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Shen T, Zhao J, Zhao M, Taggart MW, Ramalingam P, Gong Y, Wu Y, Liu H, Zhang J, Resetkova E, Wang WL, Ding Q, Huo L, Yoon E. Unusual Staining of Immunohistochemical Markers PAX8 and CDX2 in Breast Carcinoma: A Potential Diagnostic Pitfall. Hum Pathol 2022; 125:35-47. [DOI: 10.1016/j.humpath.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022]
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Ma Z, Xin Z, Hu W, Jiang S, Yang Z, Yan X, Li X, Yang Y, Chen F. Forkhead box O proteins: Crucial regulators of cancer EMT. Semin Cancer Biol 2018; 50:21-31. [PMID: 29427645 DOI: 10.1016/j.semcancer.2018.02.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 12/02/2017] [Accepted: 02/05/2018] [Indexed: 12/12/2022]
Abstract
The epithelial-mesenchymal transition (EMT) is an acknowledged cellular transition process in which epithelial cells acquire mesenchymal-like properties that endow cancer cells with increased migratory and invasive behavior. Forkhead box O (FOXO) proteins have been shown to orchestrate multiple EMT-associated pathways and EMT-related transcription factors (EMT-TFs), thereby modulating the EMT process. The focus of the current review is to evaluate the latest research progress regarding the roles of FOXO proteins in cancer EMT. First, a brief overview of the EMT process in cancer and a general background on the FOXO family are provided. Next, we present the interactions between FOXO proteins and multiple EMT-associated pathways during malignancy development. Finally, we propose several novel potential directions for future research. Collectively, the information compiled herein should serve as a comprehensive repository of information on this topic and should aid in the design of additional studies and the future development of FOXO proteins as therapeutic targets.
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Affiliation(s)
- Zhiqiang Ma
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, 229 Taibai North Road, Xi'an 710069 China; Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, 1 Xinsi Road, Xi'an 710038, China
| | - Zhenlong Xin
- Department of Occupational and Environmental Health and The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, 169 Changle West Road, Xi'an 710032, China
| | - Wei Hu
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an 710032, China
| | - Shuai Jiang
- Department of Aerospace Medicine, The Fourth Military Medical University, 169 Changle West Road, Xi'an 710032, China
| | - Zhi Yang
- Department of Biomedical Engineering, The Fourth Military Medical University, 169 Changle West Road, Xi'an 710032, China
| | - Xiaolong Yan
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, 1 Xinsi Road, Xi'an 710038, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, 1 Xinsi Road, Xi'an 710038, China
| | - Yang Yang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, 229 Taibai North Road, Xi'an 710069 China; Department of Biomedical Engineering, The Fourth Military Medical University, 169 Changle West Road, Xi'an 710032, China.
| | - Fulin Chen
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, Faculty of Life Sciences, Northwest University, 229 Taibai North Road, Xi'an 710069 China.
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Metastatic carcinoma of unknown primary: diagnostic approach using immunohistochemistry. Adv Anat Pathol 2015; 22:149-67. [PMID: 25844674 DOI: 10.1097/pap.0000000000000069] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Carcinoma of unknown primary origin (CUP) is one of the 10 most prevalent malignancies. CUP patients in whom a site of origin can be ascribed have better outcomes than those in which the primary tumor remains unidentified. Among the tools available to pathologists in approaching these lesions, immunohistochemistry is a reliable, inexpensive, and widely available resource. New markers continue to emerge, which, in combination with other historically useful antibodies, allow rapid and accurate identification of primary site in an increasing number of cases. This review discusses the approach to the diagnosis of CUP using immunohistochemistry and outlines some of the most useful markers with a particular focus on the utility of lineage-restricted transcription factors, including CDX2, NKX3-1, PAX8, SATB2, TTF-1, and SF1.
