Pancreatic cyst fluid protein expression profiling for discriminating between serous cystadenoma and intraductal papillary mucinous neoplasm Journal Article

Authors: Allen, P. J.; Qin, L. X.; Tang, L.; Klimstra, D.; Brennan, M. F.; Lokshin, A.
Article Title: Pancreatic cyst fluid protein expression profiling for discriminating between serous cystadenoma and intraductal papillary mucinous neoplasm
Abstract: BACKGROUND:: Many patients with benign serous cystadenoma (SCA) of the pancreas will undergo resection because of the inability to reliably discriminate between SCA and premalignant mucinous cysts (intraductal papillary mucinous neoplasm [IPMN], mucinous cystic neoplasm [MCN]). METHODS:: Cyst fluid from patients with SCA (n = 15), non main-duct and noninvasive IPMN (n = 32), and noninvasive MCN (n = 12) was aspirated at the time of operative resection and analyzed. Commercially available and custom designed multiplex assays (Luminex) were performed using a biomarker panel developed for pancreatic cancer. Differential protein expression (fluorescence intensity, FI) was compared between the 3 groups for each protein (Wilcoxon rank sum test). Unsupervised sample clustering (hierarchical clustering) and supervised sample classification (prediction analysis for microarrays [PAM]) was then performed. RESULTS:: Differential protein expression (P < 0.05) was identified between SCA and IPMN (34/51 proteins, 67%) and between SCA and MCN (13/51 proteins, 25%). The majority of proteins were down-regulated in IPMN and MCN compared with SCA. The only proteins significantly overexpressed in the cyst fluid of patients with mucinous cysts were CEA (median FI: IPMN 11.4, MCN 13.0, SCA 5.3; P < 0.001, IPMN vs. SCA) and CA72.4 (median FI: IPMN 10.4, MCN 10.5, SCA 9.9; P = 0.003, IPMN vs. SCA). Unsupervised cluster analysis demonstrated distinct clustering of SCA and IPMN with some cross-over between MCN. Supervised sample classification with 14 proteins had an overall accuracy rate of 92% between SCA and IPMN. CONCLUSIONS:: In this study differential cyst fluid protein expression was observed between SCA and IPMN for the majority of proteins assessed and multimarker sample classification accurately discriminated between SCA and IPMN in 92% of patients. Copyright © 2009 by Lippincott Williams & Wilkins.
Keywords: epidermal growth factor; adult; human tissue; protein expression; aged; aged, 80 and over; middle aged; protein array analysis; major clinical study; pancreatic neoplasms; diagnostic accuracy; cystadenoma, serous; biological marker; unindexed drug; cluster analysis; diagnosis, differential; ca 19-9 antigen; carcinoembryonic antigen; cd40 ligand; eotaxin; epidermal growth factor receptor; epidermal growth factor receptor 2; fas antigen; fas ligand; gelatinase b; granulocyte macrophage colony stimulating factor; interleukin 1 receptor blocking agent; interleukin 10; interleukin 12p70; interleukin 13; interleukin 1beta; interleukin 21; interleukin 4; interleukin 5; interleukin 6 receptor; interleukin 7; interleukin 8; macrophage inflammatory protein 1beta; myeloperoxidase; somatomedin binding protein 1; tumor necrosis factor receptor 1; tumor necrosis factor receptor 2; vascular cell adhesion molecule 1; aspiration; cystadenoma; fluorescence; intraductal papillary mucinous tumor; pancreas cyst; tumor differentiation; adenocarcinoma, mucinous; carcinoma, pancreatic ductal; carcinoma, papillary; cyst fluid; neoplasm proteins; tumor markers, biological
Journal Title: Annals of Surgery
Volume: 250
Issue: 5
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2009-11-01
Start Page: 754
End Page: 759
Language: English
DOI: 10.1097/SLA.0b013e3181bd7f20
PUBMED: 19806054
PROVIDER: scopus
PMCID: PMC4556365
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: ANSUA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Murray F Brennan
    1044 Brennan
  2. Li-Xuan Qin
    161 Qin
  3. David S Klimstra
    972 Klimstra
  4. Peter Allen
    500 Allen
  5. Laura Hong Tang
    418 Tang