Differential expression of CK7, CK20, CDX2 in intestinal and pancreatobiliary types of preriampullary carcinoma

Context: Incidence of periampullary carcinoma is low, approximately 0.5–2% of all gastrointestinal malignancies. Histologic subtyping has a prognostic bearing. The purpose of this study is to differentiate periampullary carcinomas based on immunohistochemistry (IHC) by using cytokeratin 7 (CK7), cytokeratin 20 (CK20), caudal type homeobox 2 (CDX2). Aims: To analyze the usefulness of IHC as single/panel of markers that included CK7, CK20, and CDX2. Settings and Design: This was a prospective study done from January 2017 to September 2018. Subjects and Methods: A total 50 pancreaticoduodenectomy specimens were evaluated and classified as intestinal (INT) and pancreaticobiliary (PB) types based on their morphological and immunohistochemical features, respectively. The morphologic subtypes, expression of IHC markers were correlated with different histologic parameters. Statistical Analysis: Chi-square test was used to study the association between different IHC markers with histologic parameters. Probability (P) values <0.05 were regarded as statistically significant. Results: The expression of CK7, CK20, CDX2 were studied in 50 cases to classify them as INT and pancreatobiliary subtypes. CK7 has high sensitivity (88.2%), CDX2 has high specificity (96.4%), CK20+/CDX2+ has both high sensitivity (94.2 percent) and specificity (89.2 percent) in differentiating INT from pancreatobiliary subtypes. The morphologic subtypes showed correlation with two variables (tumor grade, pathologic T stage). CK20 and CK20/CDX2 expression showed a positive correlation with tumor grade, pathologic T staging, and lymphovascular invasion. Conclusions: In conclusion, morphological classification can significantly discriminate histologic types, IHC plays a moderate role. However, the combined expression of CK20 and CDX2 is helpful in subtyping.

Expression and clinical significance of CK5/6, DSG3, P40, TTF-1, CK7, NapsinA in small biopsy specimens of non-small cell lung cancer / 中国基层医药

Objective@#To detect the expression and the differential significance of CK5/6, DSG3, P40, TTF-1, CK7, NapsinA in small biopsy specimens of non-small cell lung cancer (NSCLC), squamous cell carcinoma (SCC) and adenocarcinoma (AC).@*Methods@#Immunohistochemical SP method was used to detect the expressions of CK5/6, DSG3, P40, TTF-1, CK7 and NapsinA in 120 small biopsy specimens of NSCLC hospitalized in the Central People's Hospital of Tengzhou from January 2016 to December 2017, and the results were analyzed combined with the clinical characteristics of NSCLC.@*Results@#The positive expression rates of CK5/6, DSG3 and P40 in lung SCC were 100.0%(56/56), 89.3%(50/56) and 96.4%(54/56), respectively, with specificity of 90.6%, 100.0% and 100.0%, respectively.The positive expression rates of NapsinA, TTF-1 and CK7 in lung AC were 81.3%(52/64), 90.6%(58/64) and 93.8%(60/64), respectively, with specificity of 100.0%, 92.9% and 96.4%, respectively.The positive expression rates of CK5/6, DSG3, P40 in SCC had statistically significant differences compared with those in AC (all P<0.05), and the expression of TTF-1, CK7 and NapsinA in AC had statistically significant differences compared with those in SCC (all P<0.05).@*Conclusion@#CK5/6, DSG3, P40, TTF-1, CK7 and NapsinA are of great significance in the differential diagnosis of SCC and AC in small biopsy specimens of NSCLC.

