Identification of gastrointestinal contamination in endoscopic ultrasound-guided pancreatic fine needle aspiration

Acta Cytol. 2010 May-Jun;54(3):245-8. doi: 10.1159/000325029.

Abstract

Objective: To evaluate whether B72.3 and CEA could identify duodenal and gastric contamination in cell blocks of clinically proven cases of pancreatic ductal carcinoma, intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN).

Study design: Cell blocks of pancreatic fine needle aspirates from 19 ductal adenocarcinomas, 9 IPMNs, 5 MCNs, and 22 cases containing gastrointestinal epithelial contamination (GIC) (7 gastric, 15 duodenal) were stained with antibody to carcinoembryonic antigen (CEA) and B72.3.

Results: CEA was positive in 89% of adenocarcinomas and 92% of mucinous lesions. It was never expressed in gastric contamination and was positive in 2/15 (13%) duodenal contaminants. B72.3 was positive in 95% of adenocarcinomas and 85% of mucinous lesions. It was positive in 2/7 (28%) gastric and 7/15 (47%) duodenal contaminants.

Conclusion: In contrast to previous work, our preliminary results indicate that B72.3 expression cannot be reliably used to identify GIC. A lack of CEA expression, however, can be used to identify both gastric and duodenal contamination. This represents an important diagnostic aid in the evaluation of suspected low grade mucinous lesions.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma, Mucinous / diagnosis
  • Adenocarcinoma, Mucinous / metabolism
  • Antibodies, Neoplasm / metabolism
  • Artifacts
  • Biomarkers / metabolism
  • Biopsy, Fine-Needle
  • Carcinoembryonic Antigen / metabolism
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / metabolism
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / metabolism
  • Diagnostic Errors / prevention & control
  • Duodenum / metabolism
  • Duodenum / pathology*
  • Endosonography*
  • Gastric Mucosa / metabolism
  • Humans
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / metabolism
  • Stomach / pathology*

Substances

  • Antibodies, Neoplasm
  • B72.3 antibody
  • Biomarkers
  • Carcinoembryonic Antigen