Autoimmune Pancreatitis Type 2: Diagnostic Utility of PD-L1 Immunohistochemistry
| Autor: | Abhijit Chougule, Carlos Fernandez-del Castillo, Masayuki Akita, Yoh Zen, Vikram Deshpande, Azfar Neyaz, David G. Forcione, Rajib K Gupta, Cristina R. Ferrone |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Pancreatic ductal adenocarcinoma medicine.medical_treatment Autoimmune Pancreatitis Disease B7-H1 Antigen Pathology and Forensic Medicine Diagnosis Differential 03 medical and health sciences Young Adult 0302 clinical medicine Pancreatectomy Predictive Value of Tests PD-L1 parasitic diseases Carcinoma medicine Humans Indoleamine-Pyrrole 2 3 -Dioxygenase skin and connective tissue diseases Child Pancreas Autoimmune pancreatitis Aged biology business.industry Reproducibility of Results Middle Aged medicine.disease Immunohistochemistry Pancreatic Neoplasms 030220 oncology & carcinogenesis biology.protein Pancreatitis 030211 gastroenterology & hepatology Surgery Female Anatomy business Biomarkers Carcinoma Pancreatic Ductal |
| Zdroj: | The American journal of surgical pathology. 43(7) |
| ISSN: | 1532-0979 |
| Popis: | Autoimmune pancreatitis (AIP) encompasses a heterogenous disease group that includes IgG4-related type 1 AIP and non-IgG4-related type 2 AIP. Clinically and on imaging, type 2 AIP mimics type 1 AIP, other forms of chronic pancreatitis and pancreatic ductal adenocarcinoma (PDAC); therefore, discriminatory markers may aid proper diagnosis. Herein, we examine the expression of PD-L1 and indoleamine 2,3-dioxygenase (IDO1) as a diagnostic tool to distinguish type 2 AIP from other forms of pancreatitis and PDAC.We evaluated 35 pancreatectomy specimens diagnosed with type 2 AIP and potential mimics of this disease including type 1 AIP (n=14), chronic pancreatitis-not otherwise specified (n=10), groove pancreatitis (n=14), and PDAC (n=278). We scored inflammatory infiltrates, fibrosis and atrophy and performed immunohistochemical staining for PD-L1 and IDO1. We validated our findings on a series of endoscopic ultrasound-guided biopsies from patients with suspected type 2 AIP and inflammatory and neoplastic mimics of this disease (n=37).The mean age of patients with type 2 AIP was 50 years with a F:M ratio of 1.2:1. Patients with type 2 AIP showed pancreatic ductal staining for PD-L1 and IDO1 in 69% (24/35) and 60% (15/25) of cases, respectively. PD-L1 reactivity was noted in 3% of patients with other forms of chronic pancreatitis and 3% of PDACs; notably, peritumoral ducts and acini were negative. Eight of 9 endoscopic ultrasound-guided biopsies with pancreatic ductal epithelium from patients with type 2 AIP were positive for PD-L1, while the inflammatory and neoplastic mimics were negative. Collectively, the sensitivity and specificity of PD-L1 as a marker of type 2 AIP was 70% and 99%, respectively.Ductal PD-L1 reactivity has the potential to distinguish type 2 AIP from other forms of pancreatitis and PDAC. |
| Databáze: | OpenAIRE |
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