FOXF1 as an Immunohistochemical Marker of Hilar Cholangiocarcinoma or Metastatic Pancreatic Ductal Adenocarcinoma. Single Institution Experience

• Published in: Pathology oncology research 2021-04, Vol.27, p.1609756-1609756
• Main Authors: Hrudka, Jan, Prouzová, Zuzana, Mydlíková, Katarína, Jedličková, Kristína, Holešta, Michal, Whitley, Adam, Havlůj, Lukáš
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Automation; Bile Duct Neoplasms - metabolism; Bile Duct Neoplasms - pathology; Bile ducts; Biomarkers, Tumor - metabolism; Biopsy; Cancer; Carcinoma, Hepatocellular - metabolism; Carcinoma, Hepatocellular - pathology; Carcinoma, Pancreatic Ductal - metabolism; Carcinoma, Pancreatic Ductal - secondary; Cholangiocarcinoma; Female; Follow-Up Studies; Forkhead Transcription Factors - metabolism; Gallbladder; Humans; Immunohistochemistry; Klatskin Tumor - metabolism; Klatskin Tumor - pathology; Liver; Liver cancer; Liver Neoplasms - metabolism; Liver Neoplasms - secondary; Male; Metastasis; Middle Aged; Morphology; Pancreatic cancer; Pancreatic Neoplasms; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - pathology; Prognosis; Society Journal Archive; Surgery; Survival Rate; Tumors
• ISSN: 1532-2807; 1219-4956; 1532-2807
• DOI: 10.3389/pore.2021.1609756

Cholangiocarcinoma (CCA) is a liver malignancy associated with a poor prognosis. Its main subtypes are peripheral/intrahepatic and hilar/extrahepatic CCA. Several molecular, morphological and clinical similarities between hilar/extrahepatic CCA and pancreatic ductal adenocarcinoma (PDAC) have been described. FOXF1 is a transcription factor which has been described to have prognostic significance in various tumors and it is involved in the development of bile ducts. The aim of this study is to determine occurrence of nuclear expression of FOXF1 in both subtypes of CCA and metastatic PDAC and assess its potential usefulness as a diagnostic marker. Secondary aims were to investigate the use of C-reactive protein (CRP) immunohistochemistry for diagnosing intrahepatic peripheral CCA and the significance of histological features in CCA subtypes. 32 archive specimens of CCA, combined hepatocellular carcinoma-CCA (HCC-CCA) and liver metastasis of PDAC were stained by FOXF1 and CRP immunohistochemistry and evaluated to determine histological pattern. The CCAs were classified radiologically into peripheral/intrahepatic and hilar subtype. Using Fisher exact test, we identified nuclear FOXF1 as a fairly specific (87%) but insensitive (65%) marker of hilar and extrahepatic CCA and metastatic PDAC ( = 0.005). CRP immunohistochemistry was characterized by a high sensitivity and specificity, of 79% and 88%, respectively ( = 0.001). We did not identify any histomorphological features associated with either types of CCA or metastatic PDAC. As a conclusion of novel finding, FOXF1 immunohistochemistry may be regarded as a specific but insensitive marker of hilar/extrahepatic CCA and metastatic PDAC and it may help distinguish them from peripheral CCA.