Department of Pathology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
J Gastroenterol Hepatol. 2013 Dec;28(12):1815-22. doi: 10.1111/jgh.12319.
The cytokeratin (CK)7(-) /CK20(+) immunoprofile is characteristic of colorectal carcinoma (CRC), although CK7(+) or CK20(-) phenotypes are occasionally encountered, particularly in histologically variant CRCs. We analyzed CK7/CK20 profiles in variant CRCs in association with clinicopathologic parameters and prognosis.
CK expression in well- and moderately differentiated adenocarcinoma (WMDA) (n = 63), poorly differentiated adenocarcinoma (PDA) (n = 91), mucinous adenocarcinoma (MUA) (n = 81), signet-ring cell carcinoma (SRCC) (n = 15), undifferentiated carcinoma (UDC) (n = 12), and adenosquamous carcinoma (n = 2) was analyzed using immunohistochemistry. Cut-off scores were set at 1% for CK7 and 25% for CK20 using the receiver operating characteristic curve analysis of PDA. Association between CK20(-) and better prognosis in PDA was validated in the second cohort (n = 66).
CK7/CK20 immunoprofiling revealed a predominant CK7(-) /CK20(+) profile in WMDA, MUA, and SRCC, while the majority of UDC was characterized by a CK7(-) /CK20(-) profile. The CK7/CK20 profile in PDA was variable. Contingency table analysis revealed that CK expression was not significantly associated with any clinicopathologic parameters in WMDA, PDA, and MUA. However, survival analysis demonstrated that CK20(-) was significantly associated with better prognosis in PDA. Although CK20(-) was significantly associated with mismatch repair deficiency in PDA, it was an independent prognostic factor in multivariate analysis. Finally, we confirmed that CK20 status, determined using a 25% cut-off score, was a significant prognostic parameter in the second PDA cohort.
CK20 status may be used as a prognostic predictor of PDA.
细胞角蛋白（CK）7（-）/CK20（+）免疫表型是结直肠癌（CRC）的特征，尽管偶尔会遇到 CK7（+）或 CK20（-）表型，尤其是在组织学变异型 CRC 中。我们分析了变异型 CRC 中 CK7/CK20 表型与临床病理参数和预后的关系。
使用免疫组织化学分析了分化良好的腺癌（WMDA）（n=63）、低分化腺癌（PDA）（n=91）、黏液腺癌（MUA）（n=81）、印戒细胞癌（SRCC）（n=15）、未分化癌（UDC）（n=12）和腺鳞癌（n=2）中 CK 表达。使用 PDA 的受试者工作特征曲线分析，将 CK7 的截止值设定为 1%，CK20 的截止值设定为 25%。在第二个队列（n=66）中验证了 PDA 中 CK20（-）与更好预后的相关性。
CK7/CK20 免疫组化分析显示，WMDA、MUA 和 SRCC 主要表现为 CK7（-）/CK20（+）表型，而大多数 UDC 表现为 CK7（-）/CK20（-）表型。PDA 的 CK7/CK20 表型多样。列联表分析显示，在 WMDA、PDA 和 MUA 中，CK 表达与任何临床病理参数均无显著相关性。然而，生存分析表明，PDA 中 CK20（-）与更好的预后显著相关。尽管 CK20（-）与 PDA 中的错配修复缺陷显著相关，但在多因素分析中它是一个独立的预后因素。最后，我们证实，在第二个 PDA 队列中，使用 25%的截断值确定的 CK20 状态是一个显著的预后参数。
CK20 状态可作为 PDA 的预后预测因子。