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Aulakh KS, Chisholm CD, Smith DA, Speights VO. TTF-1 and napsin A do not differentiate metastatic lung adenocarcinomas from primary esophageal adenocarcinomas: proposal of a novel staining panel. Arch Pathol Lab Med 2013; 137:1094-8. [PMID: 23899066 DOI: 10.5858/arpa.2012-0305-oa] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT When adenocarcinomas arise within the esophagus, particularly when located away from the gastroesophageal junction, it may be important in some patients to differentiate between a primary esophageal adenocarcinoma and metastasis from another site. Lung adenocarcinoma is one tumor that has been reported to frequently metastasize to the esophagus. OBJECTIVES To create a panel of immunohistochemical markers that can reliably distinguish between an esophageal and pulmonary primary; within the gastrointestinal pathology literature, including published articles and textbooks, common lung immunohistochemical markers, such as TTF-1, are assumed to be negative in esophageal adenocarcinoma, yet, to our knowledge, no study has yet investigated the veracity of that presumption. DESIGN In this study, 24 cases each of pulmonary and esophageal adenocarcinomas were stained with TTF-1, napsin A, CDX2, 34βE12, N-cadherin, and IMP3 in an attempt to define an optimal panel for differentiation. Esophageal adenocarcinomas occurring at the gastroesophageal junction were excluded in this study because a gastric primary tumor cannot be excluded in those cases. RESULTS Surprisingly, TTF-1 and napsin A were positive in similar proportions of tumors from both sites. Those markers that differentiated statistically between esophageal and pulmonary adenocarcinoma were IMP3, CDX2, and N-cadherin. CONCLUSIONS When differentiating the origin of a tumor as either esophageal or pulmonary, an immunohistochemical panel consisting of IMP3, CDX2, and N-cadherin is superior to either TTF-1 or napsin A.
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Valor LM, Guiretti D. What's wrong with epigenetics in Huntington's disease? Neuropharmacology 2013; 80:103-14. [PMID: 24184315 DOI: 10.1016/j.neuropharm.2013.10.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/16/2013] [Accepted: 10/21/2013] [Indexed: 12/15/2022]
Abstract
Huntington's disease (HD) can be considered the paradigm of epigenetic dysregulation in neurodegenerative disorders. In this review, we attempted to compile the evidence that indicates, on the one hand, that several epigenetic marks (histone acetylation, methylation, ubiquitylation, phosphorylation and DNA modifications) are altered in multiple models and in postmortem patient samples, and on the other hand, that pharmacological treatments aimed to reverse such alterations have beneficial effects on HD phenotypic and biochemical traits. However, the working hypotheses regarding the biological significance of epigenetic dysregulation in this disease and the mechanisms of action of the tested ameliorative strategies need to be refined. Understanding the complexity of the epigenetics in HD will provide useful insights to examine the role of epigenetic dysregulation in other neuropathologies, such as Alzheimer's or Parkinson's diseases.
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Affiliation(s)
- Luis M Valor
- Instituto de Neurociencias de Alicante (Universidad Miguel Hernández, Consejo Superior de Investigaciones Científicas), Av. Santiago Ramón y Cajal s/n, Sant Joan d'Alacant, 03550 Alicante, Spain.
