Document Detail


Usefulness of endoscopic biopsy using FOXP3(+) Treg up-regulation in the duodenal papilla in the differential diagnosis between autoimmune pancreatitis and pancreatic cancer.
MedLine Citation:
PMID:  21113630     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: Expression of the forkhead/winged helix family of transcription factor P3+ regulatory T cells (FOXP3(+) Treg), a master gene of regulatory T cells (Treg) is observed in patients with autoimmune pancreatitis (AIP). We investigated the usefulness of detection of FOXP3(+) Treg in the main duodenal papilla for differential diagnosis between AIP and pancreatic cancer (Pca). PATIENTS AND METHODS: Firstly, we determined the cut-off value of FOXP3 expression in duodenal papilla taken from the patients with AIP (n = 22) and chronic pancreatitis (n = 21). Data from 32 patients with AIP and 30 patients with Pca who had undergone endoscopic biopsy were then studied. The numbers of FOXP3(+) Treg-positive lymphocytes and IgG4-positive plasma cells per high-power field (HPF) were counted in all the histopathological specimens. RESULTS: The areas under the receiver-operating characteristic (AUROC) curves for FOXP3(+) and IgG4 expression were 0.934 and 0.953, respectively. Cut-off values calculated based on AUROC data were 14/HPF in FOXP3 and 10/HPF in IgG4. Seropositivity for IgG4 was observed in 22 out of the 31 patients with AIP (sensitivity 71.0%, specificity 84.6%, accuracy 75.0%). Significant infiltration of the major duodenal papilla by FOXP3(+) lymphocytes (≥14/HPF) was recognized in 18 of the 32 patients with AIP (sensitivity 56.3%, specificity 100%, accuracy 77.4%). Significant infiltration of the major duodenal papilla by IgG4-positive plasma cells (≥10/HPF) was recognized in 27 of the 32 patients with AIP (sensitivity 84.4%, specificity 80.0%, accuracy 82.3%). CONCLUSIONS: Observation of FOXP3(+) cells in the main duodenal papilla may be useful in the differential diagnosis between AIP and Pca.
Authors:
Kensuke Kubota; Shingo Kato; Seitaro Watanabe; Koji Fujita; Masato Yoneda; Hirokazu Takahashi; Masahiko Inamori; Takeshi Shimamura; Hiroyuki Kirikoshi; Noritoshi Kobayashi; Satoru Saito; Kantaro Hisatomi; Nobuyuki Matsuhashi; Atsushi Nakajima
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-11-27
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic sciences     Volume:  -     ISSN:  1868-6982     ISO Abbreviation:  J Hepatobiliary Pancreat Sci     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528587     Medline TA:  J Hepatobiliary Pancreat Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Gastroenterology, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa, Yokohama, 236-0004, Japan, kubotak@yokohama-cu.ac.jp.
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