Cytokeratin 7 and 20 Expression in Choroid Plexus Tumors: Utility in Differentiating These Neoplasms from Metastatic Carcinomas

Gyure, Kymberly A.; Morrison, Alan L.

doi:10.1038/modpathol.3880111

Cited by 59 publications

(30 citation statements)

References 27 publications

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“…Cytokeratins have been reported to be effective in distinguishing between various subsets of primary and metastatic carcinomas in different anatomical sites. More specifically, many authors have studied the coordinate expression of CK7 and CK20 and reported the high sensibility and specificity of their association [6][7][8][9][10][11][12][13]. In our study we found that when these markers are both positive, both negative or when CK7 is positive and CK20 is negative there is relative success in finding possible origins in finding possible origins for bone metastasis from carcinoma.…”

Section: Discussionsupporting

confidence: 58%

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Immunohistochemical evaluation of bone metastases

Errani¹,

Mavrogenis²,

Megaloikonomos³

et al. 2017

Nowotwory. Journal of Oncology

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Introduction. Metastases are the most common type of malignancy involving the bone, while bone is the third most frequent site for metastases, after the lung and liver. In some patients, medical history, physical and laboratory examination are not conclusive to identify the primary tumor site. In such cases a bone biopsy and immunohistochemical analysis may contribute to the diagnosis, determination of appropriate treatment and evaluation of prognosis. In this study, we tried to evaluate the imunochistochemical expression in bone metastases. Material and methods. We reviewed 125 patients, with a mean age of 63 years, treated for bone metastases in our institution. All patients received palliative orthopaedic surgery for bone metastatic carcinoma. Fifty-eight patients had already an established diagnosis of the primary tumor, while 67 patients presented metastases with an unknown primary tumor origin. Immunohistochemical analysis was performed to intra-operative bone biopsy specimens. The expression of cytokeratine 7, cytokeratin 20 and the expression of a panel of other organ-specific markers were recorded. In patients with a known primary tumor, we examined the relationship between the origin of metastases, as suggested by the cytokeratin phenotype, compared with the one indicated by the initial histological diagnosis. We also recorded the efficacy of organ-specific markers to identify the primary tumor origin in epithelial bone metastases and we evaluated the prognosis between patients with a immunohistologically determined primary tumor origin, with those with an undetermined one. Results. Associations of cytokeratine 7 and cytokeratine 20 expression confirmed diagnosis in 51 out of the 58 patients (88%) with a known primary tumor (Cohen's K test 0.79 SE 0.80, P < 0.0005). Immunohistochemical analysis also contributed to establish the diagnosis of patients with an unknown primary tumor, yielding diagnosis in 35 out of the 67 cases (52%). Patients with an immunochistologically undetermined primary tumor site presented a statistically significant poorer prognosis. Conclusions. Cytokeratine 7 and cytokeratine20 are useful immunochistochemical markers in determining a preliminary evaluation of bone metastases. Organ-specific immunohistochemical markers have a reliable role in either suggesting or confirming the possible origin of metastases. An indeterminate immunohistochemical phenotype seems to relate to a less differentiated lesion, with a worse prognosis. NOWOTWORY

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Section: Discussionsupporting

confidence: 58%

“…A panel of tissue-or organ-specific markers is typically used. Thus, many authors underline the important role that cytokeratines and other specific markers play in the discrimination of primary tumor lineage and determination of metastatic disease [6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical evaluation of bone metastases

Errani¹,

Mavrogenis²,

Megaloikonomos³

et al. 2017

Nowotwory. Journal of Oncology

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“…28 If true, then findings from the present study suggest that, in dogs, ependymal differentiation occurs in a large proportion of both CPPs and CPCs, but its appearance is not correlated with histological grade as has been suggested for human CPTs. 17,32 Wide spectrum cytokeratin and CAM5.2 were expressed by an unexpectedly low number of both NCP and CPTs indicating that neither is an optimal marker of CPTs. Results of the current study are in contrast to most other studies, in which cytokeratin is expressed by both normal and neoplastic choroid plexus epithelium.…”

