DOI: https://doi.org/10.26641/2307-0404.2019.2.170119

The diagnostic value of the p16ink marker for verification of tumors of unknown primary site in women with isolated lesion of inguinal lymph nodes.

О. V. Poslavska, I. S. Shponka, H. S. Babiy

Abstract


Carcinomas with an unknown primary site are a heterogeneous group of metastatic tumors, numbering from 3% to 5% of all malignant carcinoma phenotypes. An isolated lesion of the inguinal lymph nodes is relevantly associated with primary localization of tumors in the pelvis, anal canal, lower abdomen, lower limbs, and more towards in the reproductive system (vulva, vagina and cervix for women, penis for men). But in the absence of clinical signs of cancer after careful research, the histological biopsy of the lymph node with additional immunohistochemical staining with organ-specific markers becomes the diagnostic method of choice. A retrospective analysis of the histological, morphometric and immunohistological characteristics of the biopsy material of 59 patients with isolated lesions of the inguinal lymph nodes (35 women and 24 men) aged from 20 to 87 years (mean 59.26±15.86; median 62 years) was conducted. The distribution of variants of an isolated lesion of the inguinal lymph nodes in women showed 14 of 35 (40.00%) metastatic tumors (the other 21 are lymphoproliferative conditions that require phenotyping, but not finding the primary localization). Of 14 metastatic lesions in women, 6 cases demonstrated a p16ink (+) phenotype. For comparison, of 24 cases in men, only 6 (25.00%) were of metastatic origin, of which p16ink (+/-) was partially 1 metastasis of melanoma (16.67%). After a thorough immunohistochemical study with a panel of organo-specific markers among isolated metastatic lesions of the inguinal lymph nodes of tumors in women, half of the revealed localized sites (7 out of 14) were in reproductive organs, namely: 4 p16ink (+) to squamous cervical cancers, 2 p16ink (+) to serous ovarian adenocarcinoma, 1 p16ink (-) to leiomyosarcoma of the uterus. Other localizations did not have a clear location, as they related to metastases of carcinoma from Merkel cells and melanomas, as a result of frequent reduction of the primary tumor lesion in the skin.


Keywords


inguinal lymph nodes; cervical cancer; p16INK; ImageJ.

References


Poslavska OV, Shponka IS, Gritsenko PO, Alekseenko OA. [Morphometric analysis of pancyto­keratin-negative neoplastic damages of the lymphatic nodes of the neck]. Medicni perspektivi. 2018;23(1):30-37. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2018.1.124915

Poslavskaya OV. [Determination of linear dimen­sions and square square surfaces areas of morphological objects on micrographs using ImageJ software]. Morpho­logia. 2016;10(3):377-81. Ukrainian. doi: https://doi.org/10.26641/1997-9665.2016.3.377-381

Fatemeh Sari Aslani, Akbar Safaei, Masoumeh Pourjabali, Mozhden Momtahan. Evaluation of Ki-67, h16 and CK17 markers in differentiationg cervical intraepithelial neoplasia and benign lesions.IranJ Med Sci. 2013;38(1):15-21.

Greco FA. Molecular diagnosis of the tissue of origin in cancer of unknown primary site: useful in patient management. Curr Treat Options Oncol. 2013;14(4):634-42. doi: https://doi.org/10.1007/s11864-013-0257-1

Pai V, Kattimani K, Manohar V, Ravindranath S. Inguinal lymph node squamous cell carcinoma of unk­nown primary site: a case report. Journal of surgery and operative care. 2016;1(2):208. doi: https://doi.org/10.15744/2455-7617.1.207

Lin F, Haiyan Liu. Immunohistochemistry in Undifferentiated Neoplasm. Tumor of Uncertain Origin. Arch Pathol Lab Med. 2014;138:1583-610. doi: https://doi.org/10.5858/arpa.2014-0061-RA

Vajdic CM, Goldstein D. Cancer of unknown primary site. Aust Fam Physician. 2015;44(9):640-43.


GOST Style Citations


  1. Пославська О. В., Шпонька І. С., Гриценко П. О., Алексєєнко О. А. Морфометричний аналіз панціто­кератин-негативних неопластичних ушкоджень лім­фатичних вузлів шиї. Медичні перспективи. 2018. Т. 23, № 1. С.30-37. DOI: https://doi.org/10.26641/2307-0404.2018.1.124915
  2. Пославська О. В. Визначення лінійних роз­мірів та площ окремих морфологічних об’єктів на мікрофотографіях за допомогою програми ImageJ. Морфологія. 2016. Т. 10, № 3. С. 377-381. DOI: https://doi.org/10.26641/1997-9665.2016.3.377-381
  3. Aslani Fatemeh Sari, Safaei Akbar, Pourjabali Masoumeh, Momtahan Mozhden. Evaluation of Ki-67, h16 and CK17 markers in differentiationg cervical intraepithelial neoplasia and benign lesions. Iran J. Med Sci. 2013. Vol. 38, N 1. P. 15-21.
  4. Greco F. A. Molecular diagnosis of the tissue of origin in cancer of unknown primary site: useful in patient management. Curr Treat Options Oncol. 2013. Vol. 14, N 4. P. 634-642. DOI: https://doi.org/10.1007/s11864-013-0257-1
  5. Pai V., Kattimani K., Manohar V., Ravindra­nath S. Inguinal lymph node squamous cell carcinoma of unknown primary site: a case report. J. surgery and operative care. 2016. Vol. 1, N 2. P. 208. DOI: https://doi.org/10.15744/2455-7617.1.207
  6. Lin F., Liu H. Immunohistochemistry in Undiffe­rentiated Neoplasm. Tumor of Uncertain Origin. Arch Pathol Lab Med. 2014. Vol. 138. Р. 1583-1610. DOI: https://doi.org/10.5858/arpa.2014-0061-RA
  7. Vajdic C. M., Goldstein D. Cancer of unknown pri­mary site. Aust Fam Physician. 2015. Vol. 44, N 9. P. 640-643.




 

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