J Korean Med Sci.  2004 Dec;19(6):826-833. 10.3346/jkms.2004.19.6.826.

E-cadherin and Cytokeratin Subtype Profiling in Effusion Cytology

• Han J
• Kim MK
• Nam SJ
• Yang JH

• KMID: 1778564
• DOI: http://doi.org/10.3346/jkms.2004.19.6.826

Abstract

Diagnostic utility of E-cadherin (E-CD) and cytokeratin (CK) subtype profiling in effusion cytology was investigated, employing immunocytochemistry on cellblock sections available from 211 metastatic carcinomas (MC), 6 mesotheliomas and 73 reactive mesothelial hyperplasias (MH). E-CD and monoclonal carcinoembryonic anti-gen (mCEA) stained 85% (120/141) and 65% (138/211) of MC, respectively. E-CD staining of MC was frequently heterogeneous (76/120) and absent in all anaplastic carcinomas (0/2). E-CD stained none (0/57) of MH while mCEA and epithelial membrane antigen (EMA) stained 12% (9/73) and 32% (16/32) of MH, respectively. Of 6 mesotheliomas, E-CD focally stained in 2 while mCEA stained none and EMA stained all. CK20 and CK17 stained none of MH or mesotheliomas. CK20 stained 15% of MC and CK 17 stained 22% of MC. CK5/6 and high molecular weight CK stained all mesotheliomas, 56% and 88% of MH, 26% and 39% of MC, respectively. MC showed predominant CK7+/20-expression, with the exceptions of MC from mucinous type of colon/rectum and ovary showing predominant CK20 positive. E-CD may be a useful positive marker for MC in effusion cytology, although it may focally stain in some mesotheliomas. Any positive staining for CK20 of MC suggests MC from the gastrointestinal tract or ovary among others.

Keyword

Pleural Effusion; Ascites; Carcinoma; Mesothelioma; Neoplasms, Mesothelial; Cadherins; Keratin; Cytokeratin 20; Keratin 7

MeSH Terms

Cadherins/*metabolism
Carcinoma/diagnosis/*metabolism/*secondary
Comparative Study
Diagnosis, Differential
Epithelium/*metabolism/*pathology
Humans
Hyperplasia/metabolism
Immunohistochemistry/methods
Keratin/*metabolism
Mesothelioma/diagnosis/*metabolism
Tumor Markers, Biological/*metabolism

Figure

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  Fig. 1 E-CD staining in metastatic adenocarcinoma (×400): metastatic papillary serous carcinoma of the ovary exhibits typical intercellular staining (A). Metastatic pulmonary adenocarcinoma exhibits a somewhat heterogeneous staining (B) or a partial loss of staining (C). Metastatic adenocarcinoma from common bile duct exhibits rather exaggerated, cytoplasmic staining (D). Metastatic signet ring cell carcinoma (arrows) of the colon Inset: cytoplasmic mucin in tumor cells, H&E (E) and metastatic undifferentiated carcinoma (arrows) of the ovary (F) exhibit none. Note many inflammatory cells are in background.

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  Fig. 2 E-CD staining in mesothelial cells: reactive mesothelial cells exhibit none (A, ×400) and neoplastic mesothelial cells (arrow) (B, ×400).

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  Fig. 3 Metastatic ovarian mucinous carcinoma (A, ×400) and metastatic gastric signet ring cell carcinoma (B, ×400) show diffuse membranous staining for CK20.

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  Fig. 4 Mesothelial cells exhibit none of stain for CK17 (A, ×400). In contrast, metastatic mammary duct carcinoma (B, ×200) and metastatic esophageal squamous cell carcinoma (C, ×400) exhibit diffuse membranous/cytoplasmic staining for CK17.

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  Fig. 5 Mesothelial cells (A, ×400) and metastatic squamous cell carcinoma of the lung (B, ×400) exhibit diffuse strong membranous/cytoplasmic staining for CK5/6.

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