Immunohistochemical evaluation of colorectal carcinoma: experience of a four-year study

Authors

DOI:

https://doi.org/10.14739/2310-1237.2024.3.312101

Keywords:

colorectal carcinoma, immunohistochemistry, CDX2, CK7, CK20

Abstract

Colorectal carcinomas (CRC) is the third most common cause of death in developed countries. Invoking of primary site of carcinoma of unknown origin using immunohistochemistry is essential for accurate diagnosis, and also for targeted therapies.

Aim. This study aimed to assess immunohistochemical expression of CK7, CK20, and CDX2 in colorectal carcinomas, and to evaluate their diagnostic role.

Materials and methods. A retrospective study was performed on 36 paraffin blocks of documented colorectal carcinomas were stained by immunohistochemical technique using a tissue microarray with CK7, CK20 and CDX2 markers. The resulted data were statistically analyzed.

Results. There was a negative association between CDX2 expression and histologic grade (p = 0.03), as well as T-pathologic stage (p = 0.01). CK7-ve / CK20+ve immune profile showed a specificity of 95 % in predicting the colorectal adenocarcinomas, which was superior to that of CDX2. CDX2 loss is related to tumour grade and depth (T-stage).

Conclusions. Both CDX2 expression, and CK7-ve / CK20+ve are the most sensitive, and specific markers to diagnose the colorectal carcinoma. CK7-ve / CK20+ve expression is used as specific marker for colorectal carcinoma for targeted therapy.

Author Biographies

Muchalapuri Sravani, SVS Medical College and Hospital, Yenugonda, Mahabubnagar, Telangana, India

MD, Assistant Professor of the Department of Pathology

 

Fatima Fatima, Osmania Medical College, Koti, Hyderabad, Telangana, India

MD, Senior resident of the Department of Pathology

Rasheed Fatima, SVS Medical College and Hospital, Yenugonda, Mahabubnagar, Telangana, India

MD, Professor of the Department of Pathology

K. N. Deepthi, SVS Medical College and Hospital, Yenugonda, Mahabubnagar, Telangana, India

MD, Professor of the Department of Pathology

Shilpa Karamchedu, SVS Medical College and Hospital, Yenugonda, Mahabubnagar, Telangana, India

MD, Associate Professor

Shaikh Nishadbanu, SVS Medical College and Hospital, Yenugonda, Mahabubnagar, Telangana, India

Postgraduate

Allam Swetha, SVS Medical College and Hospital, Yenugonda, Mahabubnagar, Telangana, India