Expression and clinical significance of CK5／6,DSG3,P40,TTF-1,CK7,NapsinA in small biopsy specimens of non-small cell lung cancer / 中国基层医药

Objective To detect the expression and the differential significance of CK 5／6,DSG3,P40,TTF-1,CK7,NapsinA in small biopsy specimens of non -small cell lung cancer ( NSCLC),squamous cell carcinoma (SCC) and adenocarcinoma (AC).Methods Immunohistochemical SP method was used to detect the expressions of CK5／6,DSG3,P40,TTF-1,CK7 and NapsinA in 120 small biopsy specimens of NSCLC hospitalized in the Central People's Hospital of Tengzhou from January 2016 to December 2017,and the results were analyzed combined with the clinical characteristics of NSCLC.Results The positive expression rates of CK5／6,DSG3 and P40 in lung SCC were 100.0%(56／56),89.3%(50／56) and 96.4%(54／56), respectively,with specificity of 90.6%,100.0% and 100.0%,respectively.The positive expression rates of NapsinA ,TTF-1 and CK7 in lung AC were 81.3%(52／64), 90.6%(58／64) and 93.8%(60／64),respectively,with specificity of 100.0%,92.9% and 96.4%,respectively. The positive expression rates of CK5／6,DSG3,P40 in SCC had statistically significant differences compared with those in AC (all P＜0.05),and the expression of TTF -1,CK7 and NapsinA in AC had statistically significant differences compared with those in SCC ( all P＜0.05).Conclusion CK5／6,DSG3,P40,TTF-1,CK7 and NapsinA are of great significance in the differential diagnosis of SCC and AC in small biopsy specimens of NSCLC .

Expression and clinical significance of p16 ,Ki-67 and CK7 in cervical precancerous lesion / 国际检验医学杂志

Objective To investigate the expression and clinical significance of p16 protein(p16) ,Ki-67 antigen(Ki-67) and cytokeratin 7(CK7) in cervical precancerous lesion .Methods The paraffin embedded tissue samples in 96 cases of cervical intraepithelial neoplasia(CIN) from January 2014 to March 2017 were selected and divided into the CIN Ⅰgroup(25 cases) ,CIN Ⅱgroup (36 cases) and CIN Ⅲ group(35 cases) according to the lesion severity ;meanwhile the paraffin embedded tissue samples in 64 ca-ses of chronic cervicitis were selected as the control group .The positive expression rates and expression modes of p16 ,Ki-67 and CK7 in different degrees of cervical lesion tissue were detected by adopting the immunohistochemistry method .Results The positive expression rates of p16 ,Ki-67 and CK7 in the CINⅠ ,Ⅱand Ⅲgroups were significantly higher than those in the control group , the difference was statistically significant (P＜0 .05) .The total score of p16 ,Ki-67 and CK7 had consistency with the degree of cervical precancerous lesions(Kappavalues were 0 .546 ,0 .628 and 0 .349 respectively) .The receiver operating characteristic curve analysis results showed that the area under the curve of p16 ,Ki-67 and CK7 combined detection was higher than that of single detection of these 3 indexes(0 .978 vs .0 .930 ,0 .966 ,0 .837) ,the difference was statistically significant (P＜0 .05) .Conclusion The expression of p16 ,Ki-67 and CK7 has the correlation with the degree of cervical precancerous lesions .Their joint detection is helpful to improve the diagnostic efficiency of cervical precancerous lesions and could be used in the assisted diagnosis of cervical lesion and prediction of high risk progress cervical precancerous lesion .

Spontaneous regression in an ulcerated CK7 positive Merkel cell carcinoma.

Merkel cell carcinoma is an aggressive and frequently lethal tumor of the elderly, associated with sun exposure and immunosuppression which is less common in the dark-skinned. We report the case of a 40-year-old woman who presented with multiple slowly progressive, mildly itchy ulcerated plaques of size ranging from 2 × 3 cm to 5 × 7 cm on the left knee of 1 year duration. Skin biopsy showed diffuse dermal infi ltration by small round cells with molding of cells and lymphocyte infi ltration. The cells stained positive for cytokeratin (CK) 20, CK7, neuron-specifi c enolase, and chromogranin. The skin lesions underwent spontaneous regression within 1 month of skin biopsy and have not recurred during the past 2 years. The immune mechanisms triggered by biopsy possibly explain the spontaneous regression.

Krukenberg tumor in a young woman: A rare presentation.

