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Diagnostic utility of CDX‐2 expression in separating metastatic gastrointestinal adenocarcinoma from other metastatic adenocarcinoma in fine‐needle aspiration cytology using cell blocks
Author(s) -
Saad Reda S.,
Essig Deborah L.,
Silverman Jan F.,
Liu Yulin
Publication year - 2004
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20342
Subject(s) - adenocarcinoma , medicine , pathology , gastrointestinal cancer , immunohistochemistry , metastasis , cancer , metastatic breast cancer , fine needle aspiration , colorectal cancer , biopsy , breast cancer
BACKGROUND CDX‐2 gene is a transcription factor that is involved in the proliferation and differentiation of intestinal epithelial cells. Recent studies have shown that CDX‐2 could be used as an immunohistochemical marker to differentiate metastatic gastrointestinal adenocarcinoma from other metastatic adenocarcinomas in surgical pathology. The objective of the current study was to investigate the diagnostic value of CDX‐2 to separate metastatic gastrointestinal adenocarcinoma from other metastatic adenocarcinomas in fine‐needle aspiration cytology (FNAC). METHODS Sixty‐two FNAC specimens of metastatic adenocarcinomas with corresponding cell blocks were retrieved from the hospital computer system. There were 22 specimens of metastatic gastrointestinal adenocarcinoma, 20 specimens of metastatic pulmonary adenocarcinoma, and 20 specimens of metastatic adenocarcinomas from other sites, including 10 from the breast, 3 from the ovaries, 4 from the pancreas, and 3 from the prostate. Radiology and histologic evaluation confirmed all cases. Sections were immunostained for CDX‐2 and thyroid transcription factor‐1 (TTF‐1) using a heat‐induced epitope retrieval technique. RESULTS In metastatic gastrointestinal adenocarcinoma, CDX‐2 demonstrated positive nuclear staining in 19 of 22 specimens (86%). Other specimens of metastatic adenocarcinoma were negative for CDX‐2. TTF‐1 expression was detected in 0%, 80%, and 0% of metastatic gastrointestinal adenocarcinoma, pulmonary adenocarcinoma, and other adenocarcinoma specimens, respectively. CONCLUSIONS The results of the current study demonstrated that CDX‐2 is a sensitive and a specific marker to separate metastatic gastrointestinal adenocarcinoma from other metastatic adenocarcinomas in FNAC specimens. Cancer (Cancer Cytopathol) 2004. © 2004 American Cancer Society.