CDX-2 expression is a common event in primary intestinal-type endocervical adenocarcinoma.
We studied the expression of cytokeratin (CK) 7, CK20, CDX-2, and p16 in 119 cervical adenocarcinomas (65 usual type [50 invasive; 15 in situ], 37 intestinal type [21 invasive; 16 in situ], 10 endometrioid, 5 adenosquamous, and 2 signet-ring carcinomas) in comparison with 55 cases of rectal adenocarcinomas. The percentage of cells staining was considered negative if 0% to 5% stained; more than 5% was considered positive. For p16, staining of more than 50% was considered positive. CK7 was expressed in all cervical cases and in 12 rectal adenocarcinomas (22%). CK20 was expressed in 17 cervical adenocarcinomas (14.3%) and in 48 rectal adenocarcinomas (87%). CK20 immunostaining was diffuse in the majority of rectal tumors but focal in most cervical tumors. CDX-2 was expressed in all cases of rectal adenocarcinoma and in 46 cervical adenocarcinomas (38.7%): usual type, 10 (15%); intestinal type, 31 (84%); endometrioid type, 5 (50%); adenosquamous and signet-ring types, 0 (0%). CDX-2 is a marker for intestinal differentiation irrespective of a rectal or cervical origin. Therefore, it should not be used as the sole basis to confirm the colorectum as the primary origin in metastatic cases.
Saad
Reda S
RS
Departments of Pathology, 1Medical Research Institute, University of Alexandria, Alexandria, Egypt
Ismiil
Nadia
N
Dubé
Valérie
V
Nofech-Mozes
Sharon
S
Khalifa
Mahmoud A
MA
D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology*; D000071616:CDX2 Transcription Factor; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000096:biosynthesis; D005260:Female; D018398:Homeodomain Proteins / Q000096:biosynthesis*; D006801:Humans; D007414:Intestinal Neoplasms / Q000503:physiopathology; D053554:Keratin-20 / Q000096:biosynthesis; D053552:Keratin-7 / Q000096:biosynthesis; D012004:Rectal Neoplasms / Q000503:physiopathology; D015534:Trans-Activators / Q000096:biosynthesis*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000503:physiopathology*
D000071616:CDX2 Transcription Factor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D018398:Homeodomain Proteins; D053554:Keratin-20; D053552:Keratin-7; D015534:Trans-Activators