DPC4 Immunostaining in Mullerian Tumors with and without Mucinous Differentiation
Esther Elishaev, Xin Li, Amal Kanbour-Shakir, Sarah E Taylor, Robert P Edwards, Jing Yu, Anna H Woodard, Mirka W Jones, Rohit Bhargava. Magee-Womens Hospital of UPMC, Pittsburgh, PA
Background: Mucinous tumors in the ovary always raise a concern for a metastasis, and require a panel of immuno stains to determine site of origin. DPC4 immuno stain is always included in the diagnostic panel as the absence of staining for this antibody supports pancreatic origin of the tumor. While studies addressing DPC4 staining pattern in primary and metastatic mucinous tumors of pancreatic origin are well documented, knowledge of DPC4 in ovarian tumors or tumors of mullerian origin with or without mucinous differentiation is very limited. To address this issue, we stained tissue microarrays (TMAs) constructed from various mullerian and ovarian tumors with DPC4. In addition PAX8 was performed to ratify müllerian origin if DPC4 staining was negative.
Design: TMAs were constructed with three fold redundancy from various müllerian tumors with DPC4 results available on 37 endocervical adenocarcinomas, 55 endometrial and 113 ovarian tumors. An H score was used to evaluate both antibodies with negative interpretation for scores 0-10, and positive for 11-300.
|EC-usual type CA||2 (11%)||17 (89%)|
|EC-variant CA||0 (0%)||18 (100%)|
|EM-endometrioid CA||1 (3%)||38 (97%)|
|EM-non endometrioid CA||1 (6%)||15 (94%)|
|OV-endometrioid CA||1 (8%)||11 (92%)|
|OV-high grade serous CA||0 (0%)||21 (100%)|
|OV-clear cell CA||4 (10%)||35 (90%)|
|OV-mucinous CA||0 (0%)||2 (100%)|
|OV-serous BT||0 (0%)||19 (100%)|
|OV-mucinous BT||0 (0%)||16 (100%)|
|OV-seromucinous BT||0 (0%)||4 (100%)|