In clinical pathology, we often use “tumor cell immunohistochemistry drug resistance prognostic markers”, but many units only write positive results without clinical significance, and the results are not very helpful to clinical practice because many doctors do not know the significance of these results, so it is recommended that when we produce such reports, we print the significance of “tumor cell immunohistochemistry drug resistance prognostic markers” in the report to increase the value of the report. Therefore, it is recommended to print the meaning of “tumor cell immunohistochemistry drug-resistant prognostic markers” in the report to increase the value of the pathology report. 1.Immunohistochemical drug resistance prognostic markers for malignant tumors, a full set of 4 items: P-gP, GSTπ, TOPO II, Ki-67. 2.Immunohistochemical drug resistance prognostic markers for breast cancer, a full set of 7 items: P-gP, GSTπ, TOPO II, Ki-67, ER, PR, C-erbB-2. 3.Significance: Marker – Role – Positive site – Clinical significance Multidrug resistance Gene protein (P-Gp) – drug pump action – cytosolic/cytoplasmic – the higher the positive rate, the greater the resistance to the following drugs: Adriamycin, erythromycin, epi-adriamycin, mitoxantrone, vincristine, vincristine, vincristine, zybinol, tysudy. The higher the rate of glutathione S-transferase (GST π) – detoxification – cytosolic – positivity, the greater the resistance to the following drugs: adriamycin, cisplatin, azacitidine, cyclophosphamide, tumefacin. Topoisomerase II (TOPO II) – target action – cytosolic – the higher the positive rate, the more effective against the following drugs: anthracycline antibiotics and onychotoxins, such as VP16, teniposide, rosmarinic acid, neomycin, erythromycin, epi-amycin, adriamycin, VM26. high positive rate is particularly effective against VP16. The higher the rate of positive estrogen receptor (ER) – sex hormone action – cytosolic – the more effective the tumor is for endocrine therapy and the better the prognosis. Progesterone receptor (PR) – sex hormone action – cytosolic nucleus – the higher the positive rate, the more effective the tumor is to endocrine therapy and the better the prognosis. C-erbB-2 – oncogene product – cytoplasm – the higher the positive rate, the more malignant the tumor. those who are positive for ER and PE and also positive for C-erbB-2 are not well treated with triamcinolone acetonide. Ki-67 – a marker of cell proliferation – cytosolic – the higher the positive rate, the faster the tumor proliferation and the higher the malignancy. Ki-67 is a marker of cell proliferation and is expressed in the G1, S, G2, and M phases of the cell cycle, and is absent in the G0 phase. It is closely related to the degree of differentiation, infiltration, metastasis, and prognosis of many tumors. PCNA (proliferating cell nuclear antigen). CEA Most adenocarcinomas express the CEA Rb (retinoblastoma retinoblastoma) gene which is a tumor suppressor gene and regulates the cell cycle. P53 is mutated in immunohistochemistry, and the higher the positive rate, the worse the prognosis. The wild type has a short half-life. Nm23 is a metastasis suppressor gene, and its positive expression and tumor metastasis are negatively correlated. It has been widely used in the detection of many malignant tumors such as breast cancer, non-small cell lung cancer, gastric cancer, colorectal cancer, liver cancer, and laryngeal cancer. Almost all studies have shown that patients with high nm23 protein expression have a relatively low rate of lymph node metastasis and a relatively long survival period. E-Ca, E calcium adhesion protein, a transmembrane glycoprotein that mediates intercellular adhesion and whose loss of function causes disruption of intercellular junctions, is mainly used in studies on tumor invasion and metastasis. PS2 (estrogen-regulated protein), whose expression is related to ER expression, can be used as one of the indicators for endocrine therapy and prognosis determination. CK18, a low molecular weight keratin protein, mainly marks various monolayers of epithelium including glandular epithelium, while compound squamous epithelium is often negative and is mainly used for the diagnosis of adenocarcinoma. CK19, distributed in monolayer epithelium and mesothelium, commonly used in adenocarcinoma diagnosis, not expressed