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난소 상피성종양에서 원발성과 전이성을 감별 진단하기 위한 면역조직학적 연구

Immunohistochemical Studies for Differential Diagnosis between Primary and Matastatic Ovarian Epithelial Tumors

대한산부인과학회지 1997년 40권 5호 p.1049 ~ 1056
방보영
권현정/추욱진/김휴/최광엽/최유덕/이미자/전호종

Abstract


To determine the distinction of primary ovarian carcinoma from metastatic ovarian carcinoma, the author studied total 40 cases of malignant tumors(13 primary ovarian carcinomas : 7 serous, 4 mucinous, and 2 endometrioid, 7 metastatic ovarian
adenocarcinomas, 10 gastric adenocarcinomas) using primary antibody to CEA, CK7, CK20 and CK18. The results were summerised as follows : The expression of CK7 was demonstrated in all(7) serous and 3 out of 4 mucinous adenocarcinoma, and 1 out of
10
each
gastric and colonic adenocarcinoma. The CK20 positivity was seen in 4 out of 10 cases of colonic adenocarcinoma and 3 out of 7 cases of metastatic adenocarcinoma. All primary ovarian carcinoma and gastric adenocarcinoma were negative for CK20
except for
focal positivity in only 1 ovaria mucinous adenocarcinoma. All types of serous and endometrioid adenocarcinoma were negative for CEA. But, the vast majority of mucinous adenocarcinoma, metastatic adenocarcinoma, gastric and colonic adenocarcinoma
were
positive for CEA. The CK18 may not be helpful to differentiate the primary or metastatic carcinoma because all cases examined were positive for CK18 except for 1 ovarian mucinous carcinoma.
Immunostainning for CK7 may be helpful on differential diagnosis of primary and metastatic ovarian carcinoma, especially mucinous adenocarcinoma and metastatic gastric and colonic adenocarcinoma. The CK20 may be a useful marker for differential
diagnosis in primary and metastatic ovarian carcinomas. The CEA may be of value on differential diagnosis of mucinous and nonmucinous(serous and endomerioid) ovarian carcinomas, and metastatic colonic adenocarcinoma and endometrioid carcinoma.
In conclusion, immunohistochemical study for CEA, CK7, and CK20 may be helpful in differential diagnosis between primary and metastatic ovarian carcinoma.

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