| | - Deisy Guiretti
- Instituto de Neurociencias de Alicante (Universidad Miguel Hernández, Consejo Superior de Investigaciones Científicas), Av. Santiago Ramón y Cajal s/n, Sant Joan d'Alacant, 03550 Alicante, Spain
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Abstract
OBJECTS CDX2 is a widely used immunohistochemical marker for intestinal differentiation in neoplasms. In the Nordic Immunohistochemical Quality Control external quality assessment scheme, only 45% of the laboratories participating in the CDX2 challenge in 2009 produced sufficient staining. A major cause of insufficient staining results appeared to be less successful primary antibody (Ab) clones. To evaluate the Ab performance in a standardized way, a comparative study was carried out. MATERIALS AND METHODS Tissue microarrays containing 309 non-neoplastic tissues and tumor samples with expected high, low, and no CDX2 expression were used. Five Abs were selected for comparison: EPR2764Y concentrated (Conc), EPR2764Y in a ready-to-use format, and DAK-CDX2, AMT28, and CDX2-88, all Conc. The CDX2 stains were scored blindly using the H-score method. Tissue/tumor samples with a maximum H-score of 150 to 300 (on the basis of the staining giving the highest score) were classified as CDX2 high expressors, samples with a maximum H-score of 10 to 149 as low expressors, and samples with a maximum H-score <10 as negative. RESULTS AND CONCLUSIONS A total of 106 tumors were CDX2 positive with at least one of the Abs. For 56 high-expressor tumors, the mean H-scores with EPR2764Y Conc, EPR2764Y ready-to-use, DAK-CDX2, AMT28, and CDX2-88 were 262, 236, 234, 167, and 149, respectively, and the percentage of positive tumors 100, 100, 100, 98, and 93, respectively. For 50 low-expressor tumors, the mean H-scores with the same Abs were 59, 26, 28, 7, and 5, respectively, and the percentage of positive tumors 98, 58, 64, 18, and 14, respectively. With EPR2764Y Conc, CDX2 was demonstrated in 5/19 (26%) urothelial carcinomas, 7/64 (11%) lung adenocarcinomas, 5/30 (17%) large cell/sarcomatoid lung carcinomas, and 4/19 (21%) esophagus squamous cell carcinomas. In-house optimized protocols gave for all 4 Conc Abs better staining results than the vendors' recommended protocols. The sensitivity of CDX2 Abs and protocols must be taken into consideration when classifying neoplasms of unknown origin.
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Mukhopadhyay S, Katzenstein ALA. Comparison of monoclonal napsin A, polyclonal napsin A, and TTF-1 for determining lung origin in metastatic adenocarcinomas. Am J Clin Pathol 2012; 138:703-11. [PMID: 23086771 DOI: 10.1309/ajcpkvbxti9o3tem] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Thyroid transcription factor 1 (TTF-1) is currently the best immunohistochemical marker for carcinomas of lung origin. Our aim was to compare napsin A to TTF-1 for identifying pulmonary origin in metastatic adenocarcinoma and its mimics. One hundred fifty-five metastatic carcinomas (55 pulmonary, 100 nonpulmonary) were stained with monoclonal napsin A and TTF-1, and most also with polyclonal napsin A. The sensitivity of monoclonal napsin A, polyclonal napsin A, and TTF-1 for metastatic adenocarcinomas of pulmonary origin was 76%, 81%, and 82%, respectively. Two lung carcinomas were diffusely positive for monoclonal napsin A, but negative or equivocal for TTF-1. TTF-1 stained 9 of 100 nonpulmonary carcinomas (all thyroid), monoclonal napsin A stained 12 of 100 (4 sites), and polyclonal napsin A stained 27 of 91 (8 sites). Napsin A is expressed in a wider variety of metastatic nonpulmonary carcinomas than TTF-1, and the monoclonal antibody is more specific. Napsin A is a useful adjunct to TTF-1, because occasional lung adenocarcinomas are TTF-1 negative but napsin A positive.
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Yang L, Lin M, Ruan WJ, Dong LL, Chen EG, Wu XH, Ying KJ. Nkx2-1: a novel tumor biomarker of lung cancer. J Zhejiang Univ Sci B 2012; 13:855-66. [PMID: 23125078 PMCID: PMC3494024 DOI: 10.1631/jzus.b1100382] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 05/30/2012] [Indexed: 12/13/2022]
Abstract
Nkx2-1 (Nkx homeobox-1 gene), also known as TTF-1 (thyroid transcription factor-1), is a tissue-specific transcription factor of the thyroid, lung, and ventral forebrain. While it has been shown to play a critical role in lung development and lung cancer differentiation and morphogenesis, molecular mechanisms mediating Nkx2-1 cell- and tissue-specific expression in normal and cancerous lungs have yet to be fully elucidated. The recent identification of prognostic biomarkers in lung cancer, particularly in lung adenocarcinoma (ADC), and the different reactivity of patients to chemotherapeutic drugs have opened new avenues for evaluating patient survival and the development of novel effective therapeutic strategies. The function of Nkx2-1 as a proto-oncogene was recently characterized and the gene is implicated as a contributory factor in lung cancer development. In this review, we summarize the role of this transcription factor in the development, diagnosis, and prognosis of lung cancer in the hope of providing insights into the utility of Nkx2-1 as a novel biomarker of lung cancer.
