细胞角蛋白7和20在卵巢转移癌中的表达

Expression of cytokeratin 7 and 20 in ovarian metastatic carcinomas

目的 观察卵巢转移癌的临床资料、病理形态和免疫组织化学改变 ,为鉴别卵巢转移癌与原发癌提供依据。方法 对 2 7例卵巢转移癌 (其中胃癌 12例 ,结肠癌 11例 ,其他 4例 )进行了临床和病理形态观察 ,同时采用免疫组织化学 (SP法 )对其分别进行细胞角蛋白 [CK(AE1/AE3) ]、细胞角蛋白 7(CK7)、细胞角蛋白 2 0 (CK2 0 )、癌胚抗原、波形蛋白、nm2 3抗原检测。结果 卵巢转移性胃癌 12例中 11例为双侧实性 ,卵巢转移性结肠癌 11例中 7例为单侧囊实性。组织学检查胃癌卵巢转移 12例全部以印戒细胞癌或低分化腺癌散在分布为特征 ,而结肠癌卵巢转移则 11例中 8例与子宫内膜样癌相似。CK2 0阳性染色使卵巢转移性胃癌 7例及结肠癌 8例得到明确诊断 ,在转移性结肠癌中CK2 0有稳定的表达。卵巢转移性胃肠道癌中CK7多数阴性。癌胚抗原、波形蛋白、nm2 3的联合使用使转移性胃癌 11例 ,结肠癌 10例得到明确诊断。结论 CK7和CK2 0在鉴别来自胃肠道的卵巢转移癌中具有重要意义 ,当几种抗体联合使用时意义更大。

Objective To study the distinctive clinicopathologic and immunohistochemical difference between ovarian metastatic carcinomas and primary ovarian carcinomas. Methods The clinical and pathological features of 27 cases of ovarian metastatic carcinomas (gastric carcinomas 12 cases, colon carcinomas 11 cases, others 4 cases) obtained from our department were reviewed. Immunostainings for CK(AE1/AE3), CK7, CK20,CEA, vimentin, nm23 were performed with SP staining methods. Results On gross examination, metastasis from gastric adenocarcinoma were usually bilateral, while solid (11/12) and metastases from colonic adenocarcinoma were more often unilateral and cystic (7/11). Microscopically, metastases from gastric adenocarcinoma revealed signet ring cells or poorly differentiated adenocarcinomas (12/12), whereas metastases from colonic adenocarcinomas showed similar morphology of endometrioid adenocarcinoma (8/11). The majority of ovarian metastases of gastric carcinoma (7/12) and colon carcinoma (8/11) were CK20 positive. In particular, CK20 was invariably expressed in colon cancer metastases. Most of the ovarian metastatic carcinomas from the gastrointestinal tract failed to react with immunostaining of CK7. A combined use of CEA, vimentin and nm23 had made a correct classification for 11/12 cases of the gastric carcinoma, 10/11 cases of the colonic cancer. Conclusions CK7 and CK20 have been proved to be useful antibodies in distinguishing between metastatic carcinomas and primary carcinomas of the ovary. Combined use of a panel of antibodies can give more significant results.