The Role Of Combined Use Of BCL-10 , Trypsin And Other Commonly Used Indicators In The Diagnosis And Differential Diagnosis Of Pancreatic Acinar Cell Carcinoma

Objective To investigate the clinicopathological characteristics of pancreatic acinar cell carcinoma(PACC),pancreatic neuroendocrine tumor(Pan NET)and solid pseudopapillary neoplasm(SPN).Immunohistochemistry was used to detect BCL-10,Trypsin,beta-catenin,CD10,PR,Cg A,Syn and Ki-67 in pancreatic acinar cell carcinoma(PACC),pancreatic neuroendocrine tumor(Pan NET)and solid pseudopapillary neoplasm(SPN).The expression and differential significance of the three tumors.Methods Forty-six cases of pancreatic cancer-related cases were collected from the Department of Pathology,First Affiliated Hospital of Anhui Medical University from2014 to 2018.Seven cases of pancreatic acinar cell carcinoma came from the Department of Pathology,Zhongshan Hospital Affiliated to Fudan University and the Department of Pathology,Yijishan Hospital,Southern Anhui Medical College.The levels of BCL-10,Trypsin,beta-catenin,CD10,PR,Cg A,Syn and Ki-67 were detected by two-step immunohistochemical En Vision method,and the clinicopathological characteristics of the three kinds of tumors were analyzed.Result(1)The positive rate of BCL-10 in pancreatic acinar cell carcinoma(8/10,80.0%)was mainly granular cytoplasm,which was not expressed in pancreatic neuroendocrine tumors and solid pseudopapillary tumors(P < 0.05).(2)The positive rate of Trypsin in pancreatic acinar cell carcinoma(7/10,70.0%)was mainly granular cytoplasm.The positive rate in pancreatic neuroendocrine tumors(3/16,18.8%)was mainly scattered weakly,and negative in solid pseudopapillary tumors of the pancreas(P < 0.05).(3)The positive rate of nuclear expression of beta-catenin in solid pseudopapillary tumors of pancreas(20/20,100.0%)was mainly nuclear positive,while that of beta-catenin in the other two tumors was mainly scattered weak membrane positive.The positive rate of nuclear expression was low.The positive rate of nuclear expression in acinar cell carcinoma of pancreas was(1/10,10.0%),and the positive rate of nucleus in neuroendocrine tumors of pancreas was(4/16,25.0%).No statistical significance(P >0.05)(4)The positive rates of CD10 and PR in solid pseudopapillary tumors of the pancreas were(19/20,95.0%)and(16/20,80.0%),respectively.They were not expressed in acinar cell carcinoma of the pancreas,but in neuroendocrine tumors of the pancreas(2/16,12.5%)and(10/16,62.5%).There was no significant difference in the expression of CD10 in the three tumors(P > 0.05).The expression of PR in pancreatic acinar cell carcinoma,pancreatic neuroendocrine tumor,pancreatic acinar cell carcinoma and solid pseudopapillary tumor was statistically significant(P < 0.05),but the expression of PR in pancreatic neuroendocrine tumor and solid pseudopapillary tumor was not statistically significant.(5)The positive rates of Cg A and Syn in pancreatic neuroendocrine tumors were(16/16,100%)and(15/16,93.7%).The positive rates in pancreatic acinar cell carcinoma were(2/10,20.0%)and(3/10,30.0%)respectively.The positive rates in solid pseudopapillary tumors of pancreas were(0/20,0.0%)and(8/20,40.0%).Cg A and Syn are mainly expressed in pancreatic neuroendocrine tumors.There was no significant difference in the expression of Cg A and Syn among the three tumors(P > 0.05).(6)The positive index of Ki-67 varies from 10% to 60% in pancreatic acinar cell carcinoma,from < 1% to 25% in pancreatic neuroendocrine tumors,and from < 1% to5% in solid pseudopapillary tumors of the pancreas.(7)The sensitivity and specificity of BCL-10 and Trypsin alone in the diagnosis of pancreatic acinar cell carcinoma were 80.0% and 70.0%,94.7% and 91.7%,respectively.(8)The sensitivity and specificity of combined use of BCL-10 and Trypsin in the diagnosis of pancreatic acinar cell carcinoma were 90.0% and 97.1%.Conclusion(1)Compared with Trypsin,BCL-10 has higher sensitivity and specificity in the diagnosis of pancreatic acinar cell carcinoma.(2)The sensitivity and specificity of combined use of BCL-10 and Trypsin were higher than those of single use of BCL-10 and Trypsin.Combined use of BCL-10 and Trypsin had higher sensitivity and specificity in the diagnosis of pancreatic acinar cell carcinoma.The combination of traditional indicators can improve the diagnosis and differential diagnosis of pancreatic acinar cell carcinoma,pancreatic neuroendocrine tumors and solid pseudopapillary tumors.