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Affiliation(s)
- Li Yang
- Department of Respiratory Medicine, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China
- Key Laboratory of Biotherapy of Zhejiang Province, Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
- †E-mail:
| | - Min Lin
- Department of Radiology, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
| | - Wen-jing Ruan
- Key Laboratory of Biotherapy of Zhejiang Province, Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Liang-liang Dong
- Key Laboratory of Biotherapy of Zhejiang Province, Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
| | - En-guo Chen
- Key Laboratory of Biotherapy of Zhejiang Province, Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Xiao-hong Wu
- Key Laboratory of Biotherapy of Zhejiang Province, Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Ke-jing Ying
- Key Laboratory of Biotherapy of Zhejiang Province, Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
- †E-mail:
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Expression of Thyroid Transcription Factor-1 in Malignant Pleural Effusions. Pathol Oncol Res 2010; 17:263-7. [DOI: 10.1007/s12253-010-9308-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 09/01/2010] [Indexed: 10/19/2022]
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Seoane J, Varela-Centelles P, López-Niño J, Vázquez I, Abdulkader I, García-Caballero T. Gingival Mucinous Adenocarcinoma of a Minor Salivary Gland. J Periodontol 2010; 81:626-31. [DOI: 10.1902/jop.2009.090370] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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CDX2, cytokeratins 7 and 20 immunoreactivity in rectal adenocarcinoma. Appl Immunohistochem Mol Morphol 2009; 17:196-201. [PMID: 19098678 DOI: 10.1097/pai.0b013e31819268f2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There are limited data regarding CDX2 expression in rectal carcinoma. The CK20/CK7 immunoprofile of colorectal adenocarcinoma has been described in studies, which have mostly lumped colonic and rectal tumors together. In this study, we investigated the diagnostic utility of immunohistochemical stains for CK7, CK20, and CDX2 in a series of rectal adenocarcinoma. Fifty-five specimens of rectal adenocarcinomas were retrieved and immunostained for CK7 (Dako-M7018), CK20 (NovoCastra NCL-L-CK20), and CDX2 (NovoCastra NCL-CDX2). Thirty cases of pancreatic adenocarcinoma and 15 cholangiocarcinomas were also studied as a comparison group. CK7 was expressed in 12/55 (22%) and CK20 in 48/55 (87%) cases of rectal adenocarcinoma. The CK7-/CK20+ immunophenotype was identified in 36/55 (65%), CK7+/CK20+ in 12/55 (22%), and CK7-/CK20- in 7/55 (13%) rectal adenocarcinoma. CDX2 showed moderate-strong positivity in all cases and was not related to tumor differentiation. Benign rectal mucosa was available in 37 cases and showed the following results: CK7-/CK20+ in 25/37 (67%), CK7+/CK20+ in 8/37 (22%) and CK7-/CK20- in 4/37 (11%) cases. In pancreatic adenocarcinomas and cholangiocarcinomas, 29/45 (64%) were CK7+/CK20+ and 16/45 (36%) were CK7+/CK20-. CDX2 was positive in only 3/45 (7%) of these cases; all were pancreatic adenocarcinomas. In conclusion, CK7 can be expressed in rectal adenocarcinoma, and should not be used as the sole basis for excluding a rectal primary. CDX2 is a sensitive marker for rectal origin of adenocarcinoma. It can be helpful in cases with metastatic rectal carcinoma, especially those with CK7+/CK20+ or CK20-/CK7- immunophenotype. In this study, CDX2 expression was not influenced by the grade (differentiation) of rectal adenocarcinoma.
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