Use of XXXX , PE-10, and cytokeratins 7 and 20 in discriminating between primary @entity2 and metastatic lesions in fine-needle aspiration biopsy specimens.

@entity1 @entity4153 @entity5 @entity957 @entity2 @entity2225 @entity189 @entity1049 @entity5822 @entity3 @entity420 @entity7457 @entity1374
BACKGROUND: The distinction of a primary @entity2 from a @entity3 is important, because the treatment and prognosis differ for @entity1 with these @entity5 . Such a distinction can be difficult because of overlapping cytologic features. It has been shown that antibodies to @entity7457 ( @entity7457 ) and PE-10 are fairly specific markers for primary @entity2 in histologic specimens. @entity7457 regulates the expression of surfactant protein production, and PE-10 is a monoclonal antibody against components of @entity1 surfactant proteins. The combination of @entity5822 ( @entity5822 ) and @entity2225 ( @entity2225 ) immunoprofiling has been helpful in the identification of the primary site of origin of @entity2 . METHODS: In the current study, the authors evaluated the utility of @entity7457 and PE-10 immunostaining and also compared the staining with expression of @entity5822 and @entity2225 in the discrimination between primary @entity2 and metastatic lesions in 55 specimens from fine-needle aspiration (FNA) biopsies of the lung. Formalin fixed, paraffin embedded cell blocks from 35 primary @entity2 (16 @entity420 , @entity957 , 6 large cell @entity189 , and 5 @entity4153 ) and 20 metastatic @entity189 (6 breast lesions, 6 @entity1049 , 3 urinary bladder lesions, 2 kidney lesions, 1 biliary tract lesion, 1 endometrial lesion, and 1 @entity1374 ) were immunostained with monoclonal antibodies to @entity7457 , PE-10, @entity5822 , and @entity2225 . Positive immunostaining for @entity5822 , @entity2225 , and PE-10 was based on cytoplasmic staining, whereas @entity7457 positive staining was based on nuclear staining of the neoplastic cells. RESULTS: Positive immunostaining with @entity7457 and PE-10 was noted in six primary @entity2 (17%). One @entity3 (5%) and two metastatic lesions (10%) were positive for @entity7457 and PE-10, respectively. The @entity5822 positive/ @entity2225 negative immunophenotype was noted in 30 primary @entity2 (86%) and in 11 metastatic lesions (55%). The @entity5822 negative/ @entity2225 negative immunophenotype was seen in four metastatic lesions and in the remaining five primary @entity2 . The @entity5822 negative/ @entity2225 positive and @entity5822 positive/ @entity2225 positive immunophenotypes were seen in two and three metastatic lesions, respectively, but in none of the primary @entity2 . When a @entity5822 positive/ @entity2225 negative @entity420 also demonstrated either @entity7457 positive or PE-10 positive staining, it was likely that the @entity420 was of pulmonary origin (P < 0.035; Fisher exact test). The specificity of such a combination for discriminating between primary and metastatic @entity420 was 94%. CONCLUSIONS: The results suggest that @entity7457 , PE-10, or @entity5822 / @entity2225 alone did not distinguish reliably between primary @entity2 and metastatic neoplasms of the lung in FNA biopsy specimens because of low sensitivity and specificity. The use of a panel of antibodies that includes @entity5822 / @entity2225 , @entity7457 , and PE-10 may be helpful in discriminating between primary and metastatic @entity420 of the lung. An @entity420 is likely a primary @entity2 when it is of the @entity5822 positive/ @entity2225 negative phenotype and demonstrates either @entity7457 positive or PE-10 positive staining.
