Scoring with MUC2, MUC5, CK7, CK20, CDX2, CEA Immnohistochemical Staining Results Can Be Useful in Identifying Metastatic Colorectal Carcinoma Involving Ovary from Primary Ovarian Mucinous Adenocarcinoma
JH Shin, CK Jung, A Lee, ES Jung, YJ Choi, KY Lee. Kangnam St Mary's Hospital, The Catholic University of Korea, Seoul, Korea
Background: Colorectal adenocarcinoma, the most common tumor metastatic to the ovary, may closely mimic primary ovarian mucinous adenocarcinoma (POMA). The differential diagnosis is difficult but crucial to treatment and prognosis.
Design: We evaluated the immunohistochemical expression of cytokeratins7 (CK7), cytokeratins20 (CK20), MUC2, MUC5, CDX2 and CEA in 20 POMAs and 41 metastatic colorectal carcinomas involving ovaries (MCCOs).
Results: MCCOs were almost always negative for MUC5 (97.6%), often negative for CK7 (82.9%), positive for CDX2 (73.2%), diffuse positive for CK20 (65.9%), positive for MUC2 (51.2%) and diffuse positive for CEA (41.5%). MCCOs were contrasted to POMAs, which were almost always negative for MUC2 (100%) and negative or focal positive for CK20 (95%) and CEA (90%) and often positive for CK7 (85%) and MUC 5 (50%). When we considered MUC2 (+), MUC5 (-), CK7 (-), CK20 (diffuse +), CDX2 (+), CEA (diffuse +) as score 1, respectively, and added the scores (range 07), with the cut-off value 3, we can correctly classified 90% of POMAs and 91.7% of MCCOs.
Conclusions: Scoring with MUC2, MUC5, CK7, CK20, CDX2, CEA immnohistochemical staining results is a useful adjunctive diagnostic tool to differentiate MCCOs from POMAs, in addition to clinical history and gross and microscopic findings.
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 146, Wednesday Morning