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Korean Journal of Obstetrics & Gynecology 2006;49(3):580-591.
Published online March 1, 2006.
Clinical Usefulness of Cytokeratin 7 and 20 Expression in Metastatic Ovarian Tumors.
Yun Hyun Cho, Kyu Rae Kim, Tae Yeon Kim, Jong Hyeok Kim, Dae Shik Suh, Yong Man Kim, Joo Hyun Nam, Jung Eun Mok, Young Tak Kim
1Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. ytkim@amc.seoul.kr
2Department of Pathology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Abstract
OBJECTIVE
To investigate the pattern of Cytokeratin (CK) 7 and 20 expression and evaluate its clinical usefulness in the differential diagnosis of metastatic ovarian carcinoma. METHODS: One hundred eighty nine cases pathologically diagnosed as having metastatic ovarian carcinoma were reviewed from January 1990 to December 2003 at Asan Medical Center. Immunohistochemistry for CK7 and CK20 was performed in 92 cases. RESULTS: One hundred seventy five cases were originated from non-gynecologic organs. The most common primary site was stomach (88 patients) followed by colon (53 patients). Fourteen cases were originated from gynecologic organs, such as uterine cervix, endometrium, and fallopian tube. 82.5% (33/40) of the stomach cancers was CK7 positive, whereas only 23.5% (8/34) of the colorectal cancers was CK7 positive. 82.5% (33/40) of the stomach cancers and 100% (34/34) of the colorectal cancers was CK20 positive. CK7+/CK20+ pattern was the most frequent in stomach cancer (70.0%, 28/40). In colorectal cancer, CK7-/CK20+ pattern had the largest portion (76.5%, 26/34) and there was no CK7+/CK20- pattern in contrast to primary ovarian carcinoma. CONCLUSION: CK7 and CK20 expression patterns in primary gastric carcinomas vary considerably. The CK7-/CK20+ expression pattern is specific for metastatic colorectal carcinomas to the ovary and expression pattern of CK is one of the useful methods to differentiate primary ovary cancers from metastatic ovarian carcinomas from colon, especially in left side colon cancer.
Key Words: Metastatic ovarian carcinoma, Cytokeratin, CK7, CK20


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