{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:40:41Z","timestamp":1790286041097,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T00:00:00Z","timestamp":1545091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["16KT0125"],"award-info":[{"award-number":["16KT0125"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accurate diagnosis of malignant and benign pancreatic lesions can be challenging, especially with endoscopic ultrasound\u2010guided fine needle aspiration (<jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>) samples that are small and\/or degraded. In the present study, we determined how to best evaluate abnormal <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 expression by immunohistochemical staining on cell block specimens from <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content> samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In surgically resected pancreas, when abnormal <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 immunolabelling was evaluated as negative <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 expression, the sensitivity was low (33%), but when it was evaluated as decreased <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 expression, the sensitivity improved (53%). Specificity and positive predictive value were high for both evaluations. There were no false\u2010positive cases. In cell block specimens, decreased <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 expression showed 47% sensitivity and 72% specificity, while negative <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 expression showed lower sensitivity (20%) and higher specificity (100%). Both evaluations in cell block specimens showed lower sensitivity and specificity compared to resected specimens. False\u2010positive and \u2010negative rates were higher for cell blocks than for resected specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Decreased <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 immunolabelling provided improved sensitivity as compared to negative <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 immunolabelling; therefore, it is important to compare <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 expression in a sample to its expression in normal cells. Abnormal <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 labelling showed low sensitivity and high specificity; therefore, <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 staining using <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content> samples might be helpful to detect malignancies that possess <jats:italic><jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4<\/jats:italic> gene abnormalities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cyt.12653","type":"journal-article","created":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T06:39:06Z","timestamp":1542091146000},"page":"201-208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Abnormal immunolabelling of <scp>SMAD<\/scp>4 in cell block specimens to distinguish malignant and benign pancreatic 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