Anti-p40 recognizes squamous and basal cells, the shortest variant of p53, and ΔNp63 (an isoform of p63). p40 has been indicated as an alternative to p63 for the detection of Squamous Cell Carcinoma (SqCC), offering the advantage of eliminating potential misinterpretation of a positive adenocarcinoma as a SqCC.
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 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.
Follicle-Stimulating Hormone (FSH) allows for progression of ovarian folliculogenesis, and enables Sertoli cell proliferation in the testis. Anti-FSH reacts with FSH-producing cells, therefore FSH staining is useful for classifying pituitary cancers and understanding pituitary disease.
Cluster of differentiation 5 (CD5) is expressed in high levels on the surface of T cells, while controversy surrounds the expression levels and role of CD5 in B cells. As a part of a diagnostic panel, its utility lies predominantly as a marker for T cells, with over 70% of T cell neoplasms expressing CD5. In particular, it is correlated with chronic lymphocytic leukemia/small lymphocytic lymphomas, mantle cell lymphoma, as well as a subset of diffuse large B cell lymphomas. CD5 demonstrates positive expression in thymic carcinomas, and is not as sensitive as CD3. CD5 also has value as a prognostic indicator, being associated with poor prognosis in acute T cell lymphoblastic leukemia.
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