WT1, Estrogen Receptor, and Progesterone Receptor
WT1, Estrogen Receptor, and Progesterone Receptor
In tissue sections, detection of the Wilms tumor susceptibility gene 1 (WT1) protein, the hormonal receptors for estrogen (ER) and progesterone (PR), and gross cystic disease fluid protein (GCDFP) are useful for diagnosing ovarian and breast adenocarcinomas. We evaluated these markers for cytology cell-block preparations from 96 effusion specimens (metastases from 29 breast, 22 ovarian, and 45 adenocarcinomas from other sites). WT1 protein was reactive in 19 cases metastatic from ovary (86%), 2 from breast (7%), and none from other sites (specificity, 97%). Of the metastatic breast carcinomas, 21 (72%) were reactive for ER, 15 (52%) for PR, and 13 (45%) for both (combined specificity, 84%). GCDFP was reactive in only 4 breast cancer cases (14%). Ovarian tumors also were frequently positive for ER (19 [86%]), PR (11 [50%]), or both (10 [45%]). WT1 protein is an effective marker for ovarian adenocarcinoma, especially in ascites. The detection of ER and PR in metastatic adenocarcinoma from pleural or pericardial effusions can distinguish breast from lung primary sites. Reactivity for ER and PR did not distinguish between breast and ovarian metastases; however, studies for WT1 protein and GCDFP may aid in making this distinction.
Malignant pleural effusion or ascites is not an uncommon clinical manifestation of adenocarcinoma. Elucidating the origin of these malignant neoplasms can pose a considerable diagnostic challenge to both clinicians and pathologists and often may have therapeutic consequences for the patient. Immunohistochemical analysis has become standard practice in the evaluation of nodal and soft tissue metastasis, and a number of highly effective tissue-specific tumor markers are available. When used in specific panels, immunohistochemical studies can be extremely useful for the determination of tumor type, particularly in cases with an unknown primary site. These markers also can be used in the identification of primary tumors in patients with malignant effusions from various body cavities. In this immunohistochemical study we examined the effectiveness of the Wilms tumor susceptibility gene 1 (WT1) protein, estrogen receptor (ER), progesterone receptor (PR), and gross cystic disease fluid protein (GCDFP) as markers for ovarian and breast adenocarcinomas in cytologic material prepared from malignant effusion specimens derived from tumors involving a variety of primary sites.
In tissue sections, detection of the Wilms tumor susceptibility gene 1 (WT1) protein, the hormonal receptors for estrogen (ER) and progesterone (PR), and gross cystic disease fluid protein (GCDFP) are useful for diagnosing ovarian and breast adenocarcinomas. We evaluated these markers for cytology cell-block preparations from 96 effusion specimens (metastases from 29 breast, 22 ovarian, and 45 adenocarcinomas from other sites). WT1 protein was reactive in 19 cases metastatic from ovary (86%), 2 from breast (7%), and none from other sites (specificity, 97%). Of the metastatic breast carcinomas, 21 (72%) were reactive for ER, 15 (52%) for PR, and 13 (45%) for both (combined specificity, 84%). GCDFP was reactive in only 4 breast cancer cases (14%). Ovarian tumors also were frequently positive for ER (19 [86%]), PR (11 [50%]), or both (10 [45%]). WT1 protein is an effective marker for ovarian adenocarcinoma, especially in ascites. The detection of ER and PR in metastatic adenocarcinoma from pleural or pericardial effusions can distinguish breast from lung primary sites. Reactivity for ER and PR did not distinguish between breast and ovarian metastases; however, studies for WT1 protein and GCDFP may aid in making this distinction.
Malignant pleural effusion or ascites is not an uncommon clinical manifestation of adenocarcinoma. Elucidating the origin of these malignant neoplasms can pose a considerable diagnostic challenge to both clinicians and pathologists and often may have therapeutic consequences for the patient. Immunohistochemical analysis has become standard practice in the evaluation of nodal and soft tissue metastasis, and a number of highly effective tissue-specific tumor markers are available. When used in specific panels, immunohistochemical studies can be extremely useful for the determination of tumor type, particularly in cases with an unknown primary site. These markers also can be used in the identification of primary tumors in patients with malignant effusions from various body cavities. In this immunohistochemical study we examined the effectiveness of the Wilms tumor susceptibility gene 1 (WT1) protein, estrogen receptor (ER), progesterone receptor (PR), and gross cystic disease fluid protein (GCDFP) as markers for ovarian and breast adenocarcinomas in cytologic material prepared from malignant effusion specimens derived from tumors involving a variety of primary sites.
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