Islet-1 is a sensitive but not entirely specific marker for pancreatic neuroendocrine neoplasms and their metastases

Rondell Graham, Bijayee Shrestha, Bolette L. Caron, Thomas Christopher Smyrk, Karen L. Grogg, Ricardo V. Lloyd, Lizhi Zhang

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Islet-1 (Isl1) is a transcription factor involved in the embryogenesis of islets of Langerhans. Immunohistochemically, Isl1 is a sensitive lineage-specific marker for pancreatic neuroendocrine neoplasms (NENs) and their metastases. Its specificity has not been documented, nor have large numbers of NENs from other parts of the gut or other organs been studied. We examined Isl1 expression in 203 primary NENs (gastroenteropancreatic, lung, breast, and ovarian neoplasms) and 40 hepatic NEN metastases (enteropancreatic and lung neoplasms) from known primaries. The correlation between Isl1 and CDX2 expression was studied using a tissue microarray containing 46 pancreatic NENs. Immunostaining for Isl1 and CDX2 was also performed in selected NENs from other sites. Isl1 was positive in 90% of pancreatic, 89% of duodenal, 100% of rectal, 38% of colonic, 14% of appendiceal, and 6% of ileal primaries. Isl1 was negative in all other NENs. Among metastatic neoplasms, 76% of pancreatic and 2 of 2 rectal NEN metastases were Isl1 positive, whereas all other tested metastases were negative. The overall sensitivity and specificity of Isl1 in identifying primary pancreatic NENs was 88% and 80%, respectively. Thirty-six of 46 pancreatic NENs in the tissue microarray were Isl1 positive; 4 were Isl1 negative but CDX2 positive. Our findings confirm that Isl1 is a sensitive marker of pancreatic origin in cases of metastatic NEN. However, Isl1 does not distinguish pancreatic NEN from duodenal and colorectal NEN, even when used in association with CDX2.

Original languageEnglish (US)
Pages (from-to)399-405
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Pancreatic Neoplasms
Neoplasm Metastasis
Lung Neoplasms
Neoplasms
Neoplasms by Site
Liver Neoplasms
Rectal Neoplasms
Islets of Langerhans
Ovarian Neoplasms
Embryonic Development
Colorectal Neoplasms
Transcription Factors
Breast Neoplasms
Sensitivity and Specificity

Keywords

  • Islet-1
  • metastases of unknown primary
  • neuroendocrine markers
  • neuroendocrine neoplasms
  • pancreas

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Islet-1 is a sensitive but not entirely specific marker for pancreatic neuroendocrine neoplasms and their metastases. / Graham, Rondell; Shrestha, Bijayee; Caron, Bolette L.; Smyrk, Thomas Christopher; Grogg, Karen L.; Lloyd, Ricardo V.; Zhang, Lizhi.

In: American Journal of Surgical Pathology, Vol. 37, No. 3, 03.2013, p. 399-405.

Research output: Contribution to journalArticle

Graham, Rondell ; Shrestha, Bijayee ; Caron, Bolette L. ; Smyrk, Thomas Christopher ; Grogg, Karen L. ; Lloyd, Ricardo V. ; Zhang, Lizhi. / Islet-1 is a sensitive but not entirely specific marker for pancreatic neuroendocrine neoplasms and their metastases. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 3. pp. 399-405.
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