefulness of Adding Maspin Staining to p53 Staining for EUS-FNA Specimens of Pancreatic Ductal Adenocarcinoma
Koh Fukushi, Akira Yamamiya, Keiichi Tominaga, Yoko Abe, Koki Hoshi, Kazunori Nagashima, Ken Kashima, Yasuhito Kunogi, Fumi Sakuma, Hidetsugu Yamagishi, Kazuyuki Ishida, Yasuo Haruyama, Atsushi Irisawa
PMID: 36294419 PMCID: PMC9605637 DOI: 10.3390/jcm11206097
Background: Endoscopic ultrasound-guided puncture aspiration biopsy (EUS-FNA) of pancreatic ductal adenocarcinoma (PDAC) is highly diagnostic, but it is difficult to distinguish from benign disease. Our objective was to determine the usefulness of maspin staining, in addition to conventional p53 staining, in the diagnosis of PDAC by EUS-FNA.
Methods: Of the patients who underwent EUS-FNA and were diagnosed with PDAC, we retrospectively identified 90 cases in which both maspin and p53 staining were performed. In addition, we identified 28 cases of benign pancreatic disease diagnosed using EUS-FNA and these were selected as a control group. For analysis of EUS-FNA specimens, Cohen’s Kappa (κ) coefficient and the prevalence and bias adjusted Kappa statistic (PABAK) were applied to assess the significance of sensitivity and specificity, comparing p53, maspin, p53+maspin.
Results: The sensitivity and specificity of p53 staining were 48.9% and 100%. The κ coefficient was 0.31 (95%CI 0.18-0.44) (p < 0.01) and the PABAK coefficient was 0.22 (95%CI 0.03-0.40). The results for maspin staining were 88.9% and 92.9%. The κ coefficient was 0.72 (95%CI 0.54-0.90) (p < 0.01) and the PABAK coefficient was 0.78 (95%CI 0.64-0.88). The results for the combination of maspin and p53 staining were 94.4% and 92.2%. The κ coefficient was 0.82 (95%CI 0.64-1.00) (p < 0.01) and the PABAK coefficient was 0.86 (95%CI 0.74-0.94).
Conclusion: Adding maspin staining to p53 staining showed high sensitivity and specificity. Our results demonstrated the usefulness of their combined use that might contribute to the improvement of tissue diagnostic performance of PDAC by EUS-FNA.
Keywords: EUS-FNA; immunohistochemical; maspin; p53; pancreatic ductal carcinoma.