in hepatocytes, but positive for bile ducts Hep par 1, hepatocyte antigen, positive for normal hepatocytes and highly differentiated hepatocellular carcinoma, weakly positive or negative for low-differentiated hepatocellular carcinoma. CK20, used for the diagnosis of gastrointestinal adenocarcinoma, ovarian mucinous tumor, skin Merkel cell carcinoma. Often negative for squamous carcinoma, breast carcinoma, lung carcinoma, endometrial and ovarian non-mucinous tumors. CK7 Ovarian, lung and breast epithelium often positive, colon, prostate, gastrointestinal epithelium negative. Villin is normally expressed in normal tissues only on cells with brush border, such as gastrointestinal epithelial cells, pancreatic and bile duct epithelial cells, and epithelial cells of the renal parenchyma (especially proximal tubules). villin is highly expressed in gastrointestinal, pancreatic, gallbladder and bile duct cancer tissues, and tumors with obvious glandular structures without The absence of villin expression in tumors with obvious adenoid structures makes it extremely unlikely that the tumor is of gastrointestinal, pancreatic, gallbladder or bile duct origin. Breast cancer is also frequently a disease to be differentially excluded in female patients with metastatic cancer of unknown primary site. Because significant positive villin immunohistochemical staining is observed on the metastatic tissue, it is highly unlikely that the tumor is of breast origin. Other tumors that usually have negative villin immunohistochemical staining include ovarian plasmacytoma, urothelial migratory cell carcinoma, and prostate cancer. Mesothelioma is also frequently villin-negative, so in some cases villin may also be used as an antibody to differentiate mesothelioma from adenocarcinoma. However, there are also tumors of non-gastrointestinal origin that express villin, such as endometrioid adenocarcinoma, mucinous carcinoma of the ovary, renal cell carcinoma, and a small percentage of lung cancers. Some experts have also reported that Villin is expressed in some cases of endocervical adenocarcinoma. Diagnosis of hepatocellular carcinoma Villin immunohistochemical staining can show capillary bile duct structures, so it may also be useful in expressing tubular structures in some hepatocellular carcinomas. Polyclonal CEA was the first reagent used for this purpose and CD10 (CALLA) is also useful in expressing this structure in hepatocellular carcinoma. The expression of polyclonal CEA, villin and CD10 (CALLA) on hepatocellular carcinoma cases does not conflict with each other in any way, so if the possibility of hepatocellular carcinoma is suspected, it is recommended to use all three antibodies together to assist in the diagnosis of difficult cases. Villin in neuroendocrine tumors Villin is also useful in the study of neuroendocrine tumors. It is well known that carcinoid tumors and islet cell tumors of the pancreas have similar morphological features, and it is almost impossible to distinguish between the two tumors only morphologically. villin is particularly useful in this case, as it has been reported in the literature that villin is expressed in 85% of gastrointestinal carcinoid tract cases, but no positive expression has been reported in islet cell tumors. villin expression in carcinoid tumors Villin expression in carcinoid tumors is usually cytosolic positive. In addition, there is some evidence that villin expression is higher in small cell carcinomas of the stomach and lower gastrointestinal tract than in small cell carcinomas of other sites. For example, lung, esophagus, bladder or prostate. It has been reported in the literature that approximately 40% of pulmonary carcinoid cases are villin positive. Villin expression is also found on some other neuroendocrine tumors, such as medullary thyroid carcinoma and a few Merkel cell tumors. MRP1 multidrug resistance-associated protein 1, which affects chemotherapy sensitivity, is associated with prognosis. MDR multidrug resistance gene TS thymidine synthase, an important target of 5-FU action, if its high expression, positive reflection ++, suggests that tumor cells are resistant to 5FU. Syn synaptophysin Nerve tissue marker S-100 Nerve tissue marker, present in nerve tissue, pituitary gland, carotid body, adrenal medulla, salivary gland, few mesenchymal tissues, commonly used in