Ohtsuki Yuji, Kuroda Naoto, Umeoka Tatsuo, Watanabe Ryohei, Ochi Kenji, Okada Yuhei, Lee Gang-Hong, Furihata Mutsuo
Division of Pathology, Matsuyama-shimin Hospital, Matsuyama, Ehime, 790-0067, Japan.
Med Mol Morphol. 2009 Jun;42(2):123-7. doi: 10.1007/s00795-009-0450-2. Epub 2009 Jun 18.
To evaluate the peculiar "inside-out" pattern in micropapillary (MP) carcinoma, we investigated the usefulness of KL-6 antibody in the assessment of the MP pattern of cancers, in comparison with antibodies to epithelial membrane antigen (EMA), MUC1 (CD227), and CD 10. Immunohistochemical investigation was performed on specimens exhibiting an MP pattern obtained from 12 persons with cancer: 4 with breast carcinoma, 3 with carcinoma of the urinary bladder, and 5 with colonic carcinoma. Immunohistochemical study with KL-6, EMA, and MUC1 antibodies revealed similar continuous linear positive patterns restricted to the surface of the MP pattern in both breast and urinary bladder cancers, revealing the peculiar "inside-out" morphology. However, EMA also gave cytoplasmic positivity in most of the cases tested, and MUC1 was also present in the cytoplasm of some cases. In sharp contrast, immune reactions of colon carcinomas with these antibodies were negative, except for focal positivity for KL-6 and MUC1 antibodies in some cases. CD10 was only focally positive in an MP pattern in 4 of the 5 cases of colon carcinoma and in 1 case with carcinoma of the urinary bladder. These findings suggest that KL-6 is a useful marker to assess the MP character of breast and urinary bladder carcinomas; that MUC1 was similarly positive, with the addition of cytoplasmic positivity in some cases; and that the MP pattern of colon cancer, positive for CD 10, was different in character from both breast and urinary bladder carcinomas, although all these cancers seemingly exhibit similar MP patterns on histopathology. This heterogeneity of the MP pattern in various cancers needs to be investigated when more cases have been accumulated.
为评估微乳头（MP）癌中独特的“由内向外”模式，我们研究了KL-6抗体在评估癌症MP模式中的效用，并与上皮膜抗原（EMA）、MUC1（CD227）和CD10抗体进行比较。对12例癌症患者获取的呈现MP模式的标本进行了免疫组织化学研究：4例乳腺癌、3例膀胱癌和5例结肠癌。用KL-6、EMA和MUC1抗体进行的免疫组织化学研究显示，在乳腺癌和膀胱癌中，相似的连续线性阳性模式局限于MP模式的表面，揭示了独特的“由内向外”形态。然而，在大多数检测病例中EMA也呈细胞质阳性，并且在一些病例的细胞质中也存在MUC1。与之形成鲜明对比的是，除了在一些病例中KL-6和MUC1抗体有局灶性阳性外，结肠癌与这些抗体的免疫反应均为阴性。在5例结肠癌中的4例以及1例膀胱癌中，CD10仅在MP模式中有局灶性阳性。这些发现表明，KL-6是评估乳腺癌和膀胱癌MP特征的有用标志物；MUC1同样呈阳性，在一些病例中还伴有细胞质阳性；尽管所有这些癌症在组织病理学上看似呈现相似的MP模式，但结肠癌的MP模式对CD10呈阳性，其特征与乳腺癌和膀胱癌均不同。当积累了更多病例时，需要对各种癌症中MP模式的这种异质性进行研究。
