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Morphological and p40 immunohistochemical analysis of squamous differentiation in endoscopic ultrasound guided fine needle biopsies of pancreatic ductal adenocarcinoma

Lookup NU author(s): Dr Beate Haugk, Professor Kofi Oppong, Dr John LeedsORCiD, Dr Antony Darne, Professor Philip Sloan, Dr Manu Nayar



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s).The basal-like molecular subtype of pancreatic ductal adenocarcinoma (PDAC) is associated with poor prognosis and upregulation in TP63ΔN (p40) network. Adenosquamous histology can be observed. This study assessed immunohistochemical p40 expression in fine needle biopsy (FNB) samples with PDAC and association with cytomorphological features of squamous differentiation and clinical data. 106 EUS FNBs with PDAC were assessed for eight cytomorphological features of squamous differentiation. P40 H-score (intensity 0–3 × percentage positive nuclei) was analysed for association with morphological features, patient age, gender, operability, chemotherapy and survival. P40 H-score in 14 paired FNBs and resections was compared. P40 h-score was 1–3 in 31%, 4–30 in 16% and > 30 in 13% of FNBs. It was significantly associated with intercellular bridges, elongated cell shape, sharp cell borders, angular nuclei with homogenous chromatin (p < 0.001) and dense cytoplasm (p = 0.002). Keratinisation was not seen. Inoperable patients (n = 81) had a shorter median survival for h-score > 30 (n = 9, 1.8 months) than for h-score ≤ 30 (n = 66, 6.7 months) not quite reaching statistical significance (p = 0.08). P40 was significantly associated with squamous morphology in FNBs with PDAC. P40 H-score > 30 showed a trend towards shorter survival in inoperable patients. Squamous differentiation may be a treatment target in PDAC.

Publication metadata

Author(s): Haugk B, Horton D, Oppong K, Leeds J, Darne A, Sloan P, Ness T, Jones C, Bassett P, Nayar M

Publication type: Article

Publication status: Published

Journal: Scientific Reports

Year: 2021

Volume: 11

Issue: 1

Online publication date: 28/10/2021

Acceptance date: 14/10/2021

Date deposited: 09/01/2024

ISSN (electronic): 2045-2322

Publisher: Nature Research


DOI: 10.1038/s41598-021-00652-5


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Funder referenceFunder name
Engineering and Physical Sciences Research Council (EPSRC)
Medical Research Council (MRC) Molecular Pathology Node