Avtor/Urednik		Klevišar, Andreja; Kos, Jernej
Naslov		Zasevek v osrednjem živčevju je lahko prvi znak rakastega obolenja: kje je primarni rak?
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2005
Obseg		str. 31
Jezik		slo
Abstrakt		Background. Brain metastases (BM) can be the first clinical manifestation of cancer disease. Treatment and survival of such patients depend on the early identification of the primary cancer. The pathologist is regularly consulted to collaborate with the clinicians in establishing the origin of the primary tumor. Since BM often lack distinctive histological feature, immunohistochemical (IH) markers are valuable in characterizing the origin of the primary cancer. No single specific marker exists for the most frequent cancers that give rise to BM, such as those originating in breast, lung or colon. As a result, several combinations of IH markers have been used in the attempt to characterize the origin of the primary cancer. Aim. The aim of this study was to probe the usefulness of defined combinations of nonspecific IH markers (i.e. CK7, CK20 and TTF-1) to predict the origin of carcinomatous BM in patients with cancer of unknown primary disease at the time of the BM excision. Hypotheses. We posit two working hypotheses: 1. BM expressing the combination of IH markers CK7>CK20, TTF-1=1 and CK7=CK20=pos., TTF-1=1 most probably originates in the lung. 2. BM expressing the combination of IH markers CK20>CK7, TTF-1=0 most probably originate in the colon. Methods. Our retrospective study included tissue from 171 subjects afflicted by BM that was processed for immunohistochemistry by standard and routine methods. The IH reaction was assessed semi-quantitatively by light microscopy. We evaluated sensitivity, specificity and predictive value of defined combinations of IH markers for the most frequent sources of BM. Results. The IH markers CK7>CK20, TTF-1=1 and CK7=CK20=pos., TTF-1=1 labeled lung BM with 96,9% positive predictive value and 55,4% sensitivity. The IH markers CK20>CK7, TTF-1=0 labeled colon BM with 75,0% positive predictive value and 83,3% sensitivity. (Abstract truncated at 2000 characters)
Deskriptorji		BRAIN NEOPLASMS TUMOR MARKERS, BIOLOGICAL NEOPLASMS, UNKNOWN PRIMARY COLONIC NEOPLASMS LUNG NEOPLASMS BREAST NEOPLASMS SENSITIVITY AND SPECIFICITY PREDICTIVE VALUE OF TESTS RETROSPECTIVE STUDIES