Plectin-1 as a Biomarker of Malignant Progression in Intraductal Papillary Mucinous Neoplasms: A Multicenter Study

• Published in: Pancreas Vol. 45; no. 9; p. 1353
• Main Authors: Moris, Maria, Dawson, David W, Jiang, Jennifer, Lewis, Jason, Nassar, Aziza, Takeuchi, Kenneth K, Lay, Anna R, Zhai, Qihui, Donahue, Timothy R, Kelly, Kimberly A, Crawford, Howard C, Wallace, Michael
• Format: Journal Article
• Language: English
• Published: United States 01.10.2016
• Subjects: Adenocarcinoma, Mucinous; Biomarkers, Tumor; Carcinoma, Pancreatic Ductal; Humans; Pancreatic Neoplasms; Plectin
• ISSN: 1536-4828
• DOI: 10.1097/MPA.0000000000000652

This study aimed to evaluate Plectin-1 expression as a biomarker of malignant risk for intraductal papillary mucinous neoplasms (IPMNs). Plectin-1 immunohistochemistry (IHC) was performed retrospectively on surgical (n = 71) and cytological (n = 33) specimens from Mayo Clinic Jacksonville and UCLA Medical Center, including IPMNs with low-grade dysplasia, high-grade dysplasia (HGD), or an associated invasive adenocarcinoma. Plectin-1 expression was increased in invasive adenocarcinoma compared with adjacent in situ IPMN (P = 0.005), as well as the in situ HGD component of IPMNs with invasive cancer compared with HGD of IPMNs without invasive cancer (P = 0.02). Plectin IHC discriminated IPMNs with invasive adenocarcinoma from noninvasive IPMN (area under the curve [AUC] of 0.79, 75% sensitivity, and 85% specificity) but was insufficient for discriminating HGD IPMN from low-grade dysplasia IPMNs in surgical resections (AUC of 0.67, 56% sensitivity, and 64% specificity) or fine-needle aspiration specimens (AUC of 0.45). Although Plectin-1 IHC has insufficient accuracy to be used as a definitive biomarker for malignant risk in the evaluation of IPMN biopsy or cytological specimens, increased Plectin-1 expression observed in both invasive cancer and in situ HGD of malignant IPMNs suggests that it might be successfully leveraged as a cyst fluid biomarker or molecular imaging target.