Ductal adenocarcinoma of the pancreas: analysis of primary diagnosis and immunohistochemical features of the tumor

Authors

Keywords:

ductal adenocarcinoma, pancreas, desmoplastic stroma, immunohistochemistry, alpha-SMA, vimentin, desmin, fibronectin, CK7, CK18

Abstract

Background: Today, pancreatic cancer (PC) ranks 11th worldwide among other cancers. Ranks 5th in terms of mortality. The incidence rate is increasing every year. The reason for the high mortality rate is late diagnosis of pancreatic cancer. Objective: analysis of primary diagnosis and determination of characteristic microscopic and immunohistochemical features of pancreatic ductal adenocarcinoma. Methods: the analysis of statistical data on the cancer registry of Ukraine 2015-2019rr and a comprehensive pathohistological and immunohistochemical study of 45 cases (surgical material of patients with ductal adenocarcinoma of the pancreas). Results: According to the Ukrainian Cancer Register in Ukraine, pancreas cancer (PCa) is diagnosed at stages II and III, in Zaporozhye and in the Zaporozhye region, PCa is diagnosed at stage IV of tumor development. Microscopic examination revealed that PDAC consists of a cancerous glandular-ductal compartment and a significant volume of stromal compartment, which makes up 67.61 84.24% of the total tumor area. Immunohistochemical study (IHC) using primary antibodies against α-SMA, vimentin, CK7, CK18, desmin, fibronectin. According to the results of the IHC study, it was found that the cytoplasmic expression of CK7 (M = 13.03% (Q1 = 8.40%; Q3 = 19.52%)) and CK18 (M = 8.54%) is determined in the cancer epithelium of ductulo-like and glandular-like structures. (Q1 = 5.99%; Q3 = 10.23%)). In the stromal compartment in fibroblasts and fusiform cells, the expression of vimentin is determined (M = 16.49% (Q1 = 10.64%, Q3 = 23.82%)), and around the ductulo-glandular cancer structures in pancreatic stellate cells, the expression of α- SMA (17.55% (Q1 = 11.43%, Q3 = 22.13%)). Significant expression of fibronectin and less expressive expression of desmin (M = 76.10% (Q1 = 70.23%; Q3 = 82.02%) and M = 24.01% (Q1 = 21.11 %; Q3 = 27.31%)). Conclusions: CK-7 is the optimal marker for the determination of the cancerous glandular ductal compartment of the PDAC. A well-developed fibroplastic stroma plays a significant role in the aggressive course of PDAC.

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Published

2023-06-26

How to Cite

Kabachenko , V. (2023). Ductal adenocarcinoma of the pancreas: analysis of primary diagnosis and immunohistochemical features of the tumor. Морфологія / Morphologia / Morfologìâ, 15(4), 62–70. Retrieved from https://morphology.dma.edu.ua/article/view/282857

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Vol. 15 No. 4 (2021)

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