| Objective: Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) has become established in the diagnosis of pancreatic adenocarcinoma. But the sensitive of diagnosis was not satisfied. Expression of mesothelin, Cathepsin E, Maspin and S100P in Specimen of Pancreatic adenocarcinoma Fine-needle Aspiration was investigated to improve the sensitive of diagnosis. Methods: A New Type Endoscopic Ultrasonography Fine Needle was invented and evaluated by analogue test in vitro. Levels of CEA and CA19-9 in serum and in Fine-needle Aspiration were measured by chemiluminescence immunoassay. Mesothelin.Cathepsin E,Maspin,S100P was analyzed with immunohistochemical analysis ,PCR,ELISA ,Western blotting in the specimens obtained by EUS-FNA. Results: Average cell population was 18.58±12.65 in popular type needle and 36.88±17.91 in new type needle (p< 0.01) The contents of CEA, CA199 in Fine-needle Aspiration were significantly higher than that in serum obtained from patients with pancreatic carcinoma (P<0.05). S100P mRNA was detected at high amounts in specimens of EUS-FNA in cases with pancreatic carcinoma. In contrast, S100P mRNA was absent or low level in patients with chronic pancreatitis. Significant differences between pancreatic adenocarcinoma and chronic pancreatitis for mesothelin protein in specimens of EUS-FNA (P < 0.01) was observed .The expression of Cathepsin E (83.3%, p=0.029) , Maspin (79.2 %,p=0.023), S100P(91.7%,p=0.036)was observed in specimens of EUS-FNA but less in serum in cases with pancreatic carcinoma.Conclusions:Using the new type EUS fine needle can gained more specimens. Mesothelin, Cathepsin E, Maspin and S100P are differential expression genes of pancreatic adenocarcinoma and they are overexpression in pancreatic adenocarcinoma. Mesothelin, Cathepsin E, Maspin S100P,CEA and CA19-9 in Specimen of EUS-FNA examination may improve the diagnostic sensibility for pancreatic adenocarcinoma. The data has significant diagnostic implications.
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