Diagnostic BioSystems

Catch it early, catch it right, with immunohistochemistry (IHC), we bring Bowel cancer for the better treatments. IHC detection is a key to the fight!



Colorectal cancer (CRC) is a primary epithelial malignancy that arises in the colore**um. More than 1 million new cases occur worldwide per year. It is the second or third most common cancer and cause of cancer deaths in men and in women. Approximately 98% of colonic cancers are adenocarcinomas. CRC represents most common gastrointestinal tumor in U.S.; less common in Africa, Asia and parts of South America. Peak age for CRC to occur is 60 - 79 years, < 20% of cases occur before age 50 and rare before age 40, except in patients with a predisposition syndrome. CRC may arise anywhere in the colore**um but sigmoid colon and re**um are most common sites. Around 60% of patients have lymph node or distant metastases at diagnosis and most common metastatic sites are regional lymph nodes, liver, peritoneum, lung, ovaries. Five year survival is 40% - 60% and most recurrences are within 2 years.

CK20 &CK7: The most common immunophenotype of colorectal cancer is positivity for CK20 and negativity for CK7, which is a relatively specific staining pattern for colorectal primary origin of the colore**um. However, maybe up to 20% of the tumors may exhibit a CK7-positve/CK20-negative staining pattern. It has been suggested that reduced or absent CK20 expression in colorectal cancer is associated with MSI-H.

CDX2 is a marker of enteric differentiation and a highly sensitive marker for adenocarcinomas of colorectal origin. Positive in >90% of colorectal cancers. However, CDX2 can be positive in any carcinoma that shows enteric differentiation, and thus is not entirely colorectal-specific.

SATB2 is a highly specific marker for distinguishing lower gastrointestinal differentiation.

MSI (Microsatellite Instability): DNA Mismatch repair (MMR) protein antibodies, MLH1, MSH2, MSH6, PMS2, are used to detect deficient MMR status. Loss of expression in these proteins acts as a surrogate marker for Microsatellite Instability High (MSI-H), which is crucial for immunotherapy decisions.

Approximately 15% colorectal cancer show dMMR, and 80% of dMMR colorectal cancer is sporadic, 20% of dMMR colorectal cancer is familiar such as Lynch syndrome. dMMR colorectal cancer has predilection for the right colon.