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Table 2 Immunohistochemical and Tissue of Origin Test results

From: Identification of tissue of origin in carcinoma of unknown primary with a microarray-based gene expression test

  Immunohistochemistry Results   Tissue of Origin (TOO) Test results
Case No. Negative Positive Suspected tissues based on clinicopathology TOO result TOO SS Rule out tissues Consistent Management Value
1 BRST-2, CK20, TTF-1, ER, PR, Her2/neu CK7 Pancreas, Breast, Upper GI Indeterminate 22.1 8 -- --
2 PSA CK20, CK7, CDX2* Kidney Colorectal 83.7 14 No* Yes
3 BRST-2, CK20, TTF-1, ER, PR, Her2/neu CK20, CK7, WT1 Ovary or Breast Ovary 87.6 14 Yes Yes
4 chromogranin, synaptophysin, calretinin, TTF-1, PR CK20, CK7, CDX-2, CK5/6, MOC31, ER, CEA GI Primary, Colorectal Colorectal 81.8 13 Yes Yes
5 CDX-2, CD31, CK20, Melan A, S-100, TTF-1 AE1/AE3, CK7 Renal cell carcinoma Indeterminate 24.7 11 -- --
6 Thyroglobulin TTF-1 Lung, Thyroid Breast 61.2 12 No* Yes
7 CK20, PSA, TTF-1 CK7, AE1/AE3, keratin 903, p63 Lung Indeterminate 23.6 8 --  
8 BRST-2, CD10, CD45, C-kit CDX-2, CAM5.2, CK20, CK7, Keratin Colorectal Colorectal 64.1 12 Yes Yes
9 CK20, CK7, TTF-1, ER, PR   Colorectal, Ovary Lung 35.5 10 No* Yes
10   CDX-2*, CK20, CK7 Colorectal, Ovary Colorectal 71.2 13 Yes Yes
11 ER, PR, Her2/neu, BRST-2, CDX-2, CK20 CK7, p53, WT1 Breast, Ovary Ovarian 86.6 14 Yes Yes
12 chromogranin, synaptophysin, surfactant, TTF, CK20, LCA, CA-125, Her2/neu ER, PR, monoclonal CEA, focal CK7 Breast, Ovary, Uterine Breast 96.4 14 Yes Yes
13 Her2/neu, PR estrogen receptor (10% cells staining at 1+) Breast Breast 95 14 Yes Yes
14 HMB45, Tyrosinase, Melan-A, RCC, ER CK7, AE1/AE3, CAM 5.2, TTF, S100, surfactant protein, CK20; weak CDX-2 Lung Ovarian 87.5 13 No* Yes
15   EGF-R Lung Lung 66.9 12 Yes Yes
16 LeuM1, S100 PLAP, CA-125, monoclonal CEA Pancreas, Ovary Pancreas 39.5 11 Yes Yes
17 PSA, neuroendocrine markers, S100 mucicarmine, CEA, cytokeratin Colon, Prostate, Stomach, Lung Pancreas 37.3 10 No* Yes
18 PSA, TTF, calretinin, thrombomodulin, P63 CK7, CK20, monoclonal CEA, CDX-2 Esophagus, Stomach, Pancreas, Biliary Breast 36.1 10 No* Yes
19 smooth myo actin, desmin, S100, HMB-45, CD34, chromogranin, CK7 focal C-kit, focal synaptophysin, focal CK20, mucicarmine, PAS Colon Colorectal 31.5 8 Yes Yes
20 Not available Not available None Indeterminate 24 9 -- --
21 mucicarmine, HepPar, alpha-fetoprotein, synaptophysin CEA monoclonal/polyclonal, Cam-5.2, AE1 Liver, Cholangiocarcinoma Indeterminate 20.7 9 -- --
  1. * Still a plausible primary call given the overall patient presentation and clinicopathologic findings; see text for discussion.
  2. SS: Similarity Score; AE: cytokeratin; BRST: Breast; C-kit: cytokine receptor CD117; CA-125: cancer antigen 125; Cam 5.2: anti-cytokeratin; CD: cluster of differentiation; CDX: an intestine-specific transcription factor; CEA: carcinoembryonic antigen; CK: cytokeratin; ER: estrogen receptor; HepPar: hepatocyte paraffin; Her-2/neu: human epidermal growth factor receptor 2; HMB-45: human melanoma black; LeuM1: a granulocyte-related differentiation antigen; P53: tumor protein 53, a transcription factor; P63: a P53-related nuclear protein; PAS: periodic acid Schiff stain; PLAP: placenta-like alkaline phosphatase; PR: progesterone receptor; PSA: prostate-specific antigen; RCC: renal cell carcinoma marker; S-100: a neuroectodermal antigen; TTF-1: thyroid transcription factor-1; WT1: Wilms' tumor protein-1