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The Diagnostic Value of Cadherin 17 and CDX2 Expression as Immunohistochemical Markers in Colorectal Adenocarcinoma

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Abstract

Background

Colorectal cancer is a major cause of morbidity and mortality throughout the world. Although the diagnosis of colorectal cancer is straightforward in primary site, yet it may represent a diagnostic problem in metastatic tumor of unknown primary origin. Hence, immunohistochemical analysis in combination with morphologic assessment and correlation with clinical data becomes crucial, because it is important to specify the primary site of metastasis since some specific tumor types may respond well to targeted molecular therapies. Therefore, establishment of reliable diagnostic markers that confirm or rule out colorectal origin is mandatory.

Aim

To study the expression of cadherin 17 and CDX2 in colorectal carcinoma and to evaluate their diagnostic roles in identifying metastatic colonic from non-colonic adenocarcinomas in cancer of unknown primary site.

Design and Methods

This retrospective study included 65 cases of adenocarcinomas: 35 cases of colorectal adenocarcinoma (primary or metastatic) and 30 cases of non-colorectal adenocarcinoma. They were retrieved from the archives of Pathology Department of Ain Shams University and Ain Shams University Specialized Hospitals during the period from 2010 to 2015. Immunohistochemical study was performed using cadherin 17 and CDX2 antibodies.

Results

The sensitivity and specificity of CDX2 and cadherin 17 are 97.1% and 53.3% and 100% and 50% in detecting colonic adenocarcinoma respectively. The PPV, NPV, and overall accuracy of CDX2 versus cadherin 17 were 70.8%, 94.1%, and 76.9% versus 70%, 100%, and 76.9% respectively.

Conclusion

Cadherin 17 is a more sensitive marker than CDX2 in diagnosis of carcinoma of unknown primary site especially when colorectal carcinoma is suspected.

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Data Availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

CDH 17:

cadherin 17

CDX2:

caudal-related homeobox gene 2

CK 7:

cytokeratin 7

CK20:

cytokeratin 20

IHC:

immunohistochemistry

PPV:

positive predictive value

NPV:

negative predictive value

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Authors and Affiliations

  1. Department of Pathology, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, 11561, Egypt

    Mariam B. Abouelkhair, Shadia H. Mabrouk, Sahar S. A. Zaki, Ola H. Nada & Sarah A. Hakim

Authors
  1. Mariam B. Abouelkhair
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  2. Shadia H. Mabrouk
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  3. Sahar S. A. Zaki
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  4. Ola H. Nada
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  5. Sarah A. Hakim
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Contributions

Mariam Bahaa conceived, designed, and coordinated the study; performed data collection; reviewed the histological diagnosis; evaluated immunohistochemistry; carried out photographing; and drafted the manuscript. Shadia Mabrouk conceived, designed, coordinated, and critically reviewed the study. Sahar Saad-ElDin coordinated and critically reviewed the study. Ola Nada coordinated and critically reviewed the study. Sarah Adel Hakim participated in the study design, reviewed the histological diagnosis, evaluated immunohistochemistry, performed the statistical analysis, helped in photographing, and contributed in writing the manuscript. The authors read and approved the final manuscript.

Corresponding author

Correspondence to Sarah A. Hakim.

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Ethics Approval and Consent to Participate

All patients who participated in this study signed a written, informed consent before surgery. The study was approved by the Research Ethical Committee (REC) at Faculty of Medicine, Ain Shams University (FWA 000017585).

Competing Interests

The authors declare that they have no competing interests.

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Abouelkhair, M.B., Mabrouk, S.H., Zaki, S.S.A. et al. The Diagnostic Value of Cadherin 17 and CDX2 Expression as Immunohistochemical Markers in Colorectal Adenocarcinoma. J Gastrointest Canc 52, 960–969 (2021). https://doi.org/10.1007/s12029-020-00513-w

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  • DOI: https://doi.org/10.1007/s12029-020-00513-w

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