Section: 33mentioning

confidence: 99%

Aberrant E-cadherin, β-catenin, and glial fibrillary acidic protein (GFAP) expression in canine choroid plexus tumors

et al. 2011

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Abstract.Expression of E-cadherin and β-catenin has been widely studied in various human and canine epithelial tumors and has been correlated with dedifferentiation, invasiveness, and metastasis. Choroid plexus tumors (CPTs) are of epithelial origin, and the most important prognostic factor in human medicine is the tumor grade. Limited information is available regarding E-cadherin and β-catenin expression in human CPTs, and no information is found in the veterinary literature. In the current study, 42 canine CPTs (19 choroid plexus papillomas and 23 choroid plexus carcinomas) were retrospectively reviewed, and the intensity and cellular staining pattern of E-cadherin and β-catenin were correlated with histological features, paying special attention to grade, invasion, and metastasis. In addition, cytokeratin and glial fibrillary acidic protein (GFAP) antibodies were evaluated as markers for canine CPTs. It was found that loss of E-cadherin and β-catenin expression was uncommon in canine CPTs. Rather, membranous expression of both molecules was increased in CPTs compared to normal choroid plexus (NCP), regardless of tumor grade. Additionally, aberrant cytoplasmic or nuclear expression of both E-cadherin and β-catenin was often observed in CPTs. GFAP was frequently expressed in CPTs in contrast to NCP. None of these parameters were correlated with malignancy, and therefore, do not appear to be useful for prognostic information. Nevertheless, a panel of antibodies including E-cadherin and GFAP might be useful to support the diagnosis of CPTs and help to differentiate them from other tumors, such as ependymomas and metastatic epithelial tumors.

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“…5 In particular, the differential expression profile of various cytokeratin (CK) types by tumors at different primary locations can be essential in determining the origin of a malignant tumor. 1,2,4,[6][7][8] CKs are intermediate filament proteins and 20 subtypes have been classified based on isoelectric pH (focusing) and molecular weight. 5,[9][10][11] Two of the most used stains are CK20 and CK7.…”

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confidence: 99%

Differential diagnostic and functional role of the multi-marker phenotype CDX2/CK20/CK7 in colorectal cancer stratified by mismatch repair status

et al. 2008

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The differentiation of colorectal cancer from primary tumors at other sites can be challenging. Often a panel of immunohistochemical protein markers is needed to distinguish between these entities. Protein expression differs significantly in colorectal cancer depending on mismatch repair status and is also heterogeneous among mismatch repair-proficient or -deficient tumors. The aim of this study was to systematically analyze the diagnostic and prognostic role of the commonly used multi-marker phenotype CK20/CK7/CDX2 on a large series of colorectal cancers stratified by mismatch repair status. The immunohistochemical analysis of CK20, CK7 and CDX2 was performed on 1197 mismatch repair-proficient and 223 mismatch repair-deficient colorectal cancers using a tissue microarray. Multi-marker combinations of CK20/CK7/CDX2 were explored. Univariate and multivariable analysis of the markers was evaluated for their association with several clinico-pathological end points namely T stage, N stage, tumor grade, vascular invasion, intratumoral lymphocytes and survival. Multimarker phenotypes with CK20 and CDX2 negativity were more frequently found in mismatch repair-deficient than in mismatch repair-proficient colorectal cancer (19.3 vs 7.5% and 21.6 vs 6.7%, respectively; Po0.001). In both colorectal cancer subsets loss of CK20 was associated with higher tumor grade (Po0.001) and with presence of intratumoral lymphocytes (Po0.001 and P ¼ 0.02, respectively). In the proficient mismatch repair subset CK20 overexpression was an independent adverse prognostic factor (P ¼ 0.041) and CDX2 underexpression was linked to tumor progression. Loss of CDX2 and CK20 is more frequently encountered in mismatch repair-deficient colorectal cancer, which should be taken into consideration to differentiate between primary and metastatic colorectal cancer in daily practice. Although associated with lower tumor grade, CK20 overexpression is an independent adverse prognostic factor in mismatch repair-proficient colorectal cancer.

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Cytokeratin 7 and 20 Expression in Choroid Plexus Tumors: Utility in Differentiating These Neoplasms from Metastatic Carcinomas

Cited by 59 publications

References 27 publications

Immunohistochemical evaluation of bone metastases

Immunohistochemical evaluation of bone metastases

Aberrant E-cadherin, β-catenin, and glial fibrillary acidic protein (GFAP) expression in canine choroid plexus tumors

Differential diagnostic and functional role of the multi-marker phenotype CDX2/CK20/CK7 in colorectal cancer stratified by mismatch repair status

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