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Cytokeratin 5/6 Immunostaining in Hepatobiliary and Pancreatic Neoplasms

Vlasoff, Dmitry M. B.Sc.; Baschinsky, Dmitry Y. M.D.; Frankel, Wendy L. M.D.

Applied Immunohistochemistry & Molecular Morphology: June 2002 - Volume 10 - Issue 2 - p 147-151

Immunohistochemistry with different cytokeratin subsets has been successfully used in the differential diagnosis of various human epithelial neoplasms. Cytokeratin 5/6 antibody, which recently became commercially available, has been found useful in the diagnosis of mesothelioma. Studies have reported only infrequent staining in adenocarcinomas. We investigated the pattern of immunoreactivity for cytokeratin 5/6 in hepatobiliary and pancreatic tumors to determine its diagnostic utility in the morphologic evaluation of these neoplasms. Formalin-fixed, paraffin-embedded tissue sections from 10 hepatocellular carcinomas, seven hepatocellular adenomas, 10 cholangiocarcinomas, 10 pancreatic ductal adenocarcinomas, and 13 pancreatic neuroendocrine carcinomas were immunostained with anti–cytokeratin 5/6 after heat-induced antigen retrieval utilizing a modified avidin-biotin complex technique. Positive and negative controls stained appropriately. Two pathologists evaluated the slides. Strong but focal cytoplasmic immunoreactivity was observed in five of 10 pancreatic ductal adenocarcinomas and two of 10 cholangiocarcinomas. No immunoreactivity was identified in any cases of hepatocellular carcinoma (0/10), hepatocellular adenoma (0/7), or pancreatic neuroendocrine carcinoma (0/13). Additionally, occasional cytokeratin 5/6 immunoreactive benign ductal epithelial cells were seen in the background in some cases. Fifty percent of pancreatic ductal adenocarcinomas and 20% of cholangiocarcinomas are positive with anti–cytokeratin 5/6 immunostaining. For the evaluation of poorly differentiated neoplasms in the liver, immunoreactivity with cytokeratin 5/6 may help to exclude the possibility of hepatocellular carcinoma. Cytokeratin 5/6 may be helpful as a component in the panel of immunostains to differentiate between poorly differentiated neoplasms.

From the Department of Pathology, The Ohio State University, Columbus, Ohio, U.S.A.

Manuscript received March 30, 2001;

sent for revision July 8, 2001; accepted September 12, 2001.

Address correspondence and reprint requests to Wendy L. Frankel, Assistant Professor of Pathology, Department of Pathology, E401 Doan Hall, The Ohio State University Medical Center, 410 W. 10th Avenue, Columbus, OH 43210-1228, U.S.A. E-mail:

Copyright 2002 Wolters Kluwer Health, Inc. All rights reserved.