An immunostaining panel for diagnosis of malignancy in mucinous tumors of the pancreas

Arch Pathol Lab Med. 2001 Jun;125(6):765-9. doi: 10.1043/0003-9985(2001)125<0765:AIPFDO>2.0.CO;2.


Background: The diagnosis of malignancy in pancreatic mucinous cystic tumors depends on demonstrating invasion that may be focal and require extensive sectioning.

Objective: To explore markers that may indicate malignant potential in mucinous cystic tumors.

Design: Routinely processed sections from resected specimens of 12 normal pancreata, 14 pancreata with chronic pancreatitis, 9 mucinous cystic tumors, and 30 invasive adenocarcinomas were immunostained with antibodies to p53, HER-2/neu, epithelial growth factor receptor (EGFR), transforming growth factor alpha (TGF-alpha), and Ki-67.

Results: Expression of p53, HER-2/neu, and Ki-67 was significantly more frequent in mucinous tumors than in normal pancreatic tissue and chronic pancreatitis tissue (P =.0003 to.05). Strong expression (more than one third of cells positive) and strong intensity (2+ and 3+) of staining of p53 and EGFR were seen only in carcinomas. Coexpression of p53/HER-2/neu and EGFR/HER-2/neu and a frequency of Ki-67+ nuclei of greater than 5% of cells discriminated between mucinous tumors and normal pancreatic tissue and chronic pancreatitis tissue. p53 expression was significantly more frequent in carcinomas than in mucinous tumor (P =.0326). Coexpression of p53/EGFR discriminated between mucinous tumors and carcinomas; however, TGF-alpha was not discriminative.

Conclusions: The immunostaining panel of p53, HER-2/neu, Ki-67, and EGFR can be helpful in indicating malignant potential in mucinous tumors of pancreas in routine pathology practice.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / pathology
  • Biomarkers, Tumor / metabolism
  • Case-Control Studies
  • Diagnosis, Differential
  • ErbB Receptors / metabolism
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / metabolism
  • Pancreas / anatomy & histology
  • Pancreas / metabolism
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / metabolism
  • Pancreatic Neoplasms / pathology
  • Pancreatitis / diagnosis
  • Pancreatitis / metabolism
  • Pancreatitis / pathology
  • Receptor, ErbB-2 / metabolism
  • Staining and Labeling
  • Transforming Growth Factor alpha / metabolism
  • Tumor Suppressor Protein p53 / metabolism


  • Biomarkers, Tumor
  • Ki-67 Antigen
  • Transforming Growth Factor alpha
  • Tumor Suppressor Protein p53
  • ErbB Receptors
  • Receptor, ErbB-2