The big picture in the diagnostic approach for patients with tumors is highly dependent on the clinical symptoms and radiologic exam results. The final diagnosis should be interpreted with the help of immunohistochemistry results. Immunohistochemistry involves several steps. Let’s discuss them briefly so you can understand the article.
The first step is always defining the lineage of tumor cells. Generalized markers are used for the different types of tumor cells. Moving forward, the subtypes of carcinomas are identified in the second step. Cytokeratin subtypes or monoclonal antibodies are used to distinguish between various types. CK7 and CK20 are the types that are commonly seen and observed.
Primary tumor sites are easily identified with these markers. It has been researched that CK7 positive and CK20 negative are seen in the carcinomas or tumors of the following:
- Breast
- Lungs
- Bladder
- Ovary
The prediction of the tumor site happens in the third step. A specific treatment plan is devised according to the diagnosis.
Ck7 Positive And Ck20 Negative Tumors Of Breast
The identification of breast carcinomas is before the tumor metastasizes. The site of the origin is located easily with Ck7 and Ck20 along with the monthly mammograms. There are few cases where it is difficult to find the location of the tumor. Hence, the treatment plan for these types of tumors cannot be predicted early.
The information regarding tumors or carcinomas which originate from the breast can be easily found out by cytokeratins and specific antibodies of mammary glands. The profile of these tumors is always like this:
- Ck7 positive
- Ck20 negative
- Mammaglobin positive
- GCDFP-15
If the tumors of the breast are categorized according to the estrogen receptor, the majority of breast tumors showed the profile of Ck7 positive and Ck20 negative. Although there might be some confusion if the results are opposite. In this case, the detection and diagnosis is a daunting task.
Ck7 Positive And Ck20 Negative Tumors Of Lungs
The diagnostic tools Ck7 and Ck20 have proven to be quite helpful to differentiate between pulmonary adenocarcinomas and metastatic colon adenocarcinoma. Metastatic colon adenocarcinoma results in Ck7 negative and Ck20 positive. The proliferation of epithelial cells is detected with the help of cytokeratin.
There are certain factors like age, gender, T stage, lymph node metastasis, and medical history which might also affect the results. Although smoking and age have no direct relationship with the survival chances of the patient diagnosed with lung cancer. The expressions Ck7 positive and Ck20 negative are commonly observed in patients with lung cancer.
The mortality of lung cancer is high around the world. The risk factors like aging and hereditary factors intensify the situation. Cell cytokeratin involvement plays a major role in the development of tumor or lung cancer. The different subtypes of tumors promote various proliferating cancerous cells in various parts and organs of the body.
Ck7 Positive And Ck20 Negative Tumors Of Bladder
Most of the urinary bladder carcinomas have Ck7 positive. But the superficial and normal tumor cells of the bladder have an expression of Ck20. Tumors in the bladder with prostate extension can be challenging to diagnose. In some cases, like metastatic urothelial carcinoma, the pattern of Ck7 and Ck20 duplicates and make it difficult to differentiate.
The Ck20 negative expression is quite commonly and extensively seen in the tumors related to the urinary bladder. PSA test(prostate antigen test) is important in this case to rule out the condition of prostate enlargement. The tumor of the bladder is associated with inflammation and irritation. Urinary retention and hematuria are common symptoms that should not be avoided.
The risk factors associated with the tumor of the bladder are endometriosis and augmentation of the bladder.
Ck7 Positive And Ck20 Negative Tumors Of Ovary
Metastatic gastrointestinal neoplasms are difficult to differentiate from ovarian tumors. The malignancies of ovarian cancer are around 30%. Clinical and genetic history is an important consideration while dealing with breast tumors. Ovarian cancers are mistaken for colonic cancer sometimes, due to the same profile and symptoms.
Histological findings are essential to diagnose ovarian tumors accurately. Ck7 positive and Ck20 negative is the profile seen with these types of tumors. These markers are vital for finding the difference between a normal tumor vs metastasized tumor. Cytokeratin7 and Cytokeratin20 are commonly found in the female genital tract, in fallopian tubes, and ovary.
The site of origin is identified with the help of Ck7 positive and Ck20. After the identification, the diagnosis and treatment plan can easily be developed.