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Cytokeratin 7 and 20 as immunohistochemical markers in identification of primary tumors in craniospinal metastases: Do they have a significant role?
Author(s) -
Taweevisit Mana,
Isarakul Putchong,
Chaipipat Mookda,
Keetacheeva Kanista,
Wattanasirmkit Vannee,
Shuangshoti Shanop
Publication year - 2003
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1046/j.1440-1789.2003.00511.x
Subject(s) - cytokeratin , medicine , pathology , keratin 7 , immunohistochemistry , differential diagnosis , immunostaining , primary tumor , metastasis , oncology , cancer
Cytokeratin (CK)7 and CK20, the low molecular weight cytokeratins, have been found to have a benefit in the differential diagnosis of some epithelial neoplasms. In the present study, the actual role of these markers in the search of primary tumors in 32 patients with craniospinal metastasis of an unknown primary site at presentation, is evaluated. A series of 36 patients with a known primary tumor were presented for comparison. In the first group, two CK7 and CK20 expression profiles were observed; 87% of metastatic tumors were CK7+/CK20‐ and 13% CK7‐/CK20‐. The lung was the major source (82%) of CK7+/CK20‐ metastatic tumors, whereas it represented only 38% of primary tumor in the second group of a known primary site ( P = 0.006). Given the fact that metastatic tumors to the craniospinal axis of an unknown primary site are frequently CK7+/CK20‐, and they have commonly metastasized from the lung, it is doubtful that immunohistochemistry is really helpful. However, CT scan and MRI of the chest still play an important role. Many patients in the present study had to undertake these imaging studies, regardless of the CK7/CK20 result. The immunostains may be useful in cases with other expression profiles, but such examples constituted only a minority in the present study.