the diagnosis of nerve sheath tumors, malignant nigra, liposarcoma, and cartilage tumors. NSE mainly used for neuroendocrine tumor diagnosis Chr,chromophores, high content in adrenal medulla, identify adrenal medulla and cortex, used for neuroendocrine tumor diagnosis. CKH high molecular keratin, mainly marks squamous cell tumor CKL low fraction of keratin, mainly marks monolayer epithelium, glandular epithelium EMA epithelial membrane antigen, glycoprotein, widely distributed various epithelium and its tumor Vim wave protein, mesenchymal tissue marker P504 formyl coenzyme A racemase assay has 97% sensitivity and 100% specificity for the diagnosis of prostate cancer. According to Rubin, AMACR can also be used as a diagnostic marker for other cancers. Examination of various cancer cells revealed that colorectal, ovarian, breast, bladder, lung, lymphoma and melanoma all overexpressed AMACR, with the highest expression in colorectal and prostate cancers. CD117 Gastrointestinal mesenchymal tumor CD10, a common acute lymphoblastic leukemia antigen, is mainly expressed in immature lymphocytes and has applications in the diagnosis of hematopoietic disorders such as Burkitt’s lymphoma and chronic myeloid leukemia. In recent years, this antigen has been found to be expressed in certain tumors outside the hematopoietic system, such as endometrial mesenchymal sarcoma and malignant melanoma. The antibody has some reference value in the diagnosis and differentiation of renal cell carcinoma. CD15 is a cell adhesion molecule and is considered an important marker for HD because of its good labeling of R-S cells in Hodgkin’s lymphoma (HD). In addition to the differential diagnosis of HD, studies on CD15 expression in tumors such as gastric, colorectal, thyroid, and breast cancers found that CD15 expression increased significantly with decreasing differentiation of cancer cells, lymph node metastasis, and increasing clinical stage. CDl5 expression is considered to be a good indicator for tumor development, lymph node metastasis and prognosis. Immunoelectron microscopy showed that CD15 antigen was mainly distributed in the boundary membrane, endoplasmic reticulum, Golgi apparatus and near nuclear membrane of colorectal cancer cell plasma, and CD15 may influence and participate in the process of tumor formation and metastasis by changing the conformation of the bound pavement. SMA Smooth muscle actin, labeling smooth muscle CD56 is a neural cell adhesion molecule, mainly distributed in most neuroectodermal-derived cells, commonly used in the diagnosis of astrocytoma, neuroblastoma, neuroendocrine tumors, also an important marker of NK cell tumors, also labeling small cell lung cancer Des,junctional protein, widely distributed in smooth muscle, cardiac muscle, skeletal muscle cells and myoepithelial cells, highly differentiated Highly expressed, low expression in low differentiation. MSA Myose-specific actin, widely distributed in almost all myotypic cells CD68 is present in bone marrow and macrophages in various neural tissues Used in the diagnosis of granulocytic leukemia, various monocyte-derived tumors, including malignant fibrous histiocytoma (preferred). CD34 is expressed in early lymphohematopoietic stem cells, progenitor cells, endothelial cells, embryonic fibroblasts and certain neural tissue cells, mostly used to label vascular endothelial cells, diagnosis of tumors of vascular origin, GIST 80-90%.CD31 also labels vascular endothelium. CD44 is a widely distributed transmembrane glycoprotein molecule, divided into two major groups, CD44s and CD44v. CD44s mainly acts as a hyaluronan receptor and affects tumor growth and metastasis after binding hyaluronan. CD44v, on the other hand, is mainly expressed in metastatic tumor cells. The expression of CD44v4/5 in 42 cases of esophageal squamous carcinoma was detected by immunohistochemical LSAB method by Dao-Ming Li et al. The positive expression rate was found to be 76.19% (16/21) in the lymph node metastasis group and 42.86% (9/12) in the non-metastasis group, with a significant difference between the two groups. Cancer cells around the nest, interstitial infiltrated cancer cells, cancer cells with nuclear division and cancer cells in the thrombus, and cancer cells infiltrating the wall of the vasculature all showed strong positive expression. The expression of CD44v6 in 