Cytology adds value to monoclonal antibody Das-1 testing for detection of high-risk pancreatic cysts.

TitleCytology adds value to monoclonal antibody Das-1 testing for detection of high-risk pancreatic cysts.
Publication TypeJournal Article
Year of Publication2021
AuthorsHeidarian A, Das KK, Mino-Kenudson M, Del Castillo CFernandez-, Pitman MB
JournalJ Am Soc Cytopathol
Volume10
Issue3
Pagination249-254
Date Published2021 May-Jun
ISSN2213-2945
KeywordsAdenocarcinoma, Mucinous, Antibodies, Antibodies, Monoclonal, Biomarkers, Tumor, Cyst Fluid, Cystadenoma, Serous, Cytodiagnosis, Data Accuracy, Humans, Neuroendocrine Tumors, Pancreatic Cyst, Pancreatic Intraductal Neoplasms, Pancreatic Neoplasms, Preoperative Period, Retrospective Studies, Sensitivity and Specificity
Abstract

INTRODUCTION: Determining the risk of malignancy in a pancreatic cyst (PC) is a clinical and diagnostic challenge. Monoclonal antibody (mAb) Das-1 test was shown to have high sensitivity, specificity, and accuracy in detecting high-risk (HR) cysts. Das-1 mAb test detects HR mucinous cysts with high-grade dysplasia (HGD), invasive carcinoma, and/or intestinal-type epithelium. Correlation of mAb Das-1 testing of PC fluids with cytomorphologic findings has not been evaluated.

MATERIALS AND METHODS: We correlated cytology with mAb Das-1 test results and resection histology in 26 PCs. There were 18 intraductal papillary mucinous neoplasms (IPMN), 1 intraductal oncocytic papillary neoplasm (IOPN), 4 mucinous cystic neoplasms (MCN), 2 serous cystadenomas, and 1 cystic pancreatic neuroendocrine tumor (PanNET). HR cysts included cysts with high-grade atypia on cytology or HGD on histology, invasive carcinoma, IOPNs, and cystic PanNETs. Intestinal type IPMNs were also HR cysts on histology.

RESULTS: In 17 cases (65.38%), cytology and mAb Das-1 test correlated with histology. There were 2 (7.69%) mAb Das-1 test negative HR PCs diagnosed by cytology. Five (19.23%) mAb Das-1 test positive HR PCs had mucin only or cells with low-grade dysplasia on cytology. Two mAb Das-1 test positive HR PCs had nondiagnostic cytology. HR IOPN and cystic PanNET were not detected by mAb Das-1 test.

CONCLUSION: The mAb Das-1 is a sensitive and specific biomarker for detecting HR mucinous PCs. Adding cytology to mAb Das-1 testing improves the sensitivity for the detection of nonmucinous HR PC. Together, cytology with mAb Das-1 testing is more accurate than either one alone.

DOI10.1016/j.jasc.2021.01.002
Alternate JournalJ Am Soc Cytopathol
PubMed ID33541830
Related Faculty: 
Amin Heidarian, M.D.

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