Value of p63 and cytokeratin 5/6 as immunohistochemical markers for the differential diagnosis of poorly differentiated and undifferentiated carcinomas
To facilitate the differential diagnosis of poorly differentiated metastatic carcinomas of unknown primary site, we evaluated p63 and cytokeratin (CK) 5/6 as immunohistochemical markers for squamous cell carcinomas. The study cases were as follows: squamous cell carcinoma of the lungs, head/neck, es...
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| Veröffentlicht in: | American journal of clinical pathology 2001-12, Vol.116 (6), p.823-830 |
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| creator | KAUFMANN, Olaf FIETZE, Ellen MENGS, Jörg DIETEL, Manfred |
| description | To facilitate the differential diagnosis of poorly differentiated metastatic carcinomas of unknown primary site, we evaluated p63 and cytokeratin (CK) 5/6 as immunohistochemical markers for squamous cell carcinomas. The study cases were as follows: squamous cell carcinoma of the lungs, head/neck, esophagus, cervix uteri, or anal canal, 73; non-squamous cell carcinomas of various primary sites, 141; and urothelial carcinoma, 20. We also tested 14 malignant mesotheliomas. Immunoreactivity for p63 was as follows: squamous cell carcinomas, 59 (81%); urothelial carcinoma, 14 (70%), most often with diffuse staining patterns; non-squamous cell carcinomas, 20 (14.2%), resulting in a specificity of 0.86 of p63 for squamous cell carcinomas. Coexpression of p63 and CK5/6 had a sensitivity of 0.77 and a specificity of 0.96 for squamous cell carcinomas. Increasing the minimal criterion of positive immunostaining for both markers to more than 50% of immunoreactive tumor cells resulted in a specificity of 0.99, although the sensitivity diminished to 0.66. All malignant mesotheliomas were negative for p63. Our data suggest that positive immunostaining for both p63 and CK5/6 in poorly differentiated metastatic carcinomas is highly predictive of a primary tumor of squamous epithelial origin. |
| doi_str_mv | 10.1309/21tw-2ndg-jrk4-pfjx |
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The study cases were as follows: squamous cell carcinoma of the lungs, head/neck, esophagus, cervix uteri, or anal canal, 73; non-squamous cell carcinomas of various primary sites, 141; and urothelial carcinoma, 20. We also tested 14 malignant mesotheliomas. Immunoreactivity for p63 was as follows: squamous cell carcinomas, 59 (81%); urothelial carcinoma, 14 (70%), most often with diffuse staining patterns; non-squamous cell carcinomas, 20 (14.2%), resulting in a specificity of 0.86 of p63 for squamous cell carcinomas. Coexpression of p63 and CK5/6 had a sensitivity of 0.77 and a specificity of 0.96 for squamous cell carcinomas. Increasing the minimal criterion of positive immunostaining for both markers to more than 50% of immunoreactive tumor cells resulted in a specificity of 0.99, although the sensitivity diminished to 0.66. All malignant mesotheliomas were negative for p63. Our data suggest that positive immunostaining for both p63 and CK5/6 in poorly differentiated metastatic carcinomas is highly predictive of a primary tumor of squamous epithelial origin.</description><identifier>ISSN: 0002-9173</identifier><identifier>EISSN: 1943-7722</identifier><identifier>DOI: 10.1309/21tw-2ndg-jrk4-pfjx</identifier><identifier>PMID: 11764070</identifier><identifier>CODEN: AJCPAI</identifier><language>eng</language><publisher>Chicago, IL: American Society of Clinical Pathologists</publisher><subject>Biological and medical sciences ; Biomarkers, Tumor - analysis ; Carcinoma, Squamous Cell - chemistry ; Carcinoma, Squamous Cell - secondary ; Diagnosis, Differential ; DNA-Binding Proteins ; Female ; Genes, Tumor Suppressor ; Humans ; Immunoenzyme Techniques ; Investigative techniques, diagnostic techniques (general aspects) ; Keratin-5 ; Keratins - analysis ; Male ; Medical sciences ; Membrane Proteins ; Miscellaneous. Technology ; Neoplasms, Unknown Primary - chemistry ; Neoplasms, Unknown Primary - pathology ; Pathology. Cytology. Biochemistry. Spectrometry. 