Immunohistochemical staining for S100P, SMAD4, and IMP3 on cell block preparations is sensitive and highly specific for pancreatic ductal adenocarcinoma

Jacob Sweeney, Rema Rao, Elizabeth Margolskee, Abha Goyal, Jonas J. Heymann, Momin T. Siddiqui

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Introduction: The diagnosis of pancreatic ductal adenocarcinoma (PDA) on endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) material is often challenging. An immunohistochemical (IHC) panel may help establish the diagnosis of PDA in cases limited by sample size or ambiguous cytology. S100P, IMP3, and SMAD4 are 3 IHC markers that have shown promise as individual markers for PDA that have never been tested together as a panel. In this study, we evaluated the individual and combined efficacy of S100P, IMP3, and SMAD4 for the detection of PDA. Materials and Methods: S100P, IMP3, and SMAD4 IHC staining was performed on cell blocks (CBs) procured from pancreatic EUS-FNA procedures. The cohort included CBs that were diagnostic for PDA (n = 35), suspicious but nondiagnostic for PDA (n = 2), as well as CBs with benign pancreatic ductal epithelium (n = 12) and benign reactive pancreatic ductal epithelium (n = 18). A positive result for IMP3 and S100P was defined as moderate or strong staining of >10% of ductal cells. Complete lack of SMAD4 nuclear staining was considered a positive result—any nuclear SMAD4 staining was considered a negative result. Results: Two and 3 IHC marker panels were almost always more specific than individual IHC markers. Positivity for at least 2 of 3 IHC markers was a sensitive (91.89%) and highly specific (100%) marker of PDA. Conclusions: The 3 IHC marker panel composed of S100P, IMP3, and SMAD4 is highly specific for PDA. Future studies should evaluate efficacy in a cohort with more atypical and suspicious cases.

Original languageEnglish (US)
Pages (from-to)318-323
Number of pages6
JournalJournal of the American Society of Cytopathology
Issue number6
StatePublished - Nov 1 2018
Externally publishedYes


  • Cell block
  • Endoscopic ultrasound-guided fine-needle aspiration
  • IMP3
  • Immunohistochemistry
  • Pancreatic ductal adenocarcinoma
  • S100P
  • SMAD4

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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