Introduction Pancreatic intraductal papillary mucinous neoplasms (IPMN) are now identified with increasing frequency. The detection of carcinoma in IPMN is difficult and suffers from high false-positive and false-negative rates, often resulting in inappropriate treatment decisions. Improved detection of malignancy using novel biomarkers may therefore improve diagnostic accuracy. One such promising novel biomarker is Plectin-1 (Plec-1). Methods Using immunohistochemistry, Plec-1 expression was assayed in benign (low and moderate dysplasia, n=6) as well as malignant IPMN (high-grade dysplasia and invasive carcinoma, n=31) and lymph node metastases from carcinoma arising in IPMN (n=12). Furthermore, cyst fluids from benign (n=3) and malignant IPMN (n=4) were evaluated for Plec-1 expression. Results and discussion Twenty-six of 31 malignant IPMN and all 12 lymph node metastases were Plec-1 positive. In contrast, only one of six benign IPMN expressed Plec-1. The specificity of Plec-1 in distinguishing malignant IPMN from benign IPMN was 83% and its sensitivity 84%. Furthermore, all (four out of four) cyst fluids from malignant IPMN, but one of the three benign IPMN, were Plec-1 positive. These data support Plec-1 as an excellent biomarker for the early etection of carcinoma arising in IPMN.
- Malignant IPMN
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