CK7, CK20, CDX2 and MUC2 Immunohistochemical Staining Used To Distinguish Metastatic Colorectal Carcinoma Involving Ovary from Primary Ovarian Mucinous Adenocarcinoma
CK7, CK20, CDX2 and MUC2 Immunohistochemical Staining Used To Distinguish Metastatic Colorectal Carcinoma Involving Ovary from Primary Ovarian Mucinous Adenocarcinoma
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DOI：
10.1093/jjco/hyp150
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发表时间：
2010-03-01
影响因子：
2.4
通讯作者：
Lee, Kyo-Young
中科院分区：
文献类型：
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作者：
Shin, Jung Ha;Bae, Jeong Hoon;Lee, Kyo-Young
结直肠腺癌是最常见的转移到卵巢的肿瘤，通常很难与原发性卵巢粘液腺癌（POMA）区分。我们检测了22例卵巢癌和41例卵巢转移性结直肠腺癌（MCAO）中细胞角蛋白7（CK 7）、细胞角蛋白20（CK 20）、CDX 2、CEA、MUC 2、MUC 5AC和α-甲基酰基-CoA消旋酶（AMACR）的免疫组织化学（IHC）表达。几乎都是MUC 5阴性（97.6%），常为CK 7阴性（82.9%），局灶性或弥漫性CDX 2阳性CK 20弥漫阳性73.2% MUC 2灶性或弥漫性阳性（51.2%），CEA弥漫性阳性（41.5%），AMACR阴性（41.5%）。因此，我们认为CK 7（-）、CK 20（弥漫性+）、CDX 2（+）和MUC 2（+）是结肠标志物，并将表达两种以上结肠标志物的病例视为MCAO，将不表达结肠标志物的病例视为POMA，将表达一种结肠标志物的病例视为不确定。CK 7/CK 20/CDX 2/MUC 2的正确分类率为82.5%，错误分类率为6.3%，不确定分类率为6.3%，CK 7、CK 20、CDX 2和MUC 2免疫组化染色是MCAO与POMA鉴别诊断的重要依据。
Colorectal adenocarcinoma, the most common tumor that metastasizes to the ovary, is often difficult to distinguish from primary ovarian mucinous adenocarcinoma (POMA). Obtaining the correct diagnosis is difficult but crucial to treatment and prognosis.We evaluated the immunohistochemical (IHC) expression of cytokeratin 7 (CK7), cytokeratin 20 (CK20), CDX2, CEA, MUC2, MUC5AC and alpha-methylacyl-CoA racemase (AMACR) in 22 POMAs and 41 metastatic colorectal adenocarcinomas (MCAOs) involving ovaries.MCAOs, in contrast with POMAs, were almost always negative for MUC5 (97.6%), often negative for CK7 (82.9%), focal or diffuse positive for CDX2 (73.2%), diffuse positive for CK20 (65.9%), focal or diffuse positive for MUC2 (51.2%), diffuse positive for CEA (41.5%) and negative for AMACR (41.5%). We therefore considered CK7 (-), CK20 (diffuse +), CDX2 (+) and MUC2 (+) to be colonic markers and regarded cases with expression of more than two colonic markers as MCAO, those with no expression of colonic markers as POMA and those with expression of one colonic marker as indeterminate. Using CK7/CK20/CDX2/MUC2, 82.5% of the cases were correctly classified, 6.3% were misclassified and 6.3% were indeterminate.CK7, CK20, CDX2 and MUC2 IHC staining is a useful adjunctive diagnostic tool to differentiate MCAOs from POMAs, in addition to clinical history and gross and microscopic findings.