A Promising Diagnostic Role of Immunohistochemical Expression of Insulin-Like Growth Factor II mRNA Binding Protein 3 (IMP3) in Pancreatic Lesions Using Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Cytology.

BACKGROUND: Poor prognosis and short survival of patients harboring pancreatic cancer emerge how advanced disease it is. In a trial to achieve the earliest and most accurate diagnosis to manage this progressive disease, we proposed that using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with an adjuvant diagnostic immunohistochemical marker would give better diagnostic results. IMP3 has gained recently wide attention, as many studies found that IMP3 has not only diagnostic but also prognostic role in different types of malignancies. AIM OF THE STUDY: This prospective work is to assess the diagnostic role of EUS-FNA combined with the immunohistochemical expression of IMP3 on different benign and malignant pancreatic lesions. MATERIAL AND METHOD: The included pancreatic lesions (n = 140) were obtained by EUS-FNA technique and stained for IMP3 immunohistochemically. Paraffin blocks from patients who underwent excision (n = 92) or core biopsies (n = 48) were performed for confirming diagnosis. RESULTS: The combined method for diagnosis showed that IMP3 was positive in 78.7%, 91.7%, 100% PAC, mucinous neoplasm with high grade dysplasia, and IPMN with high grade dysplasia, respectively, while almost all benign lesions showed negative IMP3. Also, this method showed sensitivity (78.26%), specificity (95.83%), and accuracy (84.3%). CONCLUSION: EUS-FNA cytology with IMP3 could be a reliable diagnostic tool especially for assessment of malignant pancreatic lesions.

Value of immunohistochemical IMP3 expression with endoscopic ultrasound-guided-fine needle aspiration (EUS-FNA) in diagnosing pancreatic lesions: Review Article

Pancreatic cancer (PC), a lethal condition with a poor prognosis, ranks fourth among the most common causes of cancer-related mortality as early diagnosis of PC is so tricky. Consequently, most cases at the time of initial diagnosis already harbor metastasis. PC cases' early detection and survival depend mainly on improving diagnostic approaches. This review sheds light on the role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a minimally invasive method in early PC diagnosis and differentiation between different pancreatic lesions. The discovery of new diagnostic and prognostic markers for PC will raise the accuracy of proper diagnosis, and in turn, patients will gain better survival and prognosis. Insulin-like growth factor II mRNA binding protein3 (IMP3) is overexpressed in several malignant tumors, including pancreatic cancer, which may raise its role in diagnosis and prognosis as well as its therapeutic benefit for PC.