Diagnostic utility of mucin profile in fine-needle aspiration specimens of the pancreas : An immunohistochemical study with surgical pathology correlation
The cytologic differentiation between neoplastic and reactive/reparative processes in the endoscopic ultrasound-guided fine-needle aspirations (EUS-FNA) of the pancreas can be difficult. Malignant transformation of the pancreatic ductal epithelium changes the expression of apomucins. The goal of the...
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| Veröffentlicht in: | Cancer 2006-06, Vol.108 (3), p.186-197 |
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| creator | GIORGADZE, Tamar A PETERMAN, Heather BALOCH, Zubair W FURTH, Emma E PASHA, Theresa SHIINA, Natsuko ZHANG, Paul J GUPTA, Prabodh K |
| description | The cytologic differentiation between neoplastic and reactive/reparative processes in the endoscopic ultrasound-guided fine-needle aspirations (EUS-FNA) of the pancreas can be difficult. Malignant transformation of the pancreatic ductal epithelium changes the expression of apomucins. The goal of the current study was to determine an optimal immunohistochemical panel of mucin (MUC) antibodies that would allow the cytomorphologic distinction of pancreatic ductal adenocarcinoma and its differentiation from reactive/reparative processes and inadvertently sampled gastric and duodenal mucosa.
Pancreatic EUS-FNA specimens performed on 351 patients were reviewed. Expression profiles of MUC1, 2, 5AC, and 6 were examined on 56 cell block sections and 26 follow-up pancreatectomy specimens.
MUC1 and 6 expression was found in nonneoplastic pancreatic samples, whereas there was an absence of expression of MUC2 and 5AC. MUC2 was detected in mucosal goblets cells of the duodenum, MUC6 in Brunner glands, and MUC5AC in gastric foveolar cells. MUC5AC expression in differentiating ductal adenocarcinomas from benign conditions demonstrated better operating characteristics than either MUC1 or MUC6. The apomucin expression pattern both in cytology and follow-up surgical pathology specimens was similar. In surgical pathology specimens, the panel of 3 antibodies, MUC1+/MUC2-/MUC5AC+, was noted in 15 of 17 ductal carcinomas (88.2%). In nonneoplastic pancreatic tissue, the expression panel MUC1+/MUC2-/MUC5AC- was observed in 14 of 17 (82.4%) cases. In cytology specimens, the combination of MUC1+/MUC2-/MUC5AC+ was noted in 21 of 30 ductal carcinoma cases (70.0%), 3 of 6 atypical cases (50%), and 1 of 1 suspicious for malignancy cases (100%). The combination MUC1+/MUC2-/MUC5AC+ was not observed in any of the negative for malignancy or reactive cases (0 of 6).
The most optimal panel for the diagnosis of ductal adenocarcinoma in both the EUS-FNA specimens is a panel including MUC1/MUC2/MUC5AC, whereas a panel of all 4 antibodies (MUC1, 2, 5AC, and 6) will in addition aid in differentiating inadvertently sampled normal/reactive duodenal and gastric epithelium from neoplastic pancreatic tissue. |
| doi_str_mv | 10.1002/cncr.21913 |
| format | Article |
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Pancreatic EUS-FNA specimens performed on 351 patients were reviewed. Expression profiles of MUC1, 2, 5AC, and 6 were examined on 56 cell block sections and 26 follow-up pancreatectomy specimens.
MUC1 and 6 expression was found in nonneoplastic pancreatic samples, whereas there was an absence of expression of MUC2 and 5AC. MUC2 was detected in mucosal goblets cells of the duodenum, MUC6 in Brunner glands, and MUC5AC in gastric foveolar cells. MUC5AC expression in differentiating ductal adenocarcinomas from benign conditions demonstrated better operating characteristics than either MUC1 or MUC6. The apomucin expression pattern both in cytology and follow-up surgical pathology specimens was similar. In surgical pathology specimens, the panel of 3 antibodies, MUC1+/MUC2-/MUC5AC+, was noted in 15 of 17 ductal carcinomas (88.2%). In nonneoplastic pancreatic tissue, the expression panel MUC1+/MUC2-/MUC5AC- was observed in 14 of 17 (82.4%) cases. In cytology specimens, the combination of MUC1+/MUC2-/MUC5AC+ was noted in 21 of 30 ductal carcinoma cases (70.0%), 3 of 6 atypical cases (50%), and 1 of 1 suspicious for malignancy cases (100%). The combination MUC1+/MUC2-/MUC5AC+ was not observed in any of the negative for malignancy or reactive cases (0 of 6).
