Journal article
Strong Annexin A10 Expression Supports a Pancreatic Primary and Combined Annexin A10, Claudin 18, and SOX2 Expression Supports an Esophagogastric Origin in Carcinomas of Unknown Primary
The American journal of surgical pathology, Vol.47(4), pp.440-452
04/2023
DOI: 10.1097/PAS.0000000000001994
PMID: 36730833
Abstract
Primary tumor site determination for gastrointestinal (GI) tract and pancreaticobiliary (PB) tree carcinomas that present as metastasis of unknown primary can be problematic. Annexin A10 (ANXA10), claudin 18 (CLDN18), and trefoil factor 1 (TFF1) have been identified through expression profiling as markers of gastric lineage commitment; sex-determining region Y (SRY)-box transcription factor 2 (SOX2) expression has been reported in several tumor types, including gastric adenocarcinomas. We evaluated the diagnostic utility of immunohistochemistry for ANXA10, CLDN18, SOX2, and TFF1 for determining the site of origin for GI/PB adenocarcinomas. Immunohistochemistry for all 4 markers was performed on tissue microarrays including 559 GI/PB tumors and 421 other tumors. H-scores were calculated as the product of the intensity (0 to 3) and extent (percentage, 0% to 100%) of staining. Positive staining was defined as >5% staining. ANXA10 expression was most frequent in pancreatic adenocarcinomas when compared with all other GI/PB tumors (96.4% vs. 43.5%, P<0.001). Strong staining for ANXA10 (H-score ≥200) distinguished pancreatic ductal adenocarcinoma from intrahepatic cholangiocarcinoma and adenocarcinomas of the gallbladder and colorectum (69.6% vs. 0%, P<0.001). Triple positivity for ANXA10, CLDN18, and SOX2 was more frequent in esophagogastric tumors than in other GI/PB tumors (22.6% vs. 4.1%; P<0.001). TFF1 expression was observed in nearly all tumor types. Staining for ANXA10, CLDN18, and SOX2 as part of a panel may aid in distinguishing esophagogastric adenocarcinomas from lower GI/PB tumors. ANXA10 staining may be particularly useful in distinguishing pancreatic adenocarcinomas from intrahepatic cholangiocarcinoma and adenocarcinomas of the gallbladder and colorectum.
Details
- Title: Subtitle
- Strong Annexin A10 Expression Supports a Pancreatic Primary and Combined Annexin A10, Claudin 18, and SOX2 Expression Supports an Esophagogastric Origin in Carcinomas of Unknown Primary
- Creators
- Raymond A Isidro - Brigham and Women's HospitalIbrahim Abukhiran - University of Pittsburgh Medical CenterCraig D Dunseth - Citizens Memorial Healthcare, Bolivar, MOMatthew D Gosse - University of IowaRobert M Humble - Department of Pathology, University of Iowa Hospitals and Clinics, Carver College of Medicine, Iowa City, IADaniel J Pelletier - Winfield Pathology Consultants, Oak Brook, ILNeha Varshney - University of MississippiAndrew M Bellizzi - University of IowaJason L Hornick - Brigham and Women's Hospital
- Resource Type
- Journal article
- Publication Details
- The American journal of surgical pathology, Vol.47(4), pp.440-452
- DOI
- 10.1097/PAS.0000000000001994
- PMID
- 36730833
- ISSN
- 0147-5185
- eISSN
- 1532-0979
- Language
- English
- Electronic publication date
- 11/02/2022
- Date published
- 04/2023
- Academic Unit
- Pathology
- Record Identifier
- 9984365160202771
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