Porjazova E, Zaprjanov Z, Batashki I, Markova D, Milchev N
Akush Ginekol (Sofiia). 2009;48(2):7-12.
Metastases from colorectal adenocarcinomas can be histologically similar to serous, mucinous and endometrioid ovarian adenocarcinomas. The differentiation between primary and metastatic ovarian tumours is of great importance for the patients because of the different treatment and prognosis.
The aim of the study was to determine whether the differences in the expression of Cytokeratin 7, Cytokeratin 20, Beta catenin and CDX2 can be used to distinguish the different types of carcinomas and their metastases.
The immunohistochemical expression of the listed above antibodies was examined retrospectively and prospectively in 38 colorectal adenocarcinomas (primary and metastatic) and 32 ovarian adenocarcinomas (primary and metastatic). The metastases in both types of adenocarcinomas are located in the peritoneum.
The immunohistochemical expression was evaluated using a semi-quantitative method. The ovarian adenocarcinomas are mostly positive for Cytokeratin 7 (in 63%), while colorectal carcinomas are mostly positive for Cytokeratin 20 (in 73%). Regarding Beta catenin, in colorectal carcinomas the expression is mostly nuclear (in 65%) and in ovarian carcinomas mostly membrane (in 68%). In cases of uncertain expression of the markers mentioned above, CDX2 was used. Positive nuclear expression was observed only in intestinal tumours (in 86%).
For differential diagnosis between ovarian and colorectal adenocarcinomas, the use of antibodies, determining the intestinal differentiation of the tumours like Cytokeratin 20, Beta catenin and CDX2 is recommended.
结直肠腺癌转移灶在组织学上可能与浆液性、黏液性和子宫内膜样卵巢腺癌相似。由于治疗方法和预后不同,原发性和转移性卵巢肿瘤的鉴别对患者至关重要。
本研究的目的是确定细胞角蛋白7、细胞角蛋白20、β-连环蛋白和尾型同源盒转录因子2(CDX2)表达的差异是否可用于区分不同类型的癌及其转移灶。
回顾性和前瞻性检测了38例结直肠腺癌(原发性和转移性)和32例卵巢腺癌(原发性和转移性)中上述抗体的免疫组化表达。两种腺癌的转移灶均位于腹膜。
采用半定量方法评估免疫组化表达。卵巢腺癌大多细胞角蛋白7阳性(63%),而结直肠癌大多细胞角蛋白20阳性(73%)。关于β-连环蛋白,在结直肠癌中表达大多为核阳性(65%),在卵巢癌中大多为膜阳性(68%)。在上述标志物表达不确定的情况下,使用CDX2。仅在肠道肿瘤中观察到核阳性表达(86%)。
对于卵巢癌和结直肠癌的鉴别诊断,建议使用能确定肿瘤肠化生的抗体,如细胞角蛋白20、β-连环蛋白和CDX2。