Clincopathological Research Of Glucagonoma And Study On The Expression Of Glicentin And HAb18G/CD147 In Glucagonoma

Objective To investigate the characteristics of clinicopathology and immunohistochemistry of an extremely unusual pancreatic neuroendocrine neoplasm-glucagonoma. Methods Seven cases of glucagonomas of pancreas were retrieved from the PUMCH medical record database from 1999 to 2015, and 15 cases of insulinomas and five cases of G3 non-functioning pancreatic neuroendocrine neoplasms were set as control. Clinic and histologic features of these cases were studied and immunohistochemistry was performed in these casesusing EnVison system. Results 3 patients were male, and 4 were female, with age from 32 to 55 years, with a median age 51 years. Most glucagonomas were located in the tail of the pancreas and the mean diameter was 5 cm. The histological features of the 7 cases of glucagonoma variatedgreatly, but they showed a predominance of trabecular pattern (57.1%). The histological classification and TNM staging of glucagonoma were also different greatly from the control.7 cases of glucagonoma were diffusely positive for Glucagon and Glicentin, but the control cases were negative for these two makers except focally reactive for Glicentin (1%) in 2 cases.7 cases of glucagonoma were also positive for HAb18G/CD147,4 (57.1%) in the cytoplasm and 3 (42.9%) both in the cytoplasm and cell membrane. In the control group,14/15 cases of Insulinomas were positive for HAb18G/CD147,12(85.7%)in the cytoplasm and 2 (14.3%)both in the cytoplasm and cell membrane; all 5 cases of G3 non-functioning pancreatic neuroendocrine neoplasms werepositive for HAb18G/CD147,3 (60%) in the cell membrane and 2 (40%) both in the cell membrane and cytoplasm. Conclusion Glucagonoma mainly occurred in elderly patients and women were slightly more frequently affected. The tumors were more often occurred in the tail of the pancreas and generally large. The most common symptom is glucose intolerance. The tumors showed a predominance of trabecular pattern, which could be a useful tool for the differential diagnosis of this tumor. Metastasis was commonly seen in glucagonoma, but its prognosis was relatively good. Our study indicated that the expression of proglucagon potentially depressed during the dedifferentiation of the glucagonoma, but more research is needed to confirm that. The expression level of HAb18G/CD147 was positively correlated the poor outcomes of thepancreatic neuroendocrine neoplasm, it has a potential clinical application value.