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The study cases were as follows: squamous cell carcinoma of the lungs, head/neck, esophagus, cervix uteri, or anal canal, 73; non-squamous cell carcinomas of various primary sites, 141; and urothelial carcinoma, 20. We also tested 14 malignant mesotheliomas. Immunoreactivity for p63 was as follows: squamous cell carcinomas, 59 (81%); urothelial carcinoma, 14 (70%), most often with diffuse staining patterns; non-squamous cell carcinomas, 20 (14.2%), resulting in a specificity of 0.86 of p63 for squamous cell carcinomas. Coexpression of p63 and CK5/6 had a sensitivity of 0.77 and a specificity of 0.96 for squamous cell carcinomas. Increasing the minimal criterion of positive immunostaining for both markers to more than 50% of immunoreactive tumor cells resulted in a specificity of 0.99, although the sensitivity diminished to 0.66. All malignant mesotheliomas were negative for p63. Our data suggest that positive immunostaining for both p63 and CK5/6 in poorly differentiated metastatic carcinomas is highly predictive of a primary tumor of squamous epithelial origin.</description><subject>Biological and medical sciences</subject><subject>Biomarkers, Tumor - analysis</subject><subject>Carcinoma, Squamous Cell - chemistry</subject><subject>Carcinoma, Squamous Cell - secondary</subject><subject>Diagnosis, Differential</subject><subject>DNA-Binding Proteins</subject><subject>Female</subject><subject>Genes, Tumor Suppressor</subject><subject>Humans</subject><subject>Immunoenzyme Techniques</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Keratin-5</subject><subject>Keratins - analysis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Membrane Proteins</subject><subject>Miscellaneous. Technology</subject><subject>Neoplasms, Unknown Primary - chemistry</subject><subject>Neoplasms, Unknown Primary - pathology</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Phosphoproteins - analysis</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Trans-Activators - analysis</subject><subject>Transcription Factors</subject><subject>Tumor Suppressor Proteins</subject><issn>0002-9173</issn><issn>1943-7722</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctuFDEQRS1ERIbAFyAhb2DXxM92e4kCSUiiBKHw2LVq_Mh40m0PtltkvoTfpUlGCmJV0q1zb0l1EXpFyTvKiT5ktP5qWLQ3zTrfimbj13dP0IJqwRulGHuKFoQQ1miq-D56XsqaEMo6Ip6hfUpVK4giC_T7GwyTw8njTcsxRIvNtqZbl6GGiOVhi6HgMI5TTKtQajIrNwYDAx4hz1TBPmVcVw7b4L3LLtYwL22Am5hKKPfBKeVh-y9Qnb0_NcX_RAPZhJhGKC_QnoehuJe7eYC-Hn-8PjptLq5OPh29v2iMEKw2SrbE2s4uhZFKdYYrkEZ1rTNuljglpCVet4QScFyDkVIuNZVSWPBiKYEfoLcPuZucfk6u1H4MxbhhgOjSVHrFuOg6rmeQP4Amp1Ky8_0mh_kJ256S_m8fPaPX33t2-eGkP_tyLvrPx2c_ZtfrXfy0HJ199OwKmIE3OwDK_FafIZpQHjnOlWZa8z8uVpmK</recordid><startdate>20011201</startdate><enddate>20011201</enddate><creator>KAUFMANN, Olaf</creator><creator>FIETZE, Ellen</creator><creator>MENGS, Jörg</creator><creator>DIETEL, Manfred</creator><general>American Society of Clinical Pathologists</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20011201</creationdate><title>Value of p63 and cytokeratin 5/6 as immunohistochemical markers for the differential diagnosis of poorly differentiated and undifferentiated carcinomas</title><author>KAUFMANN, Olaf ; FIETZE, Ellen ; MENGS, Jörg ; DIETEL, Manfred</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-7560dd8db4c5778c37a5c786eceb4c310060f96010ae39ac555b91554daf4b5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Biological and medical sciences</topic><topic>Biomarkers, Tumor - analysis</topic><topic>Carcinoma, Squamous Cell - chemistry</topic><topic>Carcinoma, Squamous Cell - secondary</topic><topic>Diagnosis, Differential</topic><topic>DNA-Binding