20 cases of normal gastric mucosal epithelium, 43 cases of heterogeneous hyperplasia and 85 cases of gastric cancer tissues was detected by Chengwu Zhang et al. The results showed no expression in normal gastric mucosa, while the positive rates of heterogeneous hyperplasia and gastric cancer tissues were 30.2% and 74.1%, respectively. All these results indicated that the high expression of CD44v constituted the aggressiveness and metastasis of tumor cells. NESTIN, an extremely abundant osteopontin in neural stem cells, is secreted by osteoblasts. AAT antitrypsin Fibrous histiocyte-derived tumor ACT antichymotrypsin GFAP glial fibrillary acidic protein Nerve tissue marker, mostly used in astroglioma diagnosis Tg thyroglobulin, positive for thyroid cancer TG CT Calcitonin Positive for medullary carcinoma of the thyroid PH Parathyroid hormone Positive for parathyroid tumors Small cell lung cancer and neuroblastoma with enhanced expression of N-myc lack response to chemotherapy and progress rapidly; bcl-2: resistance mechanism is anti-apoptotic, high expressers are resistant to most anti-cancer drugs/radiation therapy. Tumor-associated antigen 72 (TGA72) is expressed by a variety of malignant epithelial tumors, especially breast, ovarian and colon cancers. Normal epithelial, sarcoma, and lymphohematopoietic system tumors are usually TGA72 negative. TGA72 antibodies are more frequently used in breast cancer studies, and their high expression is usually associated with large tumor size, poorly differentiated lymph node metastatic tumor cells, and high proliferative activity. Tumor-associated antigen (GA733) encodes epithelial glycoprotein 40, an epithelial cell adhesion molecule (EP-CAM) that plays an important role in the growth and differentiation of epithelial cells. A variety of tumors can have GA733 expression, especially breast cancer, colon cancer and lung cancer, etc. Kubuschok et al. used GA733 to detect occult micrometastases in surgically resected lymph nodes of non-small cell lung cancer and found that the detection of occult foci was an independent prognostic factor in determining overall survival. The form of GA733 expression in colon cancer was correlated with tumor prognosis, and the expression in the cell membrane and cell plasma was prognostically worse than that in the basement membrane side. TTF-1 Thyroid transcription factor-1, TTF-1 is expressed in the epithelial cells of the thyroid gland and lung. In lung tumor studies, immunohistochemical results were found to be positive for TTF-1 in most small cell carcinomas of the lung, primary and metastatic lung adenocarcinomas, a small proportion of large cell undifferentiated lung carcinomas, and most atypical neuroendocrine tumors, while TTF-1 was negative for squamous lung carcinomas and most typical carcinoid tumors. TTF-1 was also positive in papillary thyroid adenocarcinoma, while TTF expression was negative in other tissues. Therefore, TTF-1 can be used to differentiate lung adenocarcinoma from squamous carcinoma and to help distinguish it from metastatic adenocarcinoma of the lung. TTF-1 is expressed mainly in the follicular cells of the thyroid gland and in the main cells of the parathyroid gland. TTF-1 is the basic substance for thyroid differentiation and regulation of thyroglobulin secretion, and can promote thyroid peroxidase and iodine/sodium transport. TTF-1 is differentially expressed in benign and malignant thyroid tissues, with more expression in normal thyroid and benign adenoma, less expression in papillary thyroid and follicular carcinoma, and no expression in undifferentiated carcinoma. The intensity of TTF-1 expression in malignant thyroid lesions increases with age, and the lesions have a long tumor survival period and a high chance of recurrence. TTF-1 expression in lung cancer 75% of non-small cell lung cancers (NSCLCs) are positive, adenocarcinomas (ACs) are significantly higher than squamous carcinomas (SCCs), and more than 90% of primary small cell lung cancers (SCLCs) are positive, TTF-1 positive expression intensity in NSCLCs is negatively correlated with patient prognosis and can be used as an independent prognostic indicator. The typical carcinoid tumors (TCS) of the lung were all negative, suggesting a theory that small cell lung cancer and non-small cell lung cancer may have a common origin different from TCS.