Zusammenfassung
Dem Immunphänotyp kommt bei der histogenetischen Zuordnung von Karzinomen wachsende Bedeutung zu. Für Cholangiokarzinome (CC) trifft dies zum einen aufgrund der zunehmenden Zahl kleiner diagnostischer Proben mit eingeschränkter morphologischer Aussagekraft zu, zum anderen treten in der Leber eine Vielzahl metastasierter Adenokarzinome mit morphologischen Überlappungen zum CC auf. Zur Immunphänotypisierung von Tumoren können Intermediärfilamente, Glykoproteine, Mukoproteine, Adhäsionsmoleküle und Rezeptoren oder auch Transkriptionsfaktoren und die Proteinprodukte von Tumorsuppressorgenen herangezogen werden. In der vorliegenden Übersicht wird das Expressionmuster des CC und der häufigsten Karzinommetastasen in der Leber für 30 in der Literatur gut dokumentierte Antikörper vergleichend dargestellt. Das typische CC weist folgenden Immunphänotyp auf: Ck 7+, Ck 17+, CD 7+, CDX 2−. Wenngleich dieser Phänotyp eine gute Abgrenzung gegenüber den meisten metastasierten Karzinomen erlaubt, zeigen Pankreaskarzinome und CC einen auch entwicklungsgeschichtlich naheliegenden Überlappungsbereich des Immunphänotyps, sodass eine zuverlässige immunhistologische Abgrenzung dieser Tumoren oft nicht möglich ist.
Abstract
The correct diagnosis of intrahepatic cholangiocarcinoma (CC) is often confounded by the small size of the diagnostic specimen and the wide morphological range of carcinomas metastasising to the liver. Expression analysis of cytokeratins, glycoproteins, mucoproteins, adhesion molecules, receptors and transcription factors has been shown to be a valuable adjunct in the typing of carcinomas. For this study, the expression pattern of 30 well documented antibodies to CC and the most common metastatic adenocarcinomas of the liver were studied. CC show a rather distinct immunophenotype with co-expression of CK7, CK17, CD7 and a lack of CDX2. Although this pattern allows the separation of CC from most metastatic carcinomas, pancreatic carcinomas show a broad overlap with this expression pattern.
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Länger, F., v. Wasielewski, R. & Kreipe, H.H. Bedeutung der Immunhistochemie für die Diagnose des Cholangiokarzinoms. Pathologe 27, 244–250 (2006). https://doi.org/10.1007/s00292-006-0836-z
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DOI: https://doi.org/10.1007/s00292-006-0836-z