الفهرس 
The utility of SMAD4 and S100P as diagnostic immunohistochemical markers for pancreatic ductal adenocarcinomas
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Abstract
seventh most frequent cancer type and is considered the seventh significant cause of death related to cancers, globally. It’s mostly presents at advanced stage, and has limited effective chemotherapeutic regimens.
Material & Methods: Sixty cases of proven pancreatic ductal adenocarcinoma, 19 cases obtained through EUS-FNA biopsies and 41 cases obtained through pancreatic resection specimens, were collected to evaluate S100P and SMAD4 immunohistochemial expression.
Results: S100P positive was expressed in 90% of studied PDCA cases with variable grades of intensity and distribution. Most PDACs showed focal and strong to moderate nuclear expression for S100P. A statistically significant relationship was attained between the S100P expression and tumor grade in studied cases (p-value = 0.015). SMAD4 was lost in most of studied cases (81.7%) in neoplastic tissue. No scientifically significant correlations exist among SMAD4 expression and any of other clinicopathological variables. S100P and SMAD4 expressions in neoplastic tissue of studied PDCA cases was scientifically correlated with its expression in adjacent normal tissue (P value
<0.001). S100P and SMAD4 had sensitivity of 90% and 81.70%, respectively, for the diagnosis of PDACs in both resection specimens and EUS-FNA cell blocks, with combined sensitivity of both markers was 98.30%.
Conclusion & Recommendations: Our data suggest the role of S100P and SMAD4 in pancreatic carcinogenesis and the involvement of S100P in tumor growth, progression and invasion. SMAD4 could be used as a diagnostic biomarker for PDACs. There is combined classification accuracy of 98.9%, suggesting that they are a promising, sensitive, and specific approach for detecting PDACs in small limited samples of EUS-FNAs and that combined panel approach was significantly more accurate and effective than any other individual approach. Larger cohort studies will be needed to confirm these findings and investigate the panel’s potential usefulness in clinical practice in the future