Immunohistochemical differentiation between primary adenocarcinomas of the ovary and ovarian metastases of colonic and breast origin. Comparison between a statistical and an intuitive approach
Immunohistochemical differentiation between primary adenocarcinomas of the ovary and ovarian metastases of colonic and breast origin. Comparison between a statistical and an intuitive approach
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DOI：
10.1136/jcp.52.4.283
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发表时间：
1999-04-01
影响因子：
3.4
通讯作者：
Meijer, CJLM
中科院分区：
文献类型：
--
作者：
Lagendijk, JH;Mullink, H;Meijer, CJLM
目的：应用逐步判别分析或决策树方法，通过免疫组织化学方法鉴别卵巢原发腺癌和卵巢转移癌，尤其是结肠癌和乳腺腺癌。这些肿瘤被分成学习组(n=159)和测试组，前者由卵巢、乳腺和结肠的原发肿瘤组成，后者包括134个来自这些部位的转移瘤和另外19个原发卵巢癌。免疫组化板由细胞角蛋白7(CK7)和28(CK20)、CA125、波形蛋白、癌胚抗原(CEA)、肉眼囊性病液蛋白15(GCDFP-15)和雌激素受体(ER)抗体组成。肿瘤染色结果用染色强度与阳性肿瘤细胞百分率的乘积表示。结果：虽然免疫染色模式在三种类型的腺癌之间有相当大的重叠，但乳腺癌通常GCDFP-15呈阳性，ER通常为阳性，而Vimentin则为阴性。卵巢癌中CK7总是阳性，CR125的阳性程度较小。结肠癌CEA、CK20阳性表达，ER、Vimentin表达阴性。在判别分析中，6种抗体(αCK7、αCK20、αCA125、αCEA、αER和αGCDFP-15)似乎是最佳分类所必需的：89%的学习集和82%的测试集被正确分类。在决策树中，仅使用4种抗体(aCK7、αCEA、αER和αGCDFP 15)获得学习集和测试集的RI正确分类分数分别为89%和84%。结论：采用逐步判别分析对6种抗体的免疫染色结果进行半定量评估，80%-90%的结肠癌、乳腺癌和卵巢腺癌可以被正确分类。判别分析是计算机辅助的，因此是一种简单的方法，并且对于每种情况都获得分类结果的概率值。直观的决策树方法提供了略好的结果，只需要四个抗体，为外科病理学家提供了一种更实用的方法。
Aim-To discriminate between adenocarcinomas that are primary to the ovary and metastatic to the ovary, especially of colonic and breast origin, by immunohistochemistry, using stepwise discriminant analysis or a decision tree.Methods-312 routinely processed, formalin fixed tissue specimens were used. The tumours were divided into a learning set (n = 159), composed of primary tumours of ovary, breast, and colon, and a test set, comprising 134 metastases from these sites and an additional 19 primary ovarian carcinomas. The immunohistochemical panel was composed of antibodies against cytokeratin 7 (CK7) and 28 (CK20), CA125, vimentin, carcinoembryonic antigen (CEA), gross cystic disease fluid protein- 15 (GCDFP-15), and the oestrogen receptor (ER). The staining results of the tumours were expressed as the product of the staining intensity and the percentage of positive tumour cells. Analyses were first performed on the learning set and then evaluated on the test set.Results-Although the immunostaining patterns showed a considerable overlap between the three types of adenocarcinoma, the breast carcinomas were typically positive for GCDFP-15 and often for ER, and negative for vimentin. Ovarian carcinomas were always positive for CK7 and to a lesser extent for CR125. Colonic carcinomas showed prominent positivity for CEA and CK20, while no staining was seen for ER and vimentin. In discriminant analysis, six antibodies (alpha CK7, alpha CK20, alpha CA125, alpha CEA, alpha ER, and alpha GCDFP-15) appeared to be necessary for optimal classification: 89% of the learning set and 82% of the test set were classified correctly. In the decision tree, only four antibodies (aCK7, alpha CEA, alpha ER, and alpha GCDFP15) were used to obtain ri correct classification score of 89% for the learning set and 84% for the test set.Conclusions-Using a semiquantitative assessment of the immunostaining results by a restricted panel of six antibodies with stepwise discriminant analysis, 80-90% of the adenocarcinomas of colon, breast, and ovary can be correctly classified. Discriminant analysis is computer aided and therefore an easy method and for each case a probability value of the classification result is obtained. The intuitive decision tree method provides a slightly better result, requires only four antibodies, and offers a more practical method for the surgical pathologist.