Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Eur Rev Med Pharmacol Sci. 2020 Dec;24(23):12171-12186. doi: 10.26355/eurrev_202012_24006.
The pathologist is often called to define the origin of tumors through the help of ancillary studies, mainly immunohistochemical stainings. In this setting, the differential diagnosis between intestinal adenocarcinomas, other tumors with intestinal-type morphology, and adenocarcinomas metastatic to the bowel can be particularly difficult. In such cases, an accurate assessment of the disease is required to address the patients to the optimal treatment. Immunohistochemistry offers the use of multiple antibodies: the integrated evaluation of specific stainings can lead to a correct diagnosis. Particularly, the use of cytokeratins, mucins, and β-catenin could be of great help in most cases. In addition, recently, novel specific markers such as SATB2 and AMACR have been introduced, improving the utility of immunohistochemistry in the differential diagnosis of intestinal-type and intestinal adenocarcinomas.
病理学家经常通过辅助研究（主要是免疫组织化学染色）来确定肿瘤的来源。在这种情况下，鉴别诊断肠腺癌、具有肠型形态的其他肿瘤和转移到肠道的腺癌可能特别困难。在这种情况下，需要准确评估疾病，以便为患者提供最佳治疗。免疫组织化学提供了多种抗体的应用：特定染色的综合评估可以得出正确的诊断。特别是细胞角蛋白、黏蛋白和β-连环蛋白的使用在大多数情况下都有很大帮助。此外，最近还引入了 SATB2 和 AMACR 等新型特异性标志物，提高了免疫组织化学在鉴别诊断肠型和肠腺癌中的实用性。
