Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation.
Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation.
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DOI：
10.1016/j.humpath.2008.08.014
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发表时间：
2009-03
期刊：
影响因子：
3.3
通讯作者：
Resnick, Murray B.
中科院分区：
文献类型：
--
作者：
Winn, Brody;Tavares, Rosemarie;Fanion, Jacqueline;Noble, Lelia;Gao, John;Sabo, Edmond;Resnick, Murray B.
与低分化结肠癌（PDC）相比，未分化癌或髓样癌（MC）的特点是其独特的组织学外观和相对较好的预后。仅通过光学显微镜可能很难区分这两个实体。仅报道了有限的 MC 免疫组织化学研究。这些研究表明肠道分化丧失，CDX2 阴性比例较高就是例证。我们的目的是进一步表征 MC 的免疫组织化学特征，特别强调肠道标记物。取回 16 例 MC 和 33 例 PDC 的石蜡块，构建组织微阵列并用免疫组织化学组染色，包括 CDX2、CK7、CK20、p53、肠三叶因子 3 (TFF3)、嗜铬蛋白、突触素、MLH-1、MUC-1、MUC-2 和钙视网膜蛋白。根据之前的研究，与 PDC 相比，MC 的比例明显较高，显示 MLH-1 和肠道转录因子 CDX2 的染色丢失。 MLH-1 染色仅存在于 21% 的 MC 病例中，而 PDC 病例中有 60% (p=0.02)，而 CDX2 在 19% 的 MC 和 55% 的 PDC 中呈阳性 (p=0.03)。有趣的是，钙结合蛋白染色在 73% 的 MC 中呈强阳性，而在 PDC 中只有 12% (p<0.0001)。通过 MUC-1、MUC-2 和 TFF-3 染色，分别在 67%、60% 和 53% 的 MC 中观察到肠分化的证据。这三个标志物在许多 CDX2 阴性 MC 病例中经常呈阳性。结肠髓样癌保留了显着程度的肠分化，其 MUC-1、MUC-2 和 TFF-3 染色百分比很高就证明了这一点。 Calretinin、MLH-1 和 CDX2 可能有助于区分结肠的 MC 和 PDC。
Undifferentiated or medullary carcinoma (MC) is characterized by its distinct histologic appearance and relatively better prognosis compared to poorly differentiated colonic carcinoma (PDC). These two entities may be difficult to differentiate by light microscopy alone. Only limited immunohistochemical studies investigating MC have been reported. These studies suggest a loss of intestinal differentiation, exemplified by a high percentage of CDX2 negativity. Our aim was to further characterize the immunohistochemical profile of MC, with particular emphasis on intestinal markers. Paraffin blocks from 16 cases of MC and 33 cases of PDC were retrieved and tissue microarrays were constructed and stained with an immunohistochemical panel including, CDX2, CK7, CK20, p53, intestinal trefoil factor 3 (TFF3), chromogranin, synaptophysin, MLH-1, MUC-1, MUC-2 and calretinin. A significantly higher proportion of MC, as opposed to PDC showed loss of staining for MLH-1 and for the intestinal transcription factor CDX2, in accordance with previous studies. MLH-1 staining was present in only 21% of MC cases compared with 60% of the PDC cases (p=0.02), whereas CDX2 was positive in 19% of MCs and 55% of PDCs (p=0.03). Interestingly, calretinin staining was strongly positive in 73% of MCs compared to only 12% of PDCs (p<0.0001). Evidence of intestinal differentiation by MUC-1, MUC-2 and TFF-3 staining was seen in 67, 60 and 53% of the MCs respectively. These three markers were frequently positive in many of the CDX2 negative MC cases. Medullary carcinoma of the colon retains a significant degree of intestinal differentiation as evidenced by its high percentage of staining for MUC-1, MUC-2, and TFF-3. Calretinin, MLH-1 and CDX2 may help to differentiate MC from PDC of the colon.
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影响因子：
6
作者：
Hinoi, T;Tani, M;Fearon, ER
通讯作者：
Fearon, ER
影响因子：
29.4
作者：
NAKAMORI, S;OTA, DM;IRIMURA, T
通讯作者：
IRIMURA, T
影响因子：
1.9
作者：
Drummond, F;Putt, W;Edwards, YH
通讯作者：
Edwards, YH
影响因子：
29.4
作者：
TYTGAT, KMAJ;BULLER, HA;DEKKER, J
通讯作者：
DEKKER, J
DOI：
10.1016/0167-4889(96)00090-0
发表时间：
1996-10-11
影响因子：
5.1
作者：
Cargnello, R;Celio, MR;Gotzos, V
通讯作者：
Gotzos, V