| Effective new markers of pancreatic carcinoma are urgently needed. In this study, we evaluate the potential contribution of mesothelin and fascin to pancreatic adenocarcinoma and to the interpretation of pancreas FNAs. Mesothelin mRNA and fascin mRNA expression was evaluated using RT-PCR. whereas mesothelin protein and fascinprotein expression was evaluated by immunohistochemistry. Mesothelin mRNA expression was confirmed in 17 of 18 resected primary pancreatic adenocarcinomas and in 4 of 4 pancreatic cancer cell lines; Fascin mRNA expression was confirmed in 14 of 18 resected primary pancreatic adenocarcinomas and in 3 of 4 pancreatic cancer cell lines;There were no mesothelin mRNA and fascin mRNA expression in 18 adjacent normal pancreatic tissues.The positive expression of mesothelin and fascin was 75.9%(41/54) and 64.81%(35/54) in 54 pancreatic cancer tissues, respectively; and there were no positive expression of mesothelin and fascin in 42 adjacent normal pancreas tissues. For EUS-FNA specimens, mesothelin labeling was seen in 14 of the 19 patients ultimately shown to have carcinoma and was absent in 7 of the 8 benign lesions. Fascin labeling was present in 13 of the 19 patients who ultimately were proven to have carcinoma; Fascin labeling was absent in 7 of the 8 lesions proven to be benign. Seven of the 7 cytologically suspicious cases with malignant follow-up labeled for either mesothelin or fascin ,5 of the 7 cases labeled for mesothelin ,and 5 labeled for fascin , and 3 labeled for both markers. Mesothelin gene and fascin gene appears to be almost universally overexpressed in pancreatic cancer tissues.Irnmunohistochemical labeling of mesothelin and fascin appears highly specific for pancreatic adenocarcinoma in FNA specimens and useful in categorizing cytologically suspicious lesions. |
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