The most optimal panel for the diagnosis of ductal adenocarcinoma in both the EUS-FNA specimens is a panel including MUC1/MUC2/MUC5AC, whereas a panel of all 4 antibodies (MUC1, 2, 5AC, and 6) will in addition aid in differentiating inadvertently sampled normal/reactive duodenal and gastric epithelium from neoplastic pancreatic tissue.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.21913</identifier><identifier>PMID: 16628655</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York, NY: Wiley-Liss</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy, Fine-Needle ; Carcinoma, Ductal - diagnosis ; Carcinoma, Ductal - metabolism ; Carcinoma, Ductal - pathology ; Child ; Diagnosis, Differential ; Duodenum - pathology ; Female ; Gastric Mucosa - pathology ; Humans ; Immunohistochemistry ; Intestinal Mucosa - pathology ; Male ; Medical sciences ; Middle Aged ; Mucins - metabolism ; Pancreas - metabolism ; Pancreas - pathology ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - metabolism ; Pancreatic Neoplasms - pathology ; Tumors</subject><ispartof>Cancer, 2006-06, Vol.108 (3), p.186-197</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c274t-87e21db93ac2245a43459328f1bbe375e4037f6e00d3045914f4c62258e288723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17864003$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16628655$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GIORGADZE, Tamar A</creatorcontrib><creatorcontrib>PETERMAN, Heather</creatorcontrib><creatorcontrib>BALOCH, Zubair W</creatorcontrib><creatorcontrib>FURTH, Emma E</creatorcontrib><creatorcontrib>PASHA, Theresa</creatorcontrib><creatorcontrib>SHIINA, Natsuko</creatorcontrib><creatorcontrib>ZHANG, Paul J</creatorcontrib><creatorcontrib>GUPTA, Prabodh K</creatorcontrib><title>Diagnostic utility of mucin profile in fine-needle aspiration specimens of the pancreas : An immunohistochemical study with surgical pathology correlation</title><title>Cancer</title><addtitle>Cancer</addtitle><description>The cytologic differentiation between neoplastic and reactive/reparative processes in the endoscopic ultrasound-guided fine-needle aspirations (EUS-FNA) of the pancreas can be difficult. Malignant transformation of the pancreatic ductal epithelium changes the expression of apomucins. The goal of the current study was to determine an optimal immunohistochemical panel of mucin (MUC) antibodies that would allow the cytomorphologic distinction of pancreatic ductal adenocarcinoma and its differentiation from reactive/reparative processes and inadvertently sampled gastric and duodenal mucosa.
Pancreatic EUS-FNA specimens performed on 351 patients were reviewed. Expression profiles of MUC1, 2, 5AC, and 6 were examined on 56 cell block sections and 26 follow-up pancreatectomy specimens.
MUC1 and 6 expression was found in nonneoplastic pancreatic samples, whereas there was an absence of expression of MUC2 and 5AC. MUC2 was detected in mucosal goblets cells of the duodenum, MUC6 in Brunner glands, and MUC5AC in gastric foveolar cells. MUC5AC expression in differentiating ductal adenocarcinomas from benign conditions demonstrated better operating characteristics than either MUC1 or MUC6. The apomucin expression pattern both in cytology and follow-up surgical pathology specimens was similar. In surgical pathology specimens, the panel of 3 antibodies, MUC1+/MUC2-/MUC5AC+, was noted in 15 of 17 ductal carcinomas (88.2%). In nonneoplastic pancreatic tissue, the expression panel MUC1+/MUC2-/MUC5AC- was observed in 14 of 17 (82.4%) cases. In cytology specimens, the combination of MUC1+/MUC2-/MUC5AC+ was noted in 21 of 30 ductal carcinoma cases (70.0%), 3 of 6 atypical cases (50%), and 1 of 1 suspicious for malignancy cases (100%). The combination MUC1+/MUC2-/MUC5AC+ was not observed in any of the negative for malignancy or reactive cases (0 of 6).