Krukenberg tumors mostly occur after 40 years. Metastatic ovarian tumors in young age are very rare and reported to be 2% of all the cases. Thirty percent of all ovarian neoplasms occurring during childhood and adolescence are malignant. A 25-year-old woman, parity- 2, presented with abdominal distension, pain in abdomen and amenorrhea. On examination, 18 weeks lump was palpable, fi rm to hard in consistency, non-tender and mobile. On ultrasonography bilateral ovarian tumors were reported, without any peritoneal free fl uid. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Microscopic examination revealed signet ring cells with glandular differentiation, diffusely invading the ovarian parenchyma. Tumor cells exhibited strong, diffuse immunopositivity for CEA with focal strong immunopositivity for CK7 and CK20 and immunonegativity for SATB2. Diagnosis of Krukenberg tumor was made. Endoscopic biopsy confi rmed the diagnosis of adenocarcinoma stomach. This case is reported because of its rarity in younger age group.

Expression of CD133, CD44, CK7, and OCT4 in Animal Cancers / 대한수의학회지

Cancers are mainly sustained by a small pool of neoplastic cells, known as cancer stem cells or tumor-initiating cells. These cells possess the ability to self-renew and proliferate, and are thus able to form the tumor. In the present study cells that correspond to cancer stem cells in mammary and liver cancers in animals were identified by the expression of CD133, CD44, CK7, and OCT4 using immunochemistry. As a result, we found with CD133+ and CD44+ cancer stem cell-like phenotypes in mouse and canine hepatocellular carcinoma and canine mammary gland tumors. However, CK7+ and OCT4+ cells were not identified in animal mammary and liver cancer. CD133+ and CD44+ cells are wellknown stem cell lines and play key roles in development and metastasis in human cancer. These findings suggest that cancer stem cells are involved in animal tumorigenesis and may provide insight into mechanisms in cancer development as well as cancer diagnostics.

Mucinous tubular and spindle cell carcinoma of kidney: A clinicopathologic study of six cases.

Background: Mucinous tubular and spindle carcinoma (MTSCC) of kidney is a rare, low-grade polymorphic tumor. Recent studies have described a wide morphology spectrum of this tumor. Aim: To report the clinico-pathologic features of six cases of MTSCC of kidney. Materials and Methods: Six cases of MTSCC of kidney were studied and literature was reviewed. Immunohistochemistry was done by Envision method. Results: The age of the patients ranged from 44 to 84 years (mean 58.5 years). Four patients were males and two were females. The tumor was located in the left kidney in four cases and in the right kidney in two cases. The tumor size ranged from 4.5 to 15 cm (mean 6.4 cm). All tumors exhibited an admixture of tubules, spindle cells, and mucinous stroma in variable proportions. Tubules were predominant in five cases and spindle cells in one case. Psammomatous calcifications, papillations, and necrosis were seen in two cases. Collections of foamy histiocytes were noted in four cases. Cytoplasmic vacuoles and osseous metaplasia were seen in one case each. All cases were Fuhrman's nuclear grade II. Five cases were of stage pT1, and one was pT3. All cases stained positive for alcian blue at pH 2.5. Immunohistochemical stain CK7 was positive in all cases and CD10 was positive in 1/1 case. All patients were alive and well at follow-up of 12-59 months (mean 33.5 months). No metastases were detected. Conclusions: We report six cases of MTSCC of kidney, a rare distinct variant of RCC, with a favorable prognosis. A male predominance was seen in our cases. MTSCC shares histologic and immunohistochemical overlap with papillary renal cell carcinoma (PRCC) and cytogenetic analysis should be performed in difficult cases to avoid a misdiagnosis.

Pure micropapillary rectal carcinoma with CK7 and CK20 coexpression and loss of CDX2 reactivity / Carcinoma micropapilar rectal puro con coexpresión de CK7 y CK20 y pérdida de reactividad CDX2

The micropapillary carcinoma is regarded as an aggressive variant of adenocarcinoma in any location. Histologically is characterized by papillary cell clusters surrounded by clear spaces. The reported proportion of micropapillary carcinoma component to the entire tumor ranged from 5 to 80 percent and no pure cases has been reported. There are near of 130 cases reported to date in colorectum. We experienced a patient with a pure micropapillary carcinoma showing coexpression of CK7, CK20, and absence of CDX2, which had an aggressive neoplasm with extense perineural, vascular and lymphatic invasion also extensive nodal metastasis. The presence of a micropapillary carcinoma in the colorectum seemed to be closely related with nodal metastasis, similar to the case for micropapillary carcinomas in other organs. Therefore, if a micropapillary component is identified in a tumor, particularly in a biopsy specimen, even if the pre-operative diagnosis is a pedunculated early colorectal cancer, should be carefully consider the extent of surgical resection due to the high potential for nodal metastasis.

