ZIP4 is a novel diagnostic and prognostic marker in human pancreatic cancer: a systemic comparison between EUS-FNA and surgical specimens - PubMed (original) (raw)

doi: 10.2174/1566524013666131217112921.

M B Wallace, J Yang, L Jiang, Q Zhai, Y Zhang, C Hong, Y Chen, T S Frank, J A Stauffer, H J Asbun, M Raimondo, T A Woodward, Z Li, S Guha, L Zheng, M Li 1

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ZIP4 is a novel diagnostic and prognostic marker in human pancreatic cancer: a systemic comparison between EUS-FNA and surgical specimens

C Xu et al. Curr Mol Med. 2014 Mar.

Abstract

Aberrant expression of a zinc transporter ZIP4 in pancreatic ductal adenocarcinoma (PDAC) has been shown to contribute to tumor progression and is a potential target for individualized therapy. The overall objective of this study was to determine whether ZIP4 could serve as a novel diagnostic and prognostic marker in human PDAC, and if it can be assessed by minimally invasive sampling using endoscopic ultrasound guided fine needle aspiration (EUS-FNA). Immunohistochemistry was performed to compare ZIP4 expression in the PDAC samples obtained from EUS-FNA and matched surgical tumors (parallel control). Samples were reported by sensitivity, specificity, and predictive values, all with 95% confidence intervals (CI). A total of 23 cases with both FNA and surgical specimens were evaluated. We found that ZIP4 was significantly overexpressed in tumor cells from both sets of samples. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ZIP4 for the diagnosis of PDAC were 72.9%, 72.5%, 76.1%, and 69.0% in EUS-FNA samples, and were 97.9%, 65.4%, 83.9%, and 94.4% in surgical specimens, respectively. The association between the positive rate of ZIP4 expression in FNA and surgical samples is statistically significant (P=0.0216). Both the intensity and percentage of ZIP4 positive cells from the surgical samples correlated significantly with tumor stage (P=0.0025 and P=0.0002). ZIP4 intensity level in FNA samples was significantly associated with tumor differentiation and patient survival. These results indicate that EUS-FNA is capable of non-operative detection of ZIP4, thus offering the potential to direct pre-operative detection and targeted therapy of PDAC.

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Conflict of interest statement

CONFLICT OF INTEREST

Dr. Michael B. Wallace received research funding from Boston Scientific. Other authors declare no conflict of interest.

Figures

Fig. 1

Fig. 1. ZIP4 is overexpressed in PDAC surgical samples

IHC staining of ZIP4 in surgically resected human PDAC tissues with AEC substrate. (A) ZIP4 positive staining with surrounding non-tumoral glands as an internal negative control. The upper half is pancreatic ductal adenocarcinoma with strongly positive (3+) ZIP4 staining. The lower half is benign pancreatic tissue including glands, ducts, and stroma which are negative for ZIP4. (B) ZIP4 positive staining with 3+ intensity. (C) ZIP4 positive staining with 2+ intensity. (D) ZIP4 positive staining with 1+ intensity.

Fig. 2

Fig. 2. ZIP4 is overexpressed in FNA samples

IHC staining of ZIP4 in EUS-FNA human PDAC samples with AEC substrate. (A) ZIP4 positive staining with 3+ intensity. (B) ZIP4 positive staining with 2+ intensity. (C) ZIP4 positive staining with 1+ intensity. (D) ZIP4 negative staining.

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