Immunohistochemistry for Diagnosis of Metastatic Carcinomas of Unknown Primary Site.
Immunohistochemistry for Diagnosis of Metastatic Carcinomas of Unknown Primary Site.
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DOI：
10.3390/cancers10040108
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发表时间：
2018-04-05
期刊：
影响因子：
5.2
通讯作者：
Ilié M
中科院分区：
文献类型：
--
作者：
Selves J;Long-Mira E;Mathieu MC;Rochaix P;Ilié M
免疫组织化学已成为识别和分类原发灶不明的癌(CUPS)的必要辅助检查。在过去的十年里，器官或肿瘤特异性免疫标记物的诊断准确性和有效的免疫组织化学面板的临床验证都有了显著的提高。在处理小样本量时，诊断的准确性至关重要，特别是在当前靶向分子和基于免疫的疗法的时代。有效、系统地使用适当的免疫组织化学面板，能够准确地对大多数未分化癌进行分类，并仔细保存组织以进行潜在的分子或其他辅助测试。该综述讨论了使用CK7和CK20染色模式诊断CUPS的算法方法。它概述了最常用的组织特异性抗体，提供了一些在避免潜在诊断错误方面必不可少的陷阱，并讨论了辅助工具，如分子肿瘤概况和突变特异性抗体，以改进诊断和预测治疗反应。
Immunohistochemistry has become an essential ancillary examination for the identification and classification of carcinomas of unknown primary site (CUPs). Over the last decade, the diagnostic accuracy of organ- or tumour-specific immunomarkers and the clinical validation of effective immunohistochemical panels has improved significantly. When dealing with small sample sizes, diagnostic accuracy is crucial, particularly in the current era of targeted molecular and immune-based therapies. Effective systematic use of appropriate immunohistochemical panels enables accurate classification of most of the undifferentiated carcinomas as well as careful preservation of tissues for potential molecular or other ancillary tests. This review discusses the algorithmic approach to the diagnosis of CUPs using CK7 and CK20 staining patterns. It outlines the most frequently used tissue-specific antibodies, provides some pitfalls essential in avoiding potential diagnostic errors and discusses the complementary tools, such as molecular tumour profiling and mutation-specific antibodies, for the improvement of diagnosis and prediction of the treatment response.