A 5-marker immunohistochemical panel of CK17, MEP1A, PAX8, SMAD4, and CDX2 to distinguish ovarian mucinous carcinoma from metastatic pancreatic ductal adenocarcinoma.

IF 4.1 2区医学 Q2 CELL BIOLOGY

Histopathology Pub Date : 2025-09-19 DOI:10.1111/his.70002

Astrid De Boeck, Eun Young Kang, Nicola S Meagher, Kylie L Gorringe, Cheng Han Lee, Parham Minoo, Martin Köbel

{"title":"A 5-marker immunohistochemical panel of CK17, MEP1A, PAX8, SMAD4, and CDX2 to distinguish ovarian mucinous carcinoma from metastatic pancreatic ductal adenocarcinoma.","authors":"Astrid De Boeck, Eun Young Kang, Nicola S Meagher, Kylie L Gorringe, Cheng Han Lee, Parham Minoo, Martin Köbel","doi":"10.1111/his.70002","DOIUrl":null,"url":null,"abstract":"Aims: Metastatic pancreatic adenocarcinoma (PDAC), albeit uncommon, may involve the ovary, and distinction from primary ovarian mucinous tumours (OMT) poses a diagnostic challenge. Our aim was to develop an ancillary immunohistochemical (IHC) panel to aid in diagnosis and to validate the morphological features of metastatic PDAC.Methods and results: Six IHC markers (CDX2, CK17, MEP1A, MUC2, PAX8, SMAD4) selected based on a literature review were stained on tissue microarrays containing 256 PDAC, 102 mucinous ovarian carcinomas (MC) and 58 mucinous borderline ovarian tumours (MBOT). Detailed morphological features were reviewed in 16 ovarian metastases from PDAC, 25 MC, and 9 MBOT. We confirmed that tumours with a size less than 13 cm, bilaterality, ovarian surface involvement, low-power nodularity, infiltrative invasion, pseudomyxoma ovarii despite cystadenoma or borderline areas, and moderate nuclear atypia should raise suspicion for metastatic PDAC and prompt evaluation with the recommended IHC panel. A 5-marker panel consisting of CK17, MEP1A, PAX8, SMAD4, and CDX2 had an overall accuracy of 91.8% (95% CI 88.8%-94.3%) using recursive partitioning, with the highest weight resting on CK17. CK17 was expressed in 80.9% of PDAC compared to 18.6% of MC and 1.7% of MBOT, respectively.Conclusions: This is the first ancillary IHC panel to distinguish between PDAC and OMT with high accuracy. These results inform further studies on diagnostic workflows tailored to the complexity of metastatic presentations of tumours at the ovary.","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Histopathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/his.70002","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CELL BIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: Metastatic pancreatic adenocarcinoma (PDAC), albeit uncommon, may involve the ovary, and distinction from primary ovarian mucinous tumours (OMT) poses a diagnostic challenge. Our aim was to develop an ancillary immunohistochemical (IHC) panel to aid in diagnosis and to validate the morphological features of metastatic PDAC.

Methods and results: Six IHC markers (CDX2, CK17, MEP1A, MUC2, PAX8, SMAD4) selected based on a literature review were stained on tissue microarrays containing 256 PDAC, 102 mucinous ovarian carcinomas (MC) and 58 mucinous borderline ovarian tumours (MBOT). Detailed morphological features were reviewed in 16 ovarian metastases from PDAC, 25 MC, and 9 MBOT. We confirmed that tumours with a size less than 13 cm, bilaterality, ovarian surface involvement, low-power nodularity, infiltrative invasion, pseudomyxoma ovarii despite cystadenoma or borderline areas, and moderate nuclear atypia should raise suspicion for metastatic PDAC and prompt evaluation with the recommended IHC panel. A 5-marker panel consisting of CK17, MEP1A, PAX8, SMAD4, and CDX2 had an overall accuracy of 91.8% (95% CI 88.8%-94.3%) using recursive partitioning, with the highest weight resting on CK17. CK17 was expressed in 80.9% of PDAC compared to 18.6% of MC and 1.7% of MBOT, respectively.

Conclusions: This is the first ancillary IHC panel to distinguish between PDAC and OMT with high accuracy. These results inform further studies on diagnostic workflows tailored to the complexity of metastatic presentations of tumours at the ovary.

查看原文本刊更多论文

CK17、MEP1A、PAX8、SMAD4和CDX2的5标记免疫组化检测可用于区分卵巢粘液癌和转移性胰腺导管腺癌。

目的：转移性胰腺腺癌（PDAC）虽然不常见，但可能累及卵巢，并且与原发性卵巢粘液瘤（OMT）的区别提出了诊断挑战。我们的目的是开发一种辅助免疫组织化学（IHC）小组，以帮助诊断和验证转移性PDAC的形态学特征。方法和结果：通过文献综述选择6个IHC标志物（CDX2、CK17、MEP1A、MUC2、PAX8、SMAD4），在包含256个PDAC、102个黏液性卵巢癌（MC）和58个黏液性交界性卵巢肿瘤（MBOT）的组织芯片上进行染色。我们回顾了16例PDAC、25例MC和9例MBOT卵巢转移的详细形态学特征。我们证实，当肿瘤大小小于13cm、双侧、卵巢表面受损伤、低强度结节性、浸润性侵袭、卵巢假粘液瘤（尽管存在囊腺瘤或交界区）和中度核异型时，应怀疑PDAC转移，并及时采用推荐的免疫组化检查。由CK17， MEP1A, PAX8， SMAD4和CDX2组成的5个标记面板使用递归划分的总体准确率为91.8% (95% CI 88.8%-94.3%)， CK17的权重最高。CK17分别在80.9%的PDAC、18.6%的MC和1.7%的MBOT中表达。结论：这是第一个区分PDAC和OMT的辅助IHC面板，具有很高的准确性。这些结果为进一步研究针对卵巢肿瘤转移表现复杂性的诊断工作流程提供了依据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Histopathology 医学-病理学

CiteScore

10.20

自引率

4.70%

发文量

239

审稿时长

1 months

期刊介绍： Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.