van Lier M G F, Bomhof F J, Leendertse I, Flens M, Balk A T, Loffeld R J L F
Department of Internal Medicine, De Heel Zaans Medisch Centrum, 1500 EE Zaandam, The Netherlands.
J Clin Pathol. 2005 Jul;58(7):722-4. doi: 10.1136/jcp.2004.024265.
It is sometimes difficult to distinguish between cardia cancer and oesophageal cancer.
To evaluate whether cytokeratin (CK) expression of the tumour can be of value in differentiating between the two tumour types.
Consecutive patients with a malignant tumour in the oesophagus or stomach were recruited. Biopsy specimens were taken for routine haematoxylin and eosin staining. One tissue block with representative tissue was selected for immunohistochemical staining (CK7 and CK20).
Endoscopically located adenocarcinoma of the oesophagus was present in 84 patients (64 men, 20 women; mean age, 68 years; range, 44-91). Cancer located primarily in the gastric cardia was present in 63 patients (42 men, 21 women; mean age, 68 years; range, 42-88). The histological diagnosis was metastasis from a primary tumour outside the oesophagus or stomach in 19 patients. The patients were divided into three groups for the immunohistochemical analysis. Patients in group A had definite oesophageal cancer, group B patients had a definite carcinoma located in the gastric cardia, and group C patients had an obstructing tumour distal in the oesophagus at the level of the diaphragm, which could not be passed with the endoscope. Paraffin wax embedded material was available from 122 patients for immunostaining and CK analysis. There was no significant difference in expression or distribution of CK7 or CK20 in the three groups of patients.
CK phenotyping cannot distinguish between cancer arising from a Barrett's oesophagus and carcinoma originating in the gastric cardia.
有时很难区分贲门癌和食管癌。
评估肿瘤的细胞角蛋白（CK）表达在区分这两种肿瘤类型方面是否有价值。
招募连续的食管或胃恶性肿瘤患者。取活检标本进行常规苏木精和伊红染色。选择一块具有代表性组织的组织块进行免疫组织化学染色（CK7和CK20）。
84例患者存在内镜下定位的食管腺癌（64例男性，20例女性；平均年龄68岁；范围44 - 91岁）。63例患者主要位于胃贲门部的癌症（42例男性，21例女性；平均年龄68岁；范围42 - 88岁）。19例患者的组织学诊断为食管或胃外原发性肿瘤的转移。将患者分为三组进行免疫组织化学分析。A组患者患有明确的食管癌，B组患者患有明确的位于胃贲门部的癌，C组患者在食管膈水平远端有阻塞性肿瘤，内镜无法通过。122例患者有石蜡包埋材料可用于免疫染色和CK分析。三组患者中CK7或CK20的表达或分布无显著差异。
CK表型分析无法区分巴雷特食管起源的癌症和胃贲门部起源的癌。
