Immunohistochemical evaluation of colorectal carcinoma: experience of a four-year study
DOI:
https://doi.org/10.14739/2310-1237.2024.3.312101Keywords:
colorectal carcinoma, immunohistochemistry, CDX2, CK7, CK20Abstract
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.
References
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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