Cytokeratin 7 and Cytokeratin 20 Expression in Epithelial Neoplasms: A Survey of 435 Cases

Chu, Peiguo; Wu, Emerald; Weiss, Lawrence M.

doi:10.1038/modpathol.3880175

Cited by 904 publications

(656 citation statements)

References 24 publications

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“…Immunohistological analysis of paraffin sections is useful for confirmation of differential diagnosis 20 specific expression of TTF-1 in lung and thyroid, 21 and a panel of antibodies for the diagnosis of mesothelioma 22 are commonly used. Although we reported that mRNA expression of MGB1 could be used for differential diagnosis of breast cancer, 7 examination of mRNA expression using clinical material, especially biopsy specimens, is very difficult.…”

Section: Discussionmentioning

confidence: 99%

Breast-specific expression of MGB1/mammaglobin: an examination of 480 tumors from various organs and clinicopathological analysis of MGB1-positive breast cancers

Sasaki

Tsunoda

Hatanaka³

et al. 2007

Modern Pathology

122

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Previously, we used the reverse transcription-polymerase chain reaction (RT-PCR) to show that mammaglobin (MGB1) can serve as a differential marker of breast cancer metastasis from primary lung cancer. However, mRNA-based methods are not appropriate for use in clinical practices. In this study, we examined MGB1 protein expression in 480 tumors from various organs using immunohistochemical detection and a tissue microarray technique. Breast cancers expressing MGB1 were also analyzed clinicopathologically to determine whether these cancers constitute a characteristic subset. Immunohistochemically, MGB1 was expressed specifically in breast cancers. Of the other cancers examined, including 29 of the head and neck, eight of the thyroid, 106 of the lung, 35 of the gastrointestinal tract, three of the pancreas, 14 of the uterine cervix and 13 of the ovary, none were positive for MGB1 except a proportion of salivary gland tumors (6/11, 55%) and endometrial cancers (3/23, 13%). Among the 238 breast cancers, MGB1 was expressed in 114 (48%), most of which were classified histologically as invasive duct or lobular carcinomas. Clinicopathologically, MGB1 expression was associated with positive expression of estrogen receptors and negative expression of CK5, but not with pathological stage, HER2 gene amplification or p53 immunoreactivity. Kaplan-Meier analysis revealed prolonged disease-free survival in patients with MGB1-positive breast cancers (log rank test, P ¼ 0.016), but the Cox proportional hazard model failed to confirm that MGB1 was an independent prognostic factor (hazard ratio 1.77, P ¼ 0.1755). In terms of practical diagnosis, MGB1 immunohistochemistry can serve as a differential marker of breast cancer metastasis from primary lung cancer for two reasons. Firstly, HER2-positive breast cancer frequently lacks estrogen receptor expression, but MGB1 is expressed in about half of this subtype. Secondly, as primary lung adenocarcinomas may express estrogen receptors, MGB1 expression provides further discrimination of the origin of breast cancers.

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Section: Discussionmentioning

confidence: 99%

Breast-specific expression of MGB1/mammaglobin: an examination of 480 tumors from various organs and clinicopathological analysis of MGB1-positive breast cancers

Sasaki

Tsunoda

Hatanaka³

et al. 2007

Modern Pathology

122

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“…However, none of these stainings is specific for clear cell renal cell carcinoma, and the characteristic immunoprofile for renal cell carcinoma displays overlap with other tumors that may be confused with renal cell carcinoma. [16][17][18][19][20][21] The high percentage of CD10 staining of clear cell renal cell carcinoma has been described recently. 11 The histogenesis of the stromal cells of hemangioblastoma remains unclarified.…”

Section: Discussionmentioning

confidence: 99%

Immunoreactivity of CD10 and inhibin alpha in differentiating hemangioblastoma of central nervous system from metastatic clear cell renal cell carcinoma

Jung

Kuo

2005

Modern Pathology

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The differential diagnosis between hemangioblastoma of the central nervous system and metastatic clear cell renal cell carcinoma can be problematic, because they may share striking morphologic similarities. Since CD10 is expressed in clear cell renal cell carcinoma, while inhibin alpha is expressed in hemangioblastoma, we used CD10 and inhibin alpha (inhibin A) to study their possible use in the distinction of these two entities. A total of 22 cases of cerebellar hemangioblastoma, five cases of metastatic clear cell renal cell carcinoma to the central nervous system, and 16 primary cases of clear cell renal cell carcinoma were studied with immunohistochemical staining of both CD10 and inhibin A. All 22 cases of hemangioblastoma were immunonegative for CD10 in the stromal cells. In contrast, all five cases of metastatic clear cell renal cell carcinoma and 16 cases of primary clear cell renal cell carcinoma showed positive CD10 membranous staining. In all, 20 cases of hemangioblastoma (20/22, 91%) expressed inhibin A in the stromal cells. Two cases of primary clear cell renal cell carcinoma (2/16, 13%) and three cases of metastatic clear cell renal cell carcinoma (3/5, 60%) showed immunopositivity for inhibin A. In conclusion, in addition to the immunostaining of inhibin A, CD10 is a superior marker for distinguishing between a hemangioblastoma and a metastatic clear cell renal cell carcinoma.