El carcinoma micropapilar es considerado como una variante agresiva del cáncer en cualquier localización. Histológicamente se caracteriza por grupos de células papilares rodeada de espacios libres. Se informó que la proporción del componente carcinoma micropapilar en la totalidad de un tumor varió entre 5 por ciento a 80 por ciento y no se han reportado casos puros. Existen cerca de 130 casos reportados hasta la fecha en colon y recto. Se describe el caso de un paciente con un carcinoma micropapilar puro que muestra coexpresión de CK7, CK20, y la ausencia de CDX2, que tenía un tumor agresivo con extensa invasión perineural, vascular y linfática además de metástasis nodular extensa. La presencia de un carcinoma micropapilar en la región colorrectal parece estar estrechamente relacionada con metástasis nodular, similar al caso del carcinomas micropapilar en otros órganos. Por lo tanto, si un componente micropapilar se identifica en un tumor, sobre todo en una muestra de biopsia, incluso si el diagnóstico pre-operatorio es un cáncer colorrectal temprano pediculado, se debe considerar cuidadosamente la extensión de la resección quirúrgica debido a la alta probabilidad de metástasis nodular.

The Expressions of CK7, CK20, Vimentin, p53 and Ki-67 in Papillary Thyroid Carcinoma / 대한내분비외과학회지

PURPOSE: The expressions of Cytokeratin7 (CK7) and CK20 have been studied by a lot of cancer researchers, and these 2 protein markers are often used to find the primary foci of metastatic cancers. There have been numerous studies on vimentin, p53 and Ki-67 as prognostic factors for different cancers. However, it seems that there are a few investigations on the expression of CK7 and CK20 in papillary carcinoma of the thyroid. This study aimed to investigate the expressions of CK7, CK20, vimentin, p53 and Ki-67 in papillary thyroid carcinoma, and we wanted to determine whether the expressions of vimentin, p53, and Ki-67 are related to such prognostic factors as age, the tumor size, nodal metastasis or perithyroidal tissue invasion. METHODS: Paraffin slices of 44 papillary thyroid carcinomas from 44 patients were used for immunohistochemistry with using monoclonal antibody against CK7, CK20, vimentin, p53 and Ki-67. The expressions of CK7, CK20 and vimentin were determined simply by the staining competence, and more than 5% positive cells out of 1,000 cells in a highpowered microscopic view was considered as positive for the p53 and Ki-67 expressions. The expressions of vimentin, p53 and Ki-67 were investigated for their correlation with age, perithyroidal tissue invasion, the size of the tumor and metastasis to the cervical lymph nodes. RESULTS: Total of 44 patients (7 men and 37 women) were examined. The average size of tumor was 1.3 cm, and 28 (63.6%) out of 44 patients had perithyroidal tissue invasion. 29 (65.9%) patients had cervical lymph node metastases. The expression of CK7 was observed in all 44 (100%) patients, but only three (6.8%) among them had the expression of CK20. The expression of vimentin was shown in 43 (97.7%) patients. The expressions of p53 and Ki-67 were seen in 33 (75%) patients and 12 (27.7%) patients, respectively. The expressions of vimentin, p53 and Ki-67 were not significantly related with age (P=1.0, 0.084), perithyroidal tissue invasion (P=1.0, 0.798), the size of the tumor (P=0.234, 0.313) and cervical lymph node metastases (P=0.582, 0.948). CONCLUSION: As expected, papillary thyroid carcinoma showed a CK7(+)/CK20(-) pattern. Further research is needed to find the meaning of the expression of vimentin because it was meaningless analyzing the relationship between the prognostic factors due to fact that 97.7% of the patients had the expression of vimentin. There was no statistically significant relation between the expressions of p53 and Ki-67 and age, the size of thyroid tumor, perithyroidal tissue invasionand cervical lymph node metastasis.

