The prognostic role of thyroid transcription factor-1 in lung adenocarcinoma

Aims: In this study, we investigated the expression of thyroid transcription factor-1 (TTF-1) in lung adenocarcinoma patients' samples and analyzed the association of TTF-1 with clinicopathological parameters, prognosis, and treatment options in patients with lung adenocarcinoma. Subjects and Methods: This retrospective study enrolled 200 patients who were histologically confirmed lung adenocarcinoma with Stage I-IV disease, between 2008 and 2015 years. The cytological archive of these hospitals' Pathology Department was searched. The available slides and the clinical information were reviewed and correlated. All analyses were conducted by SPSS version 15.0 statistical software. Results: Sixty-five (32.5%) of the patients showed TTF-1 negativity and 135 (67.5%) of them showed TTF-1 positivity. The median survival for TTF-1 positive and negative patients was 19.6 and 12.2 months, respectively. We did not find any statistical significance in-between the parameters in terms of the survival data. In TTF-1-negative group, the survival time of epidermal growth factor receptor mutation positive (P = 0.049), cytokeratin 7 (CK7) positive (P = 0.009) patients and those who had received curative radiotherapy (P = 0.028) was significantly better as compared to TTF-1-positive group. We also analyzed the relation between TTF-1 and survival outcome or chemotherapy selection in Stage IV disease. We could not identify any correlation between TTF-1 and survival outcome or treatment selection. Conclusions: This study suggests that TTF-1 is not a favorable prognostic factor in lung adenocarcinoma patients. The prognostic role of CK7 and relationship between TFF-1 expression in lung adenocarcinoma and predictive role of TTF-1 expression for the selection of first-line treatment in Stage IV lung adenocarcinoma should be validated in prospective and randomized studies

Primary mucinous carcinoma of skin with a trichoadenomatous component: A rare case report

Primary mucinous carcinoma of the skin is a rare subtype of eccrine sweat gland tumors. Differentiating it from metastatic adenocarcinomas is important in the management of this condition. We report the case of a 55-year-old female presenting with a painless nodule, which was subsequently diagnosed as primary mucinous carcinoma of skin with a trichoadenomatous component. The possibility of a metastatic adenocarcinoma was ruled out by performing ultrasound abdomen, total body computed tomography, mammogram and colonoscopy.

Expression of Cyclin D1, Cytokeratin 7, Cytokeratin 20 and Vimentin in Papillary Thyroid Cancer and Relationship with Patient's Prognostic Factors / 대한내분비외과학회지

PURPOSE: Cyclin D1, cytokeratin(CK)7, CK20 and vimentin play an important role in tumorigenesis and tumor progression. Our aim was to investigate the expression of cyclin D1, CK7, CK20 and vimentin in 138 papillary thyroid cancer and relationship with clinicobiological factors. We also tried to evaluate the value of those as prognostic factors. METHODS: We performed an immunohistochemical assay for cyclin D1, CK7, CK20, and vimentin in 138 papillary thyroid cancer tissue specimens. The correlation between these factors and the clinicobiological parameters was analyzed. RESULTS: In 138 papillary thyroid carcinoma specimens, the expression of cyclin D1, CK7, CK20 and vimentin was seen in 118 cases (85.5%), 133 cases (96.4%), 2 cases (1.4%) and 119 cases (86.2%), respectively. In our cases, there was a significant association among the expressions of cyclin D1, gender and lymph node metastasis. However, no obvious correlation was found between those proteins, age, tumor size, tumor amount, lymph node status and the TNM stage. CONCLUSION: Our results suggested increased cyclin D1 expression was seen in female gender and it may be a useful marker for evaluating lymph node metastasis. However, the clinical utility of cyclin D1, CK7, CK20 and vimentin in thyroid cancer patients has to be further defined by prospective studies with larger sample sizes.

Sinonasal Low-Grade Adenocarcinoma: Report of Three Cases with the Clinicopathologic and Immunohistochemical Findings

Low-grade adenocarcinomas that primarily arise within the sinonasal tract are uncommon tumors. We report here on three cases of primary sinonasal low-grade adenocarcinomas. The patients were 2 females and 1 male with ages of 48, 57 and 64, respectively. Microscopically, the tumors had a well developed tubulopapillary growth pattern that consisted of columnar or pseudostratified cells with eosinophilic cytoplasm, round to oval nuclei and rare mitotic activity. On immunohistochemistry, the tumor cells were strongly positive for cytokeratin 7, but they were negative for cytokeratin 20, CDX-2 and p53. The Ki-67 labeling index was very low (mean: 1.9%). Two patients developed recurrent tumors at the primary site after the initial surgery, but all the patients are presently alive without metastasis 6 years 8 months, 8 years 8 months, and 11 months after the initial diagnosis. When considering the progress of these tumors, we think that it's important to understand the pathology of this entity to avoid underdiagnosis because a complete excision is required for effective treatment.