The most optimal panel for the diagnosis of ductal adenocarcinoma in both the EUS-FNA specimens is a panel including MUC1/MUC2/MUC5AC, whereas a panel of all 4 antibodies (MUC1, 2, 5AC, and 6) will in addition aid in differentiating inadvertently sampled normal/reactive duodenal and gastric epithelium from neoplastic pancreatic tissue.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Fine-Needle</subject><subject>Carcinoma, Ductal - diagnosis</subject><subject>Carcinoma, Ductal - metabolism</subject><subject>Carcinoma, Ductal - pathology</subject><subject>Child</subject><subject>Diagnosis, Differential</subject><subject>Duodenum - pathology</subject><subject>Female</subject><subject>Gastric Mucosa - pathology</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Intestinal Mucosa - pathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mucins - metabolism</subject><subject>Pancreas - metabolism</subject><subject>Pancreas - pathology</subject><subject>Pancreatic Neoplasms - diagnosis</subject><subject>Pancreatic Neoplasms - metabolism</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Tumors</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc9q3DAQxkVoaTZpL3mAoEtzKDjVP9va3ELStIVALy30ZrTyaK1gS45GJuyr9Gmr3SzkpBnNTx-j7yPkgrNrzpj4aoNN14KvuTwhK87WbcW4Eu_IijGmq1rJv6fkDPGptK2o5QdyyptG6KauV-TfvTfbEDF7S5fsR593NDo6LdYHOqfo_Ai0lM4HqAJAX1qDs08m-xgozmD9BAH3j_IAdDZlGTBIb-htoH6alhAHjznaASZvzUgxL_2Ovvg8UFzS9nA3mzzEMW531MaUYDyIfyTvnRkRPh3Pc_Ln4dvvux_V46_vP-9uHysrWpUr3YLg_WYtjRVC1UZJVa-l0I5vNiDbGhSTrWuAsV6yMuLKKdsIUWsQWrdCnpOrV93y3ecFMHeTRwvjaALEBbtGM6054wX88graFBETuG5OfjJp13HW7ZPo9kl0hyQKfHlUXTYT9G_o0foCfD4CBosHLhXnPL5xrW4UY1L-B6hYlAw</recordid><startdate>20060625</startdate><enddate>20060625</enddate><creator>GIORGADZE, Tamar A</creator><creator>PETERMAN, Heather</creator><creator>BALOCH, Zubair W</creator><creator>FURTH, Emma E</creator><creator>PASHA, Theresa</creator><creator>SHIINA, Natsuko</creator><creator>ZHANG, Paul J</creator><creator>GUPTA, Prabodh K</creator><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060625</creationdate><title>Diagnostic utility of mucin profile in fine-needle aspiration specimens of the pancreas : An immunohistochemical study with surgical pathology correlation</title><author>GIORGADZE, Tamar A ; PETERMAN, Heather ; BALOCH, Zubair W ; FURTH, Emma E ; PASHA, Theresa ; SHIINA, Natsuko ; ZHANG, Paul J ; GUPTA, Prabodh K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c274t-87e21db93ac2245a43459328f1bbe375e4037f6e00d3045914f4c62258e288723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Fine-Needle</topic><topic>Carcinoma, Ductal - diagnosis</topic><topic>Carcinoma, Ductal - metabolism</topic><topic>Carcinoma, Ductal - pathology</topic><topic>Child</topic><topic>Diagnosis, Differential</topic><topic>Duodenum - pathology</topic><topic>Female</topic><topic>Gastric Mucosa - pathology</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Intestinal Mucosa - pathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mucins - metabolism</topic><topic>Pancreas - metabolism</topic><topic>Pancreas - pathology</topic><topic>Pancreatic Neoplasms - diagnosis</topic><topic>Pancreatic Neoplasms - metabolism</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GIORGADZE, Tamar A</creatorcontrib><creatorcontrib>PETERMAN, Heather</creatorcontrib><creatorcontrib>BALOCH, Zubair W</creatorcontrib><creatorcontrib>FURTH, Emma E</creatorcontrib><creatorcontrib>PASHA, Theresa</creatorcontrib><creatorcontrib>SHIINA, Natsuko</creatorcontrib><creatorcontrib>ZHANG, Paul J</creatorcontrib><creatorcontrib>GUPTA, Prabodh K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GIORGADZE, Tamar