Open AccessPROGNOSTIC MARKERS IN IMMUNOHISTOCHEMICAL DIAGNOSIS OF METASTASES OF COLORECTAL PHENOTYPE CARCINOMA OF UNKNOWN PRIMARY
Author(s) -
О. V. Poslavska
Publication year - 2019
Publication title -
aktualʹnì problemi sučasnoï medicini: vìsnik ukraïnsʹkoï medičnoï stomatologìčnoï akademì
Language(s) - English
Resource type - Journals
eISSN - 2077-1126
pISSN - 2077-1096
DOI - 10.31718/2077-1096.19.1.77
Subject(s) - immunohistochemistry , colorectal cancer , microsatellite instability , medicine , phenotype , cdx2 , pathology , oncology , cancer , gene , gene expression , biology , microsatellite , allele , biochemistry , homeobox
Most metastases of cancers of unknown primary (80% -85%) are known as having unfavourable prognostic variants due to their large extant and low susceptibility to the therapy. Studies of prognostic immunohistochemical markers will provide an opportunity to understand the biological features of the rapid dissemination of individual colorectal phenotypes. In recent decades, p53 and Ki-67, the most popular antibodies have been investigated as prognostic factors for colorectal cancer. The p53 protein is a regulatory protein that is at the crossroads of cell division and cell death. The goal of this study is to explore the expression features of prognostic immunohistochemical markers Ki-67, p53, β-catenin, AMACR (p503s), HER2-new in carcinomas of unknown primary of the colorectal phenotype compared with primary tumours of the colon, to improve diagnostic algorithms. Materials and methods. A study of biopsy material taken from 37 patients aged 28 to 81 years (mean 58.46 ± 12.28; median 58), group 1, with metastases without primary localization was carried out; the immunohistochemical investigation revealed adenocarcinomas of the colorectal phenotype CK20 + / CDX2 + / CK7; the investigation of postoperative material in 41 patients aged 27 to 76 years (mean 60.56 ± 12.81; median 64), group 2, revealed primary colon tumour. Results. Positive focal expression of p53 was found in the colorectal cancers of the proximal sections (located to the right), it is they that more often have microsatellite instability, compared to distal carcinomas. Amplification of the Her-2-new gene (expression at the level of 2+ and 3+) was found in 35% (13 of 37) of metastasis of colorectal cancers, and in almost 15% (6 of 41) of primary colon adenocarcinomas that suggests the appropriateness in applying targeted therapy.Conclusions. Nuclear translocation of β-catenin, positive “focal” expression of p53 and amplification of the Her-2-new gene are statistically significantly more common in colorectal phenotype metastases compared with primary colon adenocarcinomas (all р> 0.05).