Reduced MFAP5 expression in stroma of gallbladder adenocarcinoma and its potential diagnostic utility
- PDF / 3,000,078 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 27 Downloads / 184 Views
ORIGINAL ARTICLE
Reduced MFAP5 expression in stroma of gallbladder adenocarcinoma and its potential diagnostic utility Lei Zhao 1 & Liyan Xu 2 & Amanda Hemmerich 3 & N. Lynn Ferguson 3 & Cynthia D. Guy 4 & Shannon J. McCall 4 & Diana M. Cardona 4 & Maria Westerhoff 5 & Rish K. Pai 6 & Shu-Yuan Xiao 7 & Beiyu Liu 8 & Cynthia L. Green 8 & John Hart 7 & Xuefeng Zhang 4,9 Received: 18 April 2020 / Revised: 4 August 2020 / Accepted: 2 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The diagnosis of invasive adenocarcinoma of the gallbladder can sometimes be challenging. The presence of true desmoplastic reaction facilitates the diagnosis of invasion. However, desmoplasia-like changes can be observed in benign gallbladder conditions, and recognition of desmoplasia may be challenging based on morphology. In this study, we tested the expression pattern of microfibril-associated protein 5 (MFAP5), a promising immunohistochemical marker for desmoplasia, in benign gallbladders with desmoplasia-like reaction and gallbladders with invasive adenocarcinoma. We also evaluated the diagnostic utility of MFAP5 in challenging cases with an interobserver agreement study. The results showed that all benign cases retained intact/ positive MFAP5 staining pattern in periglandular connective tissue, whereas 79.3% (23 out of 29) of cases of adenocarcinomas demonstrated diffuse and complete loss of MFAP5 staining in the tumor stroma. Interobserver agreement was improved by 2.66 times when images of MFAP5 immunohistochemistry were provided. In conclusion, MFAP5 expression is downregulated in the desmoplastic stroma of gallbladder adenocarcinoma and may provide a useful diagnostic marker in difficult cases. Keywords Gallbladder adenocarcinoma . Desmoplasia . MFAP5 . Invasion
Introduction Gallbladder histology can demonstrate a variety of reactive epithelial lesions secondary to chronic injury. RokitanskyAschoff sinuses, diverticulosis, and adenomyosis may sometimes mimic infiltrative adenocarcinoma due to their deepseated glands within the gallbladder wall and inflamed epithelium with reactive atypia [1, 2]. Desmoplastic reaction in
invasive carcinoma is one useful histologic feature to distinguish invasive adenocarcinoma from entrapped/herniated benign glandular components. However, the desmoplasia phenomenon itself can be challenging to recognize using light microscopy alone, and diagnostically helpful immunohistochemical markers for desmoplasia are very few, largely due to the lack of understanding of the biological nature of tumor stromal reaction [3].
Parts of this study have been presented as an abstract at the United States and Canadian Academy of Pathology 2018 Annual Meeting. * Xuefeng Zhang [email protected] 1
Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
2
Department of Pathology, St. Luke’s University Health Network, Bethlehem, PA, USA
3
Department of Pathology, Foundation Medicine, Inc., Morrisville, NC, USA
4
Department of Pathology, Duke University Medical Ce
Data Loading...
