Loy T S, Calaluce R D, Keeney G L
Department of Pathology, University of Missouri Medical School, Columbia, USA.
Mod Pathol. 1996 Nov;9(11):1040-4.
The differentiation of ovarian metastases from colonic carcinoma and primary ovarian carcinoma can be difficult. To assess the utility of cytokeratin 7 and cytokeratin 20 immunostains in this setting, we studied routinely processed, formalin-fixed tissue from 165 ovarian tumors, including 45 serous carcinomas, 40 mucinous carcinomas, 64 endometrioid carcinomas, and 16 metastatic colonic adenocarcinomas with an avidin-biotin immunohistochemical technique. A cytokeratin 7+/cytokeratin 20- immunophenotype was seen in 86% of the endometrioid carcinomas, 27% of the mucinous carcinomas, 40% of the serous carcinomas, and none of the metastatic colorectal carcinomas. Conversely, a cytokeratin 7-/cytokeratin 20+ immunophenotype was seen in 94% of the metastatic colonic tumors, 5% of the mucinous carcinomas, and none of the endometrioid or serous tumors. We concluded that cytokeratin immunostains can be helpful in distinguishing metastatic colonic adenocarcinoma from primary ovarian carcinomas, particularly endometrioid carcinomas. Rare ovarian mucinous carcinomas may show the same immunophenotype as metastatic colonic carcinomas.
鉴别卵巢转移癌与结肠癌及原发性卵巢癌可能存在困难。为评估细胞角蛋白7和细胞角蛋白20免疫染色在此情况下的效用，我们采用抗生物素蛋白-生物素免疫组化技术，研究了165例卵巢肿瘤经常规处理的福尔马林固定组织，其中包括45例浆液性癌、40例黏液性癌、64例子宫内膜样癌和16例转移性结肠腺癌。在86%的子宫内膜样癌、27%的黏液性癌、40%的浆液性癌中观察到细胞角蛋白7阳性/细胞角蛋白20阴性免疫表型，而转移性结直肠癌中未观察到。相反，在94%的转移性结肠肿瘤、5%的黏液性癌中观察到细胞角蛋白7阴性/细胞角蛋白20阳性免疫表型，而在子宫内膜样癌或浆液性肿瘤中未观察到。我们得出结论，细胞角蛋白免疫染色有助于鉴别转移性结肠腺癌与原发性卵巢癌，尤其是子宫内膜样癌。罕见的卵巢黏液性癌可能表现出与转移性结肠癌细胞相同的免疫表型。