Clinical Usefulness of Cytokeratin 7 and 20 Expression in Metastatic Ovarian Tumors / 대한산부인과학회지

OBJECTIVE: To investigate the pattern of Cytokeratin (CK) 7 and 20 expression and evaluate its clinical usefulness in the differential diagnosis of metastatic ovarian carcinoma. METHODS: One hundred eighty nine cases pathologically diagnosed as having metastatic ovarian carcinoma were reviewed from January 1990 to December 2003 at Asan Medical Center. Immunohistochemistry for CK7 and CK20 was performed in 92 cases. RESULTS: One hundred seventy five cases were originated from non-gynecologic organs. The most common primary site was stomach (88 patients) followed by colon (53 patients). Fourteen cases were originated from gynecologic organs, such as uterine cervix, endometrium, and fallopian tube. 82.5% (33/40) of the stomach cancers was CK7 positive, whereas only 23.5% (8/34) of the colorectal cancers was CK7 positive. 82.5% (33/40) of the stomach cancers and 100% (34/34) of the colorectal cancers was CK20 positive. CK7+/CK20+ pattern was the most frequent in stomach cancer (70.0%, 28/40). In colorectal cancer, CK7-/CK20+ pattern had the largest portion (76.5%, 26/34) and there was no CK7+/CK20- pattern in contrast to primary ovarian carcinoma. CONCLUSION: CK7 and CK20 expression patterns in primary gastric carcinomas vary considerably. The CK7-/CK20+ expression pattern is specific for metastatic colorectal carcinomas to the ovary and expression pattern of CK is one of the useful methods to differentiate primary ovary cancers from metastatic ovarian carcinomas from colon, especially in left side colon cancer.

A Case of Sebaceous Carcinoma Arising from Bowen's Disease / 대한피부과학회지

Bowen's disease is an intraepidermal squamous cell carcinoma. Although an invasive squamous cell carcinoma occasionally develops from Bowen's disease, the development of sebaceous carcinoma from Bowen's disease is very rare. We report a case of sebaceous carcinoma arising from Bowen's disease occurring on the cheek in a 72-year-old female. She presented with a crust and erythematous scaly papule on the face. Histopathologic examination of the crusted lesion showed atypical tumor cells with large, hyperchromatic nuclei and frequent mitoses in the epidermis suggesting of Bowen's disease. However, the scaly papule showed tumor lobule composed of clear cells with foamy cytoplasm and atypical undifferentiated cells suggesting of sebaceous carcinoma. CK7 staining was positive only for the tumors cells of the specimen from the scaly papule. The positive staining of CK7 may help distinguish sebaceous carcinoma from clear cell squamous cell carcinoma when that distinction can not be clearly made by light microscopy alone.

The role of CK7 monoclonal antibodies in indentification of primary and metastatic malignant ascites due to ovarian carcinoma / 中国癌症杂志

Purpose:In order to deterimine the role of CK7 and other monoclonal antibodies in identification of primary and metastatic malignant ascites due to ovarian carcinoma.Methods:We used immunocytochemical ABC assay to detect the experssions of CK7、MG7、CEA、AB、CK、CK8、EMA、HBME、LCA、VIM monoclonal antibodies in 43 ascitic samples and 22 specimens. Chi square was used for statistic assay with SPSS 8.0 software. Results:One way ANOV assay showed that: (1) Cytokeratin 7 monoclonal antibody can be a very useful mark of primary ovarian carcinoma. (2) MG7 expression in peritoneal cells was significantly different in primary ovarian cancer and metastatic ovarian carcinoma of gastric origin. (3) CEA can be helpful in suggesting the origin of intestine carcinoma or not. (4) Immunohistochemical study of the peritoneal fluids showed results, similar to those in specimens. Conclusions: Immunocytochemical assay in the peritoneal fluids is a helpful diagnostic modality in differentiating between primary and metastatic ascites due to ovarian carcinoma.