Proteins</topic><topic>Female</topic><topic>Genes, Tumor Suppressor</topic><topic>Humans</topic><topic>Immunoenzyme Techniques</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Keratin-5</topic><topic>Keratins - analysis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Membrane Proteins</topic><topic>Miscellaneous. Technology</topic><topic>Neoplasms, Unknown Primary - chemistry</topic><topic>Neoplasms, Unknown Primary - pathology</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Phosphoproteins - analysis</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Trans-Activators - analysis</topic><topic>Transcription Factors</topic><topic>Tumor Suppressor Proteins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KAUFMANN, Olaf</creatorcontrib><creatorcontrib>FIETZE, Ellen</creatorcontrib><creatorcontrib>MENGS, Jörg</creatorcontrib><creatorcontrib>DIETEL, Manfred</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KAUFMANN, Olaf</au><au>FIETZE, Ellen</au><au>MENGS, Jörg</au><au>DIETEL, Manfred</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Value of p63 and cytokeratin 5/6 as immunohistochemical markers for the differential diagnosis of poorly differentiated and undifferentiated carcinomas</atitle><jtitle>American journal of clinical pathology</jtitle><addtitle>Am J Clin Pathol</addtitle><date>2001-12-01</date><risdate>2001</risdate><volume>116</volume><issue>6</issue><spage>823</spage><epage>830</epage><pages>823-830</pages><issn>0002-9173</issn><eissn>1943-7722</eissn><coden>AJCPAI</coden><abstract>To facilitate the differential diagnosis of poorly differentiated metastatic carcinomas of unknown primary site, we evaluated p63 and cytokeratin (CK) 5/6 as immunohistochemical markers for squamous cell carcinomas. The study cases were as follows: squamous cell carcinoma of the lungs, head/neck, esophagus, cervix uteri, or anal canal, 73; non-squamous cell carcinomas of various primary sites, 141; and urothelial carcinoma, 20. We also tested 14 malignant mesotheliomas. Immunoreactivity for p63 was as follows: squamous cell carcinomas, 59 (81%); urothelial carcinoma, 14 (70%), most often with diffuse staining patterns; non-squamous cell carcinomas, 20 (14.2%), resulting in a specificity of 0.86 of p63 for squamous cell carcinomas. Coexpression of p63 and CK5/6 had a sensitivity of 0.77 and a specificity of 0.96 for squamous cell carcinomas. Increasing the minimal criterion of positive immunostaining for both markers to more than 50% of immunoreactive tumor cells resulted in a specificity of 0.99, although the sensitivity diminished to 0.66. All malignant mesotheliomas were negative for p63. Our data suggest that positive immunostaining for both p63 and CK5/6 in poorly differentiated metastatic carcinomas is highly predictive of a primary tumor of squamous epithelial origin.</abstract><cop>Chicago, IL</cop><pub>American Society of Clinical Pathologists</pub><pmid>11764070</pmid><doi>10.1309/21tw-2ndg-jrk4-pfjx</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Biomarkers, Tumor - analysis Carcinoma, Squamous Cell - chemistry Carcinoma, Squamous Cell - secondary Diagnosis, Differential DNA-Binding Proteins Female Genes, Tumor Suppressor Humans Immunoenzyme Techniques Investigative techniques, diagnostic techniques (general aspects) Keratin-5 Keratins - analysis Male Medical sciences Membrane Proteins Miscellaneous. Technology Neoplasms, Unknown Primary - chemistry Neoplasms, Unknown Primary - pathology Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Phosphoproteins - analysis Reproducibility of Results Sensitivity and Specificity Trans-Activators - analysis Transcription Factors Tumor Suppressor Proteins |
| title | Value of p63 and cytokeratin 5/6 as immunohistochemical markers for the differential diagnosis of poorly differentiated and undifferentiated carcinomas |
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