Introduction
Pancreatic duct adenocarcinoma (PDAC) is the 11th most common type of cancer
and its incidence and death rates are steadily rising. In contrast to PDAC and
pancreatic neuroendocrine tumors (PNETs), solid pseudopapillary neoplasm (SPN)
is a low-grade malignant pancreatic tumor that exhibits distinct characteristics in
terms of tumor aggressiveness, treatment, and prognosis.
Aim
To investigate the expression of L1CAM, SOX11, and chromogranin in PDAC, SPN,
and PNETs and to show their diagnostic and prognostic significance.
Materials and methods
Retrospective Immunohistochemical staining of L1CAM, Sox11, and chromogranin
was performed on selected 54 cases of pancreatic tumors.
Results
L1CAM was highly expressed in 73.3% of PDAC cases compared with 81.8% of
SPN and 100% of PNET cases. SOX11 was positive in 90.9% of SPN, but negative
in 100% of PDAC and 93.3% of PNETS cases. Chromogranin was positive in
76.9% of PNETS. SOX11 is a highly sensitive (100%) marker for discriminating
between SPN and PDAC. Both SOX11 and chromogranin are highly specific
(100%) and sensitive (90.9%) markers in differentiating SPN from PNET. L1CAM
was significantly positively correlated with tumor grade (P=0.02), T stage (P=0.02),
lymph node metastasis (P=0.002), LVI (P=0.000), and distant metastasis (P=0.046)
of PDAC studied cases.
Conclusion
SOX11 could be considered a highly sensitive marker for differentiating SPN from
PDAC and PNETs. The combined expression of L1CAM, SOX11, and chromogranin
may play a valuable role in solving this diagnostic challenge. L1CAM might have
prognostic significance for PDAC and, hence, target therapy. |