Postgraduate

References

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. doi: https://doi.org/10.3322/caac.21660
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: https://doi.org/10.3322/caac.21492
  3. Chen K, Collins G, Wang H, Toh JW. Pathological Features and Prognostication in Colorectal Cancer. Curr Oncol. 2021;28(6):5356-83. doi: https://doi.org/10.3390/curroncol28060447
  4. Baba Y, Nosho K, Shima K, Freed E, Irahara N, Philips J, et al. Relationship of CDX2 loss with molecular features and prognosis in colorectal cancer. Clin Cancer Res. 2009;15(14):4665-73. doi: https://doi.org/10.1158/1078-0432.CCR-09-0401
  5. Badia-Ramentol J, Gimeno-Valiente F, Duréndez E, Martínez-Ciarpaglini C, Linares J, Iglesias M, et al. The prognostic potential of CDX2 in colorectal cancer: Harmonizing biology and clinical practice. Cancer Treat Rev. 2023;121:102643. doi: https://doi.org/10.1016/j.ctrv.2023.102643
  6. Al-Maghrabi J, Emam E, Gomaa W. Immunohistochemical staining of cytokeratin 20 and cytokeratin 7 in colorectal carcinomas: Four different immunostaining profiles. Saudi J Gastroenterol. 2018;24(2):129-34. doi: https://doi.org/10.4103/sjg.SJG_465_17
  7. Ayed A, Saber R, Hussein N. Clinico - epidemiological study on colorectal cancer through El-Minia governorate during the years 2015 - 2019. Minia Journal of Medical Research. 2023;34(4):35-44. doi: https://doi.org/10.21608/mjmr.2023.237588.1525
  8. Metwally IH, Shetiwy M, Elalfy AF, Abouzid A, Saleh SS, Hamdy M. Epidemiology and survival of colon cancer among Egyptians: a retrospective study. Coloproctology. 2018;38(1):24-9. doi: https://doi.org/10.1016/j.jcol.2017.09.418
  9. Laprovitera N, Riefolo M, Ambrosini E, Klec C, Pichler M, Ferracin M. Cancer of Unknown Primary: Challenges and Progress in Clinical Management. Cancers (Basel). 2021 Jan 25;13(3):451. doi: https://doi.org/10.3390/cancers13030451
  10. Li Z, Rock JB, Roth R, Lehman A, Marsh WL, Suarez A, et al. Dual Stain With SATB2 and CK20/Villin Is Useful to Distinguish Colorectal Carcinomas From Other Tumors. Am J Clin Pathol. 2018;149(3):241-6. doi: https://doi.org/10.1093/ajcp/aqx160
  11. Selves J, Long-Mira E, Mathieu MC, Rochaix P, Ilié M. Immunohistochemistry for Diagnosis of Metastatic Carcinomas of Unknown Primary Site. Cancers (Basel). 2018;10(4):108. doi: https://doi.org/10.3390/cancers10040108
  12. Park JH, Kim JH. Pathologic differential diagnosis of metastatic carcinoma in the liver. Clin Mol Hepatol. 2019;25(1):12-20. doi: https://doi.org/10.3350/cmh.2018.0067
  13. de Ridder J, de Wilt JH, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget. 2016;7(34):55368-76. doi: https://doi.org/10.18632/oncotarget.10552
  14. Zygulska AL, Pierzchalski P. Novel Diagnostic Biomarkers in Colorectal Cancer. Int J Mol Sci. 2022;23(2):852. doi: https://doi.org/10.3390/ijms23020852
  15. Jelski W, Mroczko B. Biochemical Markers of Colorectal Cancer - Present and Future. Cancer Manag Res. 2020;12:4789-97. doi: https://doi.org/10.2147/CMAR.S253369
  16. Ilieva N, Tashkova D, Staykov D, Serteva D, Feodorova Y, Mehterov N, et al. Immunohistochemical expression of CK20, CK7, and CDX2 in colorectal carcinoma in correlation with pathomorphological characteristics. Folia Med (Plovdiv). 2022;64(2):214-20. doi: https://doi.org/10.3897/folmed.64.e60950
  17. Fei F, Li C, Cao Y, Liu K, Du J, Gu Y, et al. CK7 expression associates with the location, differentiation, lymph node metastasis, and the Dukes' stage of primary colorectal cancers. J Cancer. 2019;10(11):2510-9. doi: https://doi.org/10.7150/jca.29397
  18. Bayrak R, Haltas H, Yenidunya S. The value of CDX2 and cytokeratins 7 and 20 expression in differentiating colorectal adenocarcinomas from extraintestinal gastrointestinal adenocarcinomas: cytokeratin 7-/20+ phenotype is more specific than CDX2 antibody. Diagn Pathol. 2012;7:9. doi: https://doi.org/10.1186/1746-1596-7-9
  19. Bae JM, Lee TH, Cho NY, Kim TY, Kang GH. Loss of CDX2 expression is associated with poor prognosis in colorectal cancer patients. World J Gastroenterol. 2015;21(5):1457-67. doi: https://doi.org/10.3748/wjg.v21.i5.1457
  20. Dum D, Menz A, Völkel C, De Wispelaere N, Hinsch A, Gorbokon N, et al. Cytokeratin 7 and cytokeratin 20 expression in cancer: A tissue microarray study on 15,424 cancers. Exp Mol Pathol. 2022;126:104762. doi: https://doi.org/10.1016/j.yexmp.2022.104762
  21. Dalerba P, Sahoo D, Paik S, Guo X, Yothers G, Song N, et al. CDX2 as a Prognostic Biomarker in Stage II and Stage III Colon Cancer. N Engl J Med. 2016 Jan 21;374(3):211-22. doi: https://doi.org/10.1056/NEJMoa1506597
  22. Koide T, Koyanagi-Aoi M, Uehara K, Kakeji Y, Aoi T. CDX2-induced intestinal metaplasia in human gastric organoids derived from induced pluripotent stem cells. iScience. 2022;25(5):104314. doi: https://doi.org/10.1016/j.isci.2022.104314
  23. Sardar AA, Jalal JA, Ameen KS. Immunohistochemical Expression of CDX2 in Gastric Carcinoma. Iran J Pathol. 2022 Spring;17(2):143-9. doi: https://doi.org/10.30699/IJP.2022.530631.2648

Downloads

Additional Files

Published

2024-12-27

How to Cite

1.
Sravani M, Fatima F, Fatima R, Deepthi KN, Karamchedu S, Nishadbanu S, Swetha A. Immunohistochemical evaluation of colorectal carcinoma: experience of a four-year study. Pathologia [Internet]. 2024Dec.27 [cited 2026May25];21(3):199-204. Available from: https://pat.zsmu.edu.ua/article/view/312101

Issue

Section

Original research