Immunohistochemical profiles in primary lung cancers and epithelial pulmonary metastases

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Immunohistochemical profiles in primary lung cancers and epithelial pulmonary metastases. / Vidarsdottir, Halla; Tran, Lena; Nodin, Björn; Jirström, Karin; Planck, Maria; Jönsson, Per; Mattsson, Johanna S.M.; Botling, Johan; Micke, Patrick; Brunnström, Hans.

In: Human Pathology, Vol. 84, 2019, p. 221-230.

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T1 - Immunohistochemical profiles in primary lung cancers and epithelial pulmonary metastases

AU - Vidarsdottir, Halla

AU - Tran, Lena

AU - Nodin, Björn

AU - Jirström, Karin

AU - Planck, Maria

AU - Jönsson, Per

AU - Mattsson, Johanna S.M.

AU - Botling, Johan

AU - Micke, Patrick

AU - Brunnström, Hans

PY - 2019

Y1 - 2019

N2 - Correct diagnosis of pulmonary tumors is essential for treatment decision and often relies on immunohistochemical markers. We stained tissue microarrays from resected primary lung cancer (n = 665) and pulmonary metastases (n = 425) for CK7, CK20, CDX2, CK5, p40, p63, TTF-1, napsin A, GATA3, and PAX8 to systematically assess the diagnostic value of these markers. Primary lung adenocarcinomas expressed TTF-1 in 90% and napsin A in 84% of the cases, whereas 10% were positive for p63, 7% for CDX2, 2% for CK20, and 2% for GATA3. Only 68% of the lung adenocarcinomas were positive for CK7, TTF-1, and napsin A and negative for all other markers. Primary lung squamous cell carcinomas expressed CK5, p40, and p63 in 94%-97% of cases, whereas 44% were positive for CK7, 20% for GATA3, 7% for CDX2, and 3% for TTF-1. Rare cases expressed PAX8, CK20, or napsin A. Pulmonary metastases of colorectal cancer were positive for CK20 in 83% and CDX2 in 99% of the cases. Rare cases expressed CK7, p63, or PAX8, whereas 4% expressed TTF-1. Pulmonary metastases of renal cell carcinomas were positive for PAX8 in 74%, napsin A in 7%, and CK7 in 7% of the cases. Pulmonary metastases of breast cancer were positive for GATA3 in 93% and CK7 in 78% of the cases, whereas 15% expressed CK5. Information on expression and patterns of immunohistochemical markers facilitates histopathological diagnostics. Evidently, unusual immune profiles occur and may lead to incorrect diagnosis.

AB - Correct diagnosis of pulmonary tumors is essential for treatment decision and often relies on immunohistochemical markers. We stained tissue microarrays from resected primary lung cancer (n = 665) and pulmonary metastases (n = 425) for CK7, CK20, CDX2, CK5, p40, p63, TTF-1, napsin A, GATA3, and PAX8 to systematically assess the diagnostic value of these markers. Primary lung adenocarcinomas expressed TTF-1 in 90% and napsin A in 84% of the cases, whereas 10% were positive for p63, 7% for CDX2, 2% for CK20, and 2% for GATA3. Only 68% of the lung adenocarcinomas were positive for CK7, TTF-1, and napsin A and negative for all other markers. Primary lung squamous cell carcinomas expressed CK5, p40, and p63 in 94%-97% of cases, whereas 44% were positive for CK7, 20% for GATA3, 7% for CDX2, and 3% for TTF-1. Rare cases expressed PAX8, CK20, or napsin A. Pulmonary metastases of colorectal cancer were positive for CK20 in 83% and CDX2 in 99% of the cases. Rare cases expressed CK7, p63, or PAX8, whereas 4% expressed TTF-1. Pulmonary metastases of renal cell carcinomas were positive for PAX8 in 74%, napsin A in 7%, and CK7 in 7% of the cases. Pulmonary metastases of breast cancer were positive for GATA3 in 93% and CK7 in 78% of the cases, whereas 15% expressed CK5. Information on expression and patterns of immunohistochemical markers facilitates histopathological diagnostics. Evidently, unusual immune profiles occur and may lead to incorrect diagnosis.

KW - CDX2

KW - Cytokeratin

KW - GATA3

KW - Napsin A

KW - Tissue microarray

KW - TTF-1

U2 - 10.1016/j.humpath.2018.10.009

DO - 10.1016/j.humpath.2018.10.009

M3 - Article

VL - 84

SP - 221

EP - 230

JO - Human Pathology

T2 - Human Pathology

JF - Human Pathology

SN - 1532-8392

ER -