Neurofilament is superior to cytokeratin 20 in supporting cutaneous origin for neuroendocrine carcinoma
| Autor: | May P. Chan, Paul W. Harms, Douglas R. Fullen, Lauren M. Stanoszek, Nallasivam Palanisamy, Shannon Carskadon, Javed Siddiqui, Kelly L. Harms, Lori Lowe, Rajiv M. Patel |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty Skin Neoplasms Histology Neurofilament Intermediate Filaments Merkel cell polyomavirus Keratin-20 Sensitivity and Specificity Small-cell carcinoma Pathology and Forensic Medicine 03 medical and health sciences Cytokeratin 0302 clinical medicine Biomarkers Tumor medicine Carcinoma Humans biology Merkel cell carcinoma business.industry Keratin 20 food and beverages General Medicine biology.organism_classification medicine.disease Immunohistochemistry Carcinoma Merkel Cell 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis business Merkel cell |
| Zdroj: | Histopathology. 74:504-513 |
| ISSN: | 0309-0167 |
| Popis: | Aim Primary cutaneous neuroendocrine carcinoma, or Merkel cell carcinoma (MCC), cannot be distinguished morphologically from small-cell neuroendocrine carcinomas (SmCC) from other sites. Immunohistochemistry is required to confirm cutaneous origin, and is also used for detection of sentinel lymph node (SLN) metastases of MCC. Cytokeratin 20 (CK20) expression is commonly used for these purposes, but is negative in some MCC cases, and has unclear specificity. We evaluated immunohistochemistry for neurofilament and CK20 in MCC compared with SmCC from other sites. Methods and results We evaluated neurofilament expression in 55 MCC specimens from 39 unique patients, including nine CK20-negative MCC tumours. Neurofilament expression was observed in 42 of 55 (76.4%) MCC cases, including seven of nine (77.8%) CK20-negative MCC cases. Neurofilament was expressed in nine of 12 (75%) Merkel cell polyomavirus-positive tumours and five of 10 (50%) virus-negative tumours. Compared to a standard immunohistochemical panel (cytokeratin cocktail and CK20), neurofilament was 87.5% sensitive for detecting SLN metastases. Neurofilament and CK20 expression was also assessed in 61 extracutaneous SmCC from 60 unique patients, with primary sites including lung (27), bladder (18), cervix (3), gastrointestinal tract (3), sinonasal tract (2) and other sites (7). The specificity of neurofilament and CK20 for MCC versus non-cutaneous SmCC was 96.7% and 59.0%, respectively. Conclusions Neurofilament has superior specificity to CK20 in distinguishing MCC from non-cutaneous SmCC. Neurofilament is frequently expressed in CK20- and virus-negative MCC tumours. Limitations of neurofilament immunohistochemistry include lower sensitivity than CK20 and subtle staining in some tumours. However, our findings indicate that neurofilament is useful for excluding non-cutaneous SmCC. |
| Databáze: | OpenAIRE |
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