Annexin Expression in Cholangiocarcinoma, and Metastatic Pancreatic Ductal Adenocarcinoma “Is it be Helpful for Differential Diagnosis of These Tumors in the Liver?”

Background & Objective: Differential diagnosis between cholangiocarcinoma (CCA) and metastatic pancreatic ductal adenocarcinoma (PDA) in the liver is difficult and so far, no specific immunohistochemical marker is reported to differentiate these two tumors. Considering the existing literature, the level of expression of Annexins (Annexin A۱, ۱۰ and ۱۳) have been studied for differential diagnosis between these two tumors by molecular methods and promising results have been reported. Therefore, in this study, we tried to investigate the immunohistochemical value of these three Annexins for the differential diagnosis of CCA and PDA in the liver.Methods: The articles that reported the research subject in ۱۰ years (۲۰۰۹-۲۰۱۹), including ۴۵ cases of CCA and ۵۰ cases of metastatic PDA in the liver were evaluated considering the presence or absence of AnnexinA۱ (ANXA۱), Annexin A۱۰ (ANXA۱۰) and Annexin A۱۳ (ANXA۱۳) expression by immunohistochemistry, were investigated.Results & Conclusion: This study showed, ANXA۱ was positive both in PDA and CCA, ANXA۱۰ was positive in ~۶۰% of PDA cases and ~۴۰% of CCA cases, and ANXA۱۳ was mostly negative in both groups. The best sensitivity was found in cytoplasmic and nuclear ANXA۱ (۸۰% and ۸۴%, respectively) to distinguish PDA from CCA and vice versa. The best specificity was observed in ANXA۱۰ and ANXA۱۳ to distinguish PDA from CCA. Also, ANXA۱۳ had the best specificity to distinguish CCA from PDA. Our investigations showed that, ANXA۱ probably can classify positive cases correctly, but it cannot discriminate PDA from CCA. ANXA۱۰ had fair sensitivity and specificity to discriminate PDA from CCA. ANXA۱۳ apparently had a high specificity that can help to narrow-down the differential diagnoses. 

Keywords:

Annexin A۱(ANXA۱) , Annexin A۱۰(ANXA۱۰) and Annexin A۱۳(ANXA۱۳) , Cholangiocarcinoma , pancreatic ductal adenocarcinoma , Immunohistochemistry