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Cytokeratin 7 and 20 as immunohistochemical markers in identification of primary tumors in craniospinal metastases: do they have a significant role?

Abstract
Cytokeratin (CK)7 and CK20, the low molecular weight cytokeratins, have been found to have a benefit in the differential diagnosis of some epithelial neoplasms. In the present study, the actual role of these markers in the search of primary tumors in 32 patients with craniospinal metastasis of an unknown primary site at presentation, is evaluated. A series of 36 patients with a known primary tumor were presented for comparison. In the first group, two CK7 and CK20 expression profiles were observed; 87% of metastatic tumors were CK7+/CK20- and 13% CK7-/CK20-. The lung was the major source (82%) of CK7+/CK20- metastatic tumors, whereas it represented only 38% of primary tumor in the second group of a known primary site (P=0.006). Given the fact that metastatic tumors to the craniospinal axis of an unknown primary site are frequently CK7+/CK20-, and they have commonly metastasized from the lung, it is doubtful that immunohistochemistry is really helpful. However, CT scan and MRI of the chest still play an important role. Many patients in the present study had to undertake these imaging studies, regardless of the CK7/CK20 result. The immunostains may be useful in cases with other expression profiles, but such examples constituted only a minority in the present study.
AuthorsMana Taweevisit, Putchong Isarakul, Mookda Chaipipat, Kanista Keetacheeva, Vannee Wattanasirmkit, Shanop Shuangshoti
JournalNeuropathology : official journal of the Japanese Society of Neuropathology (Neuropathology) Vol. 23 Issue 4 Pg. 271-4 (Dec 2003) ISSN: 0919-6544 [Print] Australia
PMID14719541 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Biomarkers, Tumor
  • Intermediate Filament Proteins
  • KRT20 protein, human
  • KRT7 protein, human
  • Keratin-20
  • Keratin-7
  • Keratins
Topics
  • Biomarkers, Tumor (analysis)
  • Brain Neoplasms (metabolism, secondary)
  • Female
  • Humans
  • Immunohistochemistry
  • Intermediate Filament Proteins (metabolism)
  • Keratin-20
  • Keratin-7
  • Keratins (metabolism)
  • Male
  • Neoplasms, Unknown Primary (metabolism)
  • Spinal Neoplasms (metabolism, secondary)

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