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. 2002 Jun 17;86(12):1884-7.
doi: 10.1038/sj.bjc.6600326.

Cytokeratin 7 and 20 staining for the diagnosis of lung and colorectal adenocarcinoma

S Kummar  1 , M Fogarasi, A Canova, A Mota, T Ciesielski
Affiliations
Free PMC article

Cytokeratin 7 and 20 staining for the diagnosis of lung and colorectal adenocarcinoma

S Kummar et al. Br J Cancer. .
Free PMC article

Abstract

The origin of metastatic adenocarcinoma lesions can sometimes be difficult to diagnose. The objectives of our study were to establish the cytokeratin staining pattern of primary and metastatic lung and colorectal adenocarcinomas, and to determine if this helps to identify the site of origin of metastatic lesions. We reviewed a total of 102 tissue samples from patients in our tumour registry, with either primary or metastatic lung or colorectal adenocarcinoma. Tissue sections were stained for cytokeratin 7 and 20 and read as positive or negative for staining. Clinical and radiologic information was reviewed from computerised charts. The cytokeratin 7+/cytokeratin 20- pattern characterised 96% (29 out of 30) of primary and 95% (21 out of 22) of metastatic lung adenocarcinomas. All the primary (26), and 88% (21 out of 24) of metastatic colorectal adenocarcinomas stained cytokeratin 7-/cytokeratin 20+. Samples from a variety of metastatic sites were evaluated for cytokeratin 7 and 20 staining. Out of the 102 samples, in 95% (97 out of 102) of the cases, the cytokeratin 7 and cytokeratin 20 staining pattern characterised and differentiated between lung and colorectal adenocarcinoma. Primary and metastatic lung adenocarcinomas show a cytokeratin 7+/cytokeratin 20- staining pattern, while colorectal adenocarcinomas stain cytokeratin 7-/cytokeratin 20+. Cytokeratin staining is helpful in the diagnostic differentiation of metastatic lesions from these two common primaries, and assists in determining the site of origin of metastatic lesions.

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Figures

Figure 1
Figure 1
CK20 (A) and CK7 (B) immunostaining of primary lung adenocarcinoma. CK20 (C) and CK7 (D) immunostain of metastatic lung adenocarcinoma to the liver. Most of the tumour cells in both the primary and the metastatic lesion show strong cytoplasmic staining with CK7 and negative staining with CK20 (original magnification 200×).
Figure 2
Figure 2
CK20 (A) and CK7 (B) immunostaining of primary colon adenocarcinoma. CK20 (C) and CK7 (D) immunostain of metastatic colon cancer to liver. There is focal strong cytoplasmic staining for CK20 in both the primary and the metastatic lesion and negative staining with CK7 (original magnification 200×).
See this image and copyright information in PMC

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