Inflammatory protein profiling of pancreatic cyst fluid using EUS-FNA in tandem with cytokine microarray differentiates between branch duct IPMN and inflammatory cysts

Linda S. Lee, Peter A. Banks, Andrew M. Bellizzi, Nisha I. Sainani, Vivek Kadiyala, Shadeah Suleiman, Darwin L. Conwell, Joao A. Paulo

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Diagnosis of pancreatic cystic neoplasms remains problematic. We hypothesize that inflammatory mediator proteins in pancreatic cyst fluid can differentiate branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) and pancreatic inflammatory cysts. We aim to 1) detect inflammatory mediator proteins (IMPs) using a multiplexed IMP-targeted microarray in pancreatic cyst fluid obtained during endoscopic ultrasound fine needle aspiration (EUS-FNA) and 2) compare IMP profiles in pancreatic cyst fluid from BD-IPMNs and inflammatory cysts. Pancreatic cyst fluid from ten patients (5 BD-IPMN and 5 inflammatory cysts) was obtained by EUS-FNA and analyzed directly with a multiplexed microarray assay to determine concentrations of 89 IMPs. Statistical analysis was performed using non-parametric methods. Results: Eighty-three of the 89 assayed IMPs were detected in at least one of the 10 patient samples. Seven IMPs were detected in BD-IPMN but not inflammatory cysts, while eleven IMPs were identified in inflammatory cysts but not BD-IPMN. Notably, granulocyte-macrophage colony-stimulating factor (GM-CSF) expression was present in all five inflammatory cyst samples. Hepatocyte growth factor (HGF) was present in significantly higher concentrations in inflammatory cysts compared to BD-IPMN. Conclusion: Our exploratory analysis reveals that GM-CSF and HGF in EUS-FNA-collected pancreatic cyst fluid can distinguish between BD-IPMN and inflammatory cyst. Coupling microarray molecular techniques to EUS-FNA may represent a major step forward to our understanding complex pancreatic disease.

Original languageEnglish
Pages (from-to)142-149
Number of pages8
JournalJournal of Immunological Methods
Volume382
Issue number1-2
DOIs
StatePublished - Aug 31 2012

Bibliographical note

Funding Information:
Funds were provided by the American College of Gastroenterology Clinical Research Award (LL, 2011) and the NIH NIDDK NRSA Fellowship (JP, NIH NIDDK 1F32 DK085835-01A1 ) and Harvard Digestive Diseases Center (DC, NIH 5 P30 DK034854-24 ) and NIH NIDDK (DC, 1R21 DK081703-01A2 ).

Keywords

  • Biomarker
  • Cytokine
  • Endoscopic ultrasound fine needle aspiration
  • IPMN
  • Pancreas cyst
  • Pseudocyst

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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