DOG1, also known as Discovered on GIST-1, is a marker that highly specific for gastrointestinal stromal tumor (GIST). Anti-DOG1 is extremely sensitive for the detection of GIST and its diagnosis. Although some GIST stain weakly for c-kit, DOG1 is expressed in the vast majority of GIST cases. Reports have also indicated DOG1 as a marker for salivary acinar and intercalated duct differentiation.
Cluster of differentiation 44 (CD44) is a glycoprotein receptor for hyaluronic acid, which plays a fundamental role in cellular adhesion, stromal binding, migration, and cell-cell interactions. Studies have suggested that the CD44-hyaluronate interaction is central to tumor invasiveness. Positive staining with Anti-CD44 is implicated in a multitude of different cancer types, including breast, prostatic, renal cell, colonic, hepatocellular, and genitourinary carcinomas, as well as Non-Hodgkin’s Lymphoma, metastatic melanoma, gastric cancer, and some soft tissue tumors. It has also been demonstrated that there is a positive correlation between tumor progression and increased expression of CD44v, a high molecular weight CD44 isoform that has been described in epithelial cells. Given the expression of CD44 in a wide range of cancers, the most practical application of CD44 immunostaining is its use in discriminating between urothelial transitional cell carcinoma in situ from non-neoplastic changes in the urothelium.
Cytokeratin 19 (CK19) forms intermediate filaments found in the intracytoplasmic cytoskeleton of epithelial tissue and provides mechanical support. Anti-Cytokeratin 19 stains epithelia and epithelial malignancies such as carcinomas of the colon, stomach, pancreas, biliary tract, liver, and breast. Cytokeratin 19 is a useful marker for distinguishing hepatocellular carcinoma from intrahepatic cholangiocarcinoma. This differentiation is improved when stained in combination with Cytokeratin 7, CAM5.2l, Ber-EP4/MOC31, HepPar1 and TTF1. Cytokeratin 19 staining can also be used to recognize thyroid papillary carcinomas.
CDX-2 is a caudal-related homeobox transcription factor that is expressed by intestinal epithelial cells. CDX-2 is a useful marker for gastrointestinal carcinoma, and for determining the origin of gastrointestinal metastatic adenocarcinoma and carcinoids. Anti-CDX-2 is used for differentiating lung and metastatic colorectal adenocarcinoma, however mucinous ovarian carcinoma also react positively with Anti-CDX-2, thereby limiting the ability to differentiate from metastatic colorectal adenocarcinoma.
Cluster of differentiation 57 (CD57), also known as NK-1, is an antigen detectable in natural killer cells, some T-lymphocytes and normal peripheral blood mononuclear cells, myeloid cells, and a variety of polypeptides, lipids, and chondroitin sulfate proteoglycans. CD57 is indicated as a marker for tumors of neuroendocrine origin, including pheochromocytomas, paragangliomas, carcinoid tumor, and medulloblastomas, as well as various neural tumors including neuromas, neurofibromas, schwannomas, and granular cell tumors. CD57 is also detectable in ganglioneuroma and prostate carcinoma. Anti-CD57 is used to distinguish nodular lymphocyte-predominant Hodgkin’s lymphoma from T-cell/histiocyte-rich large B-cell lymphoma, nodular sclerosis Hodgkin’s disease, and follicular lymphoma.
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