Intraoperative quick immunoperoxidase staining: a useful adjunct to routine pathological diagnosis in pancreatic carcinoma.
BACKGROUND/AIMS: This paper presents the results of a study comparing conventional and quick immunostaining. This paper aims to introduce the reliability of the immunoperoxidase method for rapid intraoperative pathological diagnosis of pancreatic cancer and the quick staining method. MATERIALS AND METHODS: Intrapancreatic extension and intraperitoneal spread of pancreatic duct cell carcinoma were evaluated by both conventional and quick immunostaining using antibodies against cancer-associated antigens CA19-9, DUPAN-2, and CEA for intraoperative pathological examination during the course of laparotomy. RESULTS: For the surgical cut margin, malignant lesions were identified in six of 30 cases by H-E staining. However, cancer cells were detected in 14 of 30 cases by the immunostaining method. On peritoneal washing cytological examination, malignant cells were recognized in four of 27 cases by conventional cytology. In two other cases, positive immunocytochemical findings were noted, and these clinical courses were suggestive of the immunostaining results. CONCLUSIONS: This immunostaining method was particularly useful in defining cancer cells surrounded by dense fibrous connective tissue and a very small number of cancer cells within the mesothelium, in which malignant cells are usually difficult to identify by conventional staining. Thus, the application of such immunostaining, together with conventional staining, on the cryostat sections of biopsy or on the peritoneal washings may provide sensitive information for intraoperative pathological examination and for selection of the appropriate surgical method.