Two Cases of Adenocarcinoma Arising from Short Segment Barrett's Esophagus / 대한소화기내시경학회지

Barrett's esophagus is considered as a premalignant condition in which columnar epithelium replaces the normal esophageal squamous epithelium. The diagnosis of Barrett's esophagus is based on the endoscopic finding of columnar epithelium lining the distal esophagus and histologic confirmation of the presence of specialized intestinal metaplasia. According to the extent of the metaplastic lining from the esophagogastric junction, Barrett's esophagus has been divided into long-segment (> or =3 cm in length) and short-segment (<3 cm in length). Long-segment Barrett's esophagus can be easily identified at endoscopy, but it is difficult to separate short-segment Barrett's esophagus from intestinal metaplasia of cardia. It has been reported that Barrett's CK 7/20 pattern is an objective marker of Barrett's mucosa, and can differentiate Barrett's mucosa from gastric intestinal metaplasia. We report here two cases of adenocarcinoma of esophagus arising from short-segment Barrett's esophagus, diagnosed by endoscopic and histologic findngs, and treated by endoscopic mucosal resection.

The Expressions of Cytokeratin 7 and 20 in Epithelial Tumors: A Survey of 91 Cases / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study was performed to determine the expressions of cytokeratin 7 and cytokeratin 20 in epithelial neoplasms, and to investigate their potential role in the differential diagnosis of carcinomas of various organs. MATERIALS AND METHODS: We investigated 91 various cases of primary and metastatic cancers, using a panel of commercially available monoclonal antibodies against cytokeratins 7 and 20 (CK7 and CK20), by immunohistochemistryand an avidin-biotin immunoperoxidase technique. The specimens were formalin-fixed and paraffin- embedded, and examined using 4micrometer thick serial sections. RESULTS: The expression of CK7 was seen in the majority of carcinoma cases, including transitional cell carcinomas (100%), pulmonary adenocarcinomas (100%), ovarian serous adenocarcinomas (100%), cholangiocarcinomas (70%), colonic adenocarcinomas (64.29%) and invasive ductal carcinomas (60%). The expression of CK20 was seen in the majority of colorectal carcinomas cases (85.72%), but was virtually absent in pulmonary adenocarcinomas (0%), uterine cervical carcinomas (0%), ovarian carcinomas (0%), prostatic adenocarcinomas (0%), adenocarcinomas of the gall bladder (0%) and cholangiocarcinomas (12.5%). CONCLUSION: In the all cases investigated, either CK7 or CK20 immunophenotypes were conserved in the tumor cells of primary tumors and in those of the corresponding metastatic lesions. It is suggested that CK7/CK20 immunophenotyping, in metastatic carcinomas of an unknown origin, maybe useful in the determination of the primary site of the metastasis.

Expression of Cytokeratin 7 and 20 in Periampullary Carcinomas

The distinction of carcinomas involving periampullary region is often difficult, even in the surgically resected specimens. To examine the differences in the expressions of cytokeratin (CK) 7 and 20 in the periampullary carcinomas, we performed immunohistochemical studies on surgically resected 20 pancreatic duct adenocarcinomas (PDA), 13 distal bile duct adenocarcinomas (DBA), 10 duodenal adenocarcinomas (DA), and 18 ampulla of Vater adenocarcinomas (AVA). We analyzed the relationships between CK 7/CK 20 immunoprofile, and tumor cell differentiation and tumor size. We interpreted diffuse cytoplasmic reactivity found in > or =5% of tumor cells as positive. In the majority of cases, PDA were CK 7 /20 (95%), DBA CK 7 /20 (92.3%), DA either CK 7 /20 (40%) or CK 7 /20 (30%), AVA either CK 7 /20 (50%) or CK 7 /20 (44.4%). In DA, there was an increased CK 20 negativity in less differentiated (moderately or poorly differentiated) cases (p or =5 cm) tumor size (p=0.049). In AVA, there was a tendency of increased CK 20 positivity in less differentiated cases (p=0.10). In conclusion, the CK 7/CK 20 immunophenotype is useful in the differentiation of periampullary carcinomas: the CK 7 /CK 20 immunophenotype strongly suggests DA or AVA, whereas the CK 7 /CK 20 immunophenotype suggests PDA or DBA.