A</au><au>PETERMAN, Heather</au><au>BALOCH, Zubair W</au><au>FURTH, Emma E</au><au>PASHA, Theresa</au><au>SHIINA, Natsuko</au><au>ZHANG, Paul J</au><au>GUPTA, Prabodh K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic utility of mucin profile in fine-needle aspiration specimens of the pancreas : An immunohistochemical study with surgical pathology correlation</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2006-06-25</date><risdate>2006</risdate><volume>108</volume><issue>3</issue><spage>186</spage><epage>197</epage><pages>186-197</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>The cytologic differentiation between neoplastic and reactive/reparative processes in the endoscopic ultrasound-guided fine-needle aspirations (EUS-FNA) of the pancreas can be difficult. Malignant transformation of the pancreatic ductal epithelium changes the expression of apomucins. The goal of the current study was to determine an optimal immunohistochemical panel of mucin (MUC) antibodies that would allow the cytomorphologic distinction of pancreatic ductal adenocarcinoma and its differentiation from reactive/reparative processes and inadvertently sampled gastric and duodenal mucosa.
Pancreatic EUS-FNA specimens performed on 351 patients were reviewed. Expression profiles of MUC1, 2, 5AC, and 6 were examined on 56 cell block sections and 26 follow-up pancreatectomy specimens.
MUC1 and 6 expression was found in nonneoplastic pancreatic samples, whereas there was an absence of expression of MUC2 and 5AC. MUC2 was detected in mucosal goblets cells of the duodenum, MUC6 in Brunner glands, and MUC5AC in gastric foveolar cells. MUC5AC expression in differentiating ductal adenocarcinomas from benign conditions demonstrated better operating characteristics than either MUC1 or MUC6. The apomucin expression pattern both in cytology and follow-up surgical pathology specimens was similar. In surgical pathology specimens, the panel of 3 antibodies, MUC1+/MUC2-/MUC5AC+, was noted in 15 of 17 ductal carcinomas (88.2%). In nonneoplastic pancreatic tissue, the expression panel MUC1+/MUC2-/MUC5AC- was observed in 14 of 17 (82.4%) cases. In cytology specimens, the combination of MUC1+/MUC2-/MUC5AC+ was noted in 21 of 30 ductal carcinoma cases (70.0%), 3 of 6 atypical cases (50%), and 1 of 1 suspicious for malignancy cases (100%). The combination MUC1+/MUC2-/MUC5AC+ was not observed in any of the negative for malignancy or reactive cases (0 of 6).
The most optimal panel for the diagnosis of ductal adenocarcinoma in both the EUS-FNA specimens is a panel including MUC1/MUC2/MUC5AC, whereas a panel of all 4 antibodies (MUC1, 2, 5AC, and 6) will in addition aid in differentiating inadvertently sampled normal/reactive duodenal and gastric epithelium from neoplastic pancreatic tissue.</abstract><cop>New York, NY</cop><pub>Wiley-Liss</pub><pmid>16628655</pmid><doi>10.1002/cncr.21913</doi><tpages>12</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Biopsy, Fine-Needle Carcinoma, Ductal - diagnosis Carcinoma, Ductal - metabolism Carcinoma, Ductal - pathology Child Diagnosis, Differential Duodenum - pathology Female Gastric Mucosa - pathology Humans Immunohistochemistry Intestinal Mucosa - pathology Male Medical sciences Middle Aged Mucins - metabolism Pancreas - metabolism Pancreas - pathology Pancreatic Neoplasms - diagnosis Pancreatic Neoplasms - metabolism Pancreatic Neoplasms - pathology Tumors |
| title | Diagnostic utility of mucin profile in fine-needle aspiration specimens of the pancreas : An immunohistochemical study with surgical pathology correlation |
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