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“…Recent studies have highlighted the salient morphologic features helpful in distinguishing a primary from a metastatic tumor, 3,20 however, occasionally immunohistochemical studies may be very helpful as supportive evidence in the above differential diagnosis. Differential staining with CK7 and CK20 in conjunction with morphology and clinical information is usually adequate in ascribing a primary site in the majority of the cases 4,6,7,9,10 however, a small percentage of primary ovarian adenocarcinomas, most often mucinous or endometrioid subtypes may be difficult to distinguish from a colorectal metastasis using differential cytokeratin expression. This is largely in part due to the high percentage (approximately 60% in one study) of primary mucinous ovarian tumors that may express cytokeratin 20 4,6,9 and coexpression of CK7 in up to 10% of colorectal tumors.…”

Section: Distinguishing Primary Ovarian From Metastatic S Logani Et Almentioning

confidence: 99%

“…[4][5][6][7][8] The use of differential cytokeratin expression using cytokeratin 7 (CK7) and cytokeratin 20 (CK20) in this group of tumors is of great value, although limited by the frequent expression of cytokeratin 20 in primary mucinous tumors of the ovary (reported to be up to 60% in some studies) and the coexpression of CK7 by a small subset of primary colonic adenocarcinomas. 6,9,10 More recently, immunohistochemical detection of cellular proteins such as CDX2 and b-catenin in colorectal carcinoma, …”

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confidence: 99%

Use of novel immunohistochemical markers expressed in colonic adenocarcinoma to distinguish primary ovarian tumors from metastatic colorectal carcinoma

et al. 2005

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Distinguishing primary ovarian carcinoma, particularly endometrioid and mucinous subtypes, from metastatic colorectal carcinoma to the ovary is often difficult on histologic examination alone. Recently, three immunohistochemical markers CDX2, a homeobox gene encoding an intestine-specific transcription factor; a-methylacyl-CoA racemase (AMACR/P504S), a mitochondrial and peroxisomal enzyme with fairly restricted expression in selective tumors and b-catenin, an adenomatous polyposis coli (APC) mutation product resulting in activation of the Wnt pathway, have been reported to have specific and sensitive expression in colorectal carcinomas. We evaluated a panel consisting of antibodies to CDX2, b-catenin and P504S in 23 primary ovarian adenocarcinomas (13 mucinous and 10 endometrioid) and compared the findings to 22 metastatic colorectal adenocarcinomas (seven mucinous and 15 nonmucinous tumors with endometrioid-like morphology hereafter referred to as pseudo-endometrioid) to the ovary stained with the same panel. Twenty (91%) metastatic tumors expressed at least two markers and seven (32%) expressed all three. In contrast, only three (13%) primary ovarian tumors expressed at least two markers and none expressed all three. Strong (2 þ , 3 þ ) and diffuse (440%) expression for CDX2 was noted in 21 (95%) metastatic tumors and five (22%) primary ovarian tumors (three mucinous, two endometrioid). P504S was similarly expressed in seven (32%) metastatic and none of the primary ovarian carcinomas. Nuclear expression of b-catenin was noted in 13 (59%) metastatic tumors and in eight cases (36%), it was diffuse and strong. In contrast, four (19%) primary tumors showed nuclear expression of this protein with only one (5%) case expressing it in a diffuse pattern. Immunohistochemical expression of gene products and enzymes of colorectal carcinogenesis in some primary ovarian carcinomas suggest that the morphologic similarities between colorectal and mucinous/endometrioid carcinoma of the ovary extends to the genetic level, although differences in the level of expression exist between these tumors. Diffuse expression of all three markers (CDX2, b-catenin and P504S) in a tumor in the ovary was found to be virtually diagnostic of metastasis from a colorectal primary in this study. Keywords: ovarian cancer; mucinous; adenocarcinoma; endometrioid adenocarcinoma; metastatic; colorectal carcinoma; CDX2; b-catenin; P504S It has been estimated that metastatic tumors to the ovary account for approximately 7% of all ovarian tumors 1 and the majority of these represent spread from primary lesions in the gastrointestinal tract. 2 Distinguishing primary ovarian adenocarcinoma, particularly endometrioid and mucinous subtypes, from metastatic tumors from the colon can be challenging. 3 In the past decade, numerous markers with differing specificity and sensitivity have been evaluated in the above differential diagnosis. [4][5][6][7][8] The use of differential cytokeratin expression using cytokeratin 7 (CK7) and cytokeratin 20 (CK20) in this gro...

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Cytokeratin 7 and Cytokeratin 20 Expression in Epithelial Neoplasms: A Survey of 435 Cases

Cited by 904 publications

References 24 publications

Breast-specific expression of MGB1/mammaglobin: an examination of 480 tumors from various organs and clinicopathological analysis of MGB1-positive breast cancers

Breast-specific expression of MGB1/mammaglobin: an examination of 480 tumors from various organs and clinicopathological analysis of MGB1-positive breast cancers

Immunoreactivity of CD10 and inhibin alpha in differentiating hemangioblastoma of central nervous system from metastatic clear cell renal cell carcinoma

Use of novel immunohistochemical markers expressed in colonic adenocarcinoma to distinguish primary ovarian tumors from metastatic colorectal carcinoma

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