Expression of Cytokeratins 7 and 20 in Cholangiocarcinoma and Metastatic Colonic Adenocarcinoma of the Liver

The distinction between cholangiocarcinoma (CC) and metastatic colonic adenocarcinoma of the liver (MCA) is often difficult, particularly in needle biopsy and fine-needle aspiration specimens, if histologic features alone are used. To examine the differences in the expressions of the cytokeratin (CK) 7 and 20 in the CCs and MCAs, we performed immunohistochemical studies on surgically resected 19 CCs and 23 MCAs. We used monoclonal antibodies against CK 7 and CK 20, and applied microwave antigen retrieval technique on formalin-fixed, paraffin-embedded tissue. We interpreted diffuse cytoplasmic reactivity found in > or =5% of tumor cells as positive. CCs showed CK 7+/CK 20- immunophenotype in 63%, CK 7+/CK 20+ in 32%, CK 7-/CK 20+ in 5%, and CK 7-/CK 20- in 0%. MCAs exhibited CK 7-/CK 20+ immunophenotype in 87%, CK 7+/CK 20+ in 9%, CK 7-/CK 20- in 4%, and CK 7+/CK 20- in 0%. CK 20-reactive cells in CCs were frequently columnar in shape (p<0.05). In conclusion, the CK 7/CK 20 immunophenotype was useful in the differentiation of CCs from MCAs: the CK 7+/CK 20- immunophenotype strongly suggested CCs, whereas the CK 7-/CK 20+ immunophenotype strongly suggested MCAs.

Mucinous Tumors of the Appendix Associated with Mucinous Tumors of the Ovary and Pseudomyxoma Peritonei: A Clinicopathologic Analysis of 5 Cases Supporting an Appendiceal Origin

Pseudomyxoma peritonei often have synchronous appendiceal and ovarian mucinous tumors. There has been considerable debate as to whether the ovarian tumors are secondary to the appendiceal tumor or they are independent primary ovarian tumors. It is important to reveal the primary site for treatment and prognosis of a patient. Five cases of synchronous mucinous tumors of the ovary and appendix were studied. Four cases had pseudomyxoma peritonei and pseudomyxoma ovarii. The ovarian tumors were bilateral in two cases, right in two, and left in one. The ovarian tumors were four mucinous cystadenoma of borderine malignancy and one mucinous cystadenocarcinoma, and the appendiceal tumors consisted of four mucinous tumors of borderline malignancy and one mucinous adenocarcinoma. The histology of the ovarian and appendiceal tumors was similar. Rupture of the tumor was seen in all appendiceal tumors and two ovarian tumors. It has been reported that cytokeratin 7 is a useful marker for distinguishing primary ovarian neoplasms from metastases of intestinal origin. All ovarian and appendiceal tumors showed positive reaction for broad-spectrum cytokeratin, but negative for cytokeratin 7. Based on the clinicopathologic and immunohistochemical features, it should be considered that the appendiceal tumors are primary and ovarian tumors are secondary in the synchronous presentation of the ovarian and appendiceal mucinous tumors.

The Usefulness of Cytokeratin 7 and Colon Ovarian Tumor Antigen in the Differential Diagnosis of Primary and Metastatic Ovarian Tumors

Cytokeratin 7 has been known to be present in various types of human epithelial cells including the ovarian neoplasms, but not in colon cancers. The antibody to colon ovarian tumor antigen (COTA) has been introduced as a marker of colon and ovarian tumors. The aim of this study was to evaluate the usefulness of cytokeratin 7 and COTA in the differential diagnosis between ovarian primary and metastatic tumors. Nineteen primary ovarian epithelial tumors, seven metastatic carcinomas of the ovary from the stomach, three metastatic carcinomas of the ovary from the colon, one mucinous tumor of the ovary associated with a mucinous tumor of the appendix and pseudomyxoma peritonei, and nineteen colonic and twenty gastric adenocarcinomas were stained with monoclonal antibodies to cytokeratin 7 and COTA. The results are summerized as follows; In the primary ovarian tumors, 94.4% were positive for cytokeratin 7 and 50% were positive for COTA. In the primary colonic adenocarcinomas, 94.7% were negative for cytokeratin 7 and 68% were positive for COTA. In the metastatic ovarian tumor from the colonic adenocarcinomas, 100% were negative for cytokeratin 7 and positive for COTA. In the primary gastric adenocarcinomas, 40% were negative for cytokeratin 7 and 85% were negative for COTA. In the metastatic ovarian tumor from the gastric adenocarcinomas, 43% were negative for cytokeratin 7 and 14% were negative for COTA. From the results of this study, it could be concluded that in the differential diagnosis of primary ovarian tumors from metastatic colonic carcinomas, positive reaction for cytokeratin 7 suggests a primary ovarian tumor but a negative reaction for cytokeratin 7 and positive reaction for COTA suggest metastatic colonic carcinomas. The results of this study also reveal that cytokeratin 7 and COTA are not useful in the differential diagnosis of primary ovarian tumors from metastatic gastric carcinomas.