mAb Das-1 is specific for high-risk and malignant intraductal papillary mucinous neoplasm (IPMN)

Koushik K. Das, Hong Xiao, Xin Geng, Carlos Fernandez-del-Castillo, Vicente Morales-Oyarvide, Ebubekir Daglilar, David G. Forcione, Brenna C. Bounds, William R. Brugge, Martha B. Pitman, Mari Mino-Kenudson, Kiron M. Das

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30 Scopus citations

Abstract

Objective: Intraductal papillary mucinous neoplasm (IPMN) consists of four epithelial subtypes that correlate with histological grades and risks for malignant transformation. mAb Das-1 is a monoclonal antibody against a colonic epithelial phenotype that is reactive to premalignant conditions of the upper GI tract. We sought to assess the ability of mAb Das-1 to identify IPMN with high risk of malignant transformation. Design: mAb Das-1 reactivity was evaluated in 94 patients with IPMNs by immunohistochemistry. Lesional fluid from 38 separate patients with IPMN (n=27), low-grade non-mucinous cystic neoplasms (n=7) and pseudocysts (n=4) was analysed by ELISA and western blot. Results: Immunohistochemistry - Normal pancreatic ducts were non-reactive and low-grade gastric-type IPMN (IPMN-G) (1/17) and intermediate-grade IPMN-G (1/23) were minimally reactive with mAb Das-1. In contrast, mAb Das-1 reactivity was signi ficantly higher in high-risk/malignant lesions (p<0.0001) including: intestinal-type IPMN with intermediate-grade dysplasia (9/10); high-grade dysplasia of gastric (4/7), intestinal (12/12), oncocytic (2/2) and pancreatobiliary types (2/2); and invasive tubular (8/12), colloid (7/7) and oncocytic (2/2) carcinoma. The sensitivity and specificity of mAb Das-1 for high-risk/malignantIPMNs were 85% and 95%, respectively. Lesional fluid - Samples from low- and intermediate-grade IPMN-G (n=9), and other low-grade/benign non-mucinous lesions demonstrated little reactivity with mAb Das-1. Conversely, cyst fluid from high-risk/malignant IPMNs (n=18) expressed significantly higher reactivity ( p<0.0001). The sensitivity and speci ficity of mAbDas-1 in detecting high-risk/malignant IPMNs were 89% and 100%, respectively. Conclusions: mAb Das-1 reacts with high specificity to tissue and cyst fluid from high-risk/malignant IPMNs and thus may help in preoperative clinical risk stratification.

Original languageEnglish
Pages (from-to)1626-1634
Number of pages9
JournalGut
Volume63
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

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    Das, K. K., Xiao, H., Geng, X., Fernandez-del-Castillo, C., Morales-Oyarvide, V., Daglilar, E., Forcione, D. G., Bounds, B. C., Brugge, W. R., Pitman, M. B., Mino-Kenudson, M., & Das, K. M. (2014). mAb Das-1 is specific for high-risk and malignant intraductal papillary mucinous neoplasm (IPMN). Gut, 63(10), 1626-1634. https://doi.org/10.1136/gutjnl-2013-306219