Evaluation of L1CAM, SOX11, and chromogranin expression in pancreatic tumors: an immunohistochemical study

Abstract

Introduction Pancreatic duct adenocarcinoma (PDAC) is the 11th most common type of cancer and its incidence and death rates are steadily rising. In contrast to PDAC and pancreatic neuroendocrine tumors (PNETs), solid pseudopapillary neoplasm (SPN) is a low-grade malignant pancreatic tumor that exhibits distinct characteristics in terms of tumor aggressiveness, treatment, and prognosis. Aim To investigate the expression of L1CAM, SOX11, and chromogranin in PDAC, SPN, and PNETs and to show their diagnostic and prognostic significance. Materials and methods Retrospective Immunohistochemical staining of L1CAM, Sox11, and chromogranin was performed on selected 54 cases of pancreatic tumors. Results L1CAM was highly expressed in 73.3% of PDAC cases compared with 81.8% of SPN and 100% of PNET cases. SOX11 was positive in 90.9% of SPN, but negative in 100% of PDAC and 93.3% of PNETS cases. Chromogranin was positive in 76.9% of PNETS. SOX11 is a highly sensitive (100%) marker for discriminating between SPN and PDAC. Both SOX11 and chromogranin are highly specific (100%) and sensitive (90.9%) markers in differentiating SPN from PNET. L1CAM was significantly positively correlated with tumor grade ( P =0.02), T stage ( P =0.02), lymph node metastasis ( P =0.002), LVI ( P =0.000), and distant metastasis ( P =0.046) of PDAC studied cases. Conclusion SOX11 could be considered a highly sensitive marker for differentiating SPN from PDAC and PNETs. The combined expression of L1CAM, SOX11, and chromogranin may play a valuable role in solving this diagnostic challenge. L1CAM might have prognostic significance for PDAC and, hence, target therapy.