I. Significance of common immunohistochemical indicators
Ki-67 is a marker of cellular value-added, which is expressed in G1, S, G2 and M phases of cell cycle, but absent in G0 phase, and is closely related to the degree of differentiation, infiltration, metastasis and prognosis of many tumors. PCNA (proliferating cell nuclear antigen).
Most adenocarcinomas express CEA.
P53 is a mutant type in immunohistochemistry, and the higher the positive rate, the worse the prognosis. The wild type has a very short half-life.
Nm23 is a metastasis suppressor gene, and its positive expression and tumor metastasis are negatively correlated.
E-Ca, E calcium adhesion protein, a transmembrane glycoprotein mediating intercellular adhesion, whose loss of function causes disruption of intercellular junctions, is mainly used in studies of 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, often used for adenocarcinoma diagnosis, not expressed in hepatocytes, but positive for bile ducts
CK20, used for the diagnosis of gastrointestinal adenocarcinoma, ovarian mucinous tumor, and skin Merkel cell carcinoma. Often negative for squamous, breast, lung, 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.
S-100 Nerve tissue marker, present in nerve tissue, pituitary gland, carotid body, adrenal medulla, salivary gland, and a few mesenchymal tissues, commonly used in the diagnosis of nerve sheath tumors, malignant nigra, liposarcoma, and cartilage tumors.
Third, NSE is mainly used for the diagnosis of neuroendocrine tumors
Chr, chromogranin, high content in adrenal medulla, identify adrenal medulla and cortex, used for neuroendocrine tumor diagnosis.
CKH high molecular keratin, mainly mark squamous cell tumor
CKL low fraction keratin, mainly mark monolayer epithelium, glandular epithelium
EMA epithelial membrane antigen, glycoprotein, widely distributed in various epithelia and their tumors
Vim waveform protein, a marker of mesenchymal tissue
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 a certain reference value in the diagnosis and differentiation of renal cell carcinoma.
V. SMA smooth muscle actin, labeling smooth muscle
CD56 is a neural cell adhesion molecule, mainly distributed in most neuroectodermal cells, and is often used in the diagnosis of astrocytoma, neuroblastoma and neuroendocrine tumors, and is also an important marker for NK cell tumors, and also marks small cell lung cancer
Des,junctional protein, widely distributed in smooth muscle, cardiac muscle, skeletal muscle cells and myoepithelial cells, highly expressed in highly differentiated and lowly expressed in low differentiation.
MSA muscle-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 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.
NESTIN, extremely abundant in neural stem cells
Ost Osteopontin, secreted by osteoblasts.
AAT antitrypsin fibrous histiocyte-derived tumor ACT antichymotrypsin
GFAP Glial fibrillary acidic protein Neural tissue marker, mostly used in the diagnosis of astroglioma
Tg Thyroglobulin, positive for thyroid cancer TG
CT Calcitonin Positive for medullary carcinoma of the thyroid
PH Parathyroid hormone Positive for parathyroid tumor
TTF-I Thyroid transcription factor-1
TTF-1 is expressed in the epithelium of the thyroid gland and in the epithelial cells of the 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 carcinomas of the lung and the majority of 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.
Expression of TTF-1 in thyroid and its tumors
TTF-1 is mainly expressed in follicular cells of the thyroid gland and in the main cells of the parathyroid gland.
TTF-1 is the substance underlying thyroid differentiation and regulation of thyroglobulin secretion, and promotes thyroid peroxidase, iodine/sodium transport.
TTF-1 is associated with the activity of serum TSH.
Active TSH-R enhances the expression of TTF-1.
TTF-1 is differentially expressed in benign and malignant thyroid tissues.
Normal thyroid and benign adenoma express it more.
It is expressed more in normal thyroid and benign adenoma, less in papillary thyroid and follicular carcinoma, and not in undifferentiated carcinoma.
It is not expressed in undifferentiated carcinoma.
The intensity of TTF-1 expression in malignant thyroid lesions increases with age, and the lesions have a long tumor survival and a high recurrence rate.
Expression of TTF-1 in lung cancer
75% of lung non-small cell carcinomas (NSCLCs) were positively expressed, and adenocarcinomas (ACs) were significantly higher than squamous carcinomas (SCCs).
More than 90% of primary small cell lung cancers (SCLC) were positive for expression,
The intensity of positive expression of TTF-1 in non-small cell lung cancers (NSCLCs) was negatively correlated with patient prognosis and could 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.