Clinicohistopathological study and expression of CK7 and CK20 in mucinous tumors of gastrointestinal tract and ovary

Santhosh Rupa Killana, Prasad Uma, Atla Bhagya Lakshmi, Uttapalla Laxmi Trivedi, Juthuga Hari Chandan Kumar, Gera Arjuna


Background: Mucinous ovarian tumors differ from other types of epithelial ovarian cancers in their clinical behaviour and the need for innovative treatment approaches to achieve improved patient outcomes. Immunohistochemistry plays an important role in diagnosis and differentiates primary and secondary mucinous tumors. To know the distribution and expression of CK7 and CK20 in mucinous tumors of ovary and gastrointestinal tract.

Methods: Ninety eight cases of mucinous tumors of ovary and gastrointestinal tract were analysed as per standard protocol out of which malignant mucinous tumors constituted forty five cases. All 45 cases of mucinous carcinoma of ovary and gastrointestinal tract were subjected to IHC CK7 and CK20. The results were analysed.

Results: Total mucinous tumors of ovary were 64 cases and total mucinous tumors of gastrointestinal tract were 34 cases. Predominant expression in primary mucinous carcinoma of ovary was CK7 positive and CK20 positive, in metastatic mucinous ovarian carcinoma of gastric origin was CK7 positive and CK20 positive and from colorectal origin was CK7 negative and CK20 positive. Signet ring cell carcinoma of stomach showed CK7 diffuse positivity with focal CK20 positivity. Colorectal mucinous carcinoma was CK7 negative and CK20 positive. The expression varied with the stage of the disease.

Conclusions: CK7 and CK20 plays an important role in differentiating primary mucinous carcinoma of ovary from metastatic ovarian carcinoma arising from lower gastrointestinal tract.CK7 and CK 20 expression is variable with stage of disease hence should be interpreted in the background of histopathology.


Mucinous carcinoma of ovary, Mucinous carcinoma of GIT, CK7, CK20

Full Text:



Hess V, A’Hern R, Nasiri N, King DM, Blake PR, Barton DPJ, et al. Mucinous epithelial ovarian cancer: a separate entity requiring specific treatment. J Clin Oncol. 2004;22:1040–4.

Perren TJ. Mucinous epithelial ovarian carcinoma. Annals of Oncology. 2016;27(1):53–57.

Nitsche U, Zimmermann A, Spath C, Muller T, Maak M, Schuster T, et al. Mucinous and signet-ring cell colorectal cancers differ from classical adenocarcinomas in tumor biology and prognosis. Ann Surg. 2013;258(5):775-82 .

Tindal D, Sahasrabhojanee M, Jindal M, D’Souza J. Epidemiology of epithelial ovarian cancer: a tertiary hospital based study in Goa, India. Int J Reprod Contracept Obstet Gynecol .2017;6:2541-6.

Schiavone MB, Herzog TJ, Lewin SN, Deutsch I, Sun X, Burke WM, et al. Natural history and outcome of mucinous carcinoma of the ovary. Am J Obstet Gynecol. 2011;205(5):480.

Shimada M, Kigawa J, Ohishi Y, Yasuda M, Suzuki M, Hiura M, et al. Clinicopathological characteristics of mucinous adenocarcinoma of the ovary Gynecol Oncol. 2009;113(3):331-4.

Kriplani D, Patel MM. Immunohistochemistry: a diagnostic aid in differentiating primary epithelial ovarian tumors and tumors metastatic to the ovary. South Asian J Cancer. 2013;2(4):254–8.

Puri S, Chadha V, Pandey AK. Epidemiology of ovarian tumors in Northern India-A tertiary hospital based study. Indian J Community Fam Med. 2018;4:37-41.

Saini SK, Srivastava S, Singh Y, Dixit AK, Prasad SN. Epidemiology of Epithelial ovarian cancer,a single institution –based study in India. Clin Cancer Investig J. 2016;5:20-4.

Mondal SK. A 10 year retrospective, clinicopathological study of 2100 ovarian lesions in a rural medical college hospital of West Bengal, India. Biomed Res J. 2019;3:264-8.

Vang R, Gown AM, Barry TS, Wheeler DT, Yemelyanova A, Seidman JD, Ronnett BM. Cytokeratins 7 and 20 in primary and secondary mucinous tumors of the ovary: analysis of coordinate immunohistochemical expression profiles and staining distribution in 179 cases. Am J Surg Pathol. 2006;30(9):1130-9.

Bassiouny D, Ismiil N, Dubé V, Han G, Cesari M, Lu FI, et al. Comprehensive clinicopathologic and updated immunohistochemical characterization of primary ovarian mucinous carcinoma. Int J Surg Pathol. 2018;26(4):306-17.

Zhang M, Zhu GY, Zhang HF, Gao HY, Han XF, Xue YW. Clinicopathologic characteristics and prognosis of mucinous gastric carcinoma. J Surg Oncol. 2010;102(1):64-7.

Bu Z, Zheng Z, Li Z, Wu X, Zhang L, Wu A, et al. Clinicopathological and prognostic differences between mucinous gastric carcinoma and signet-ring cell carcinoma. Chin J Cancer Res. 2013;25(1):32–8.

Jonathan CB, Simon SBD, Naaeder RKG. Clinicopathological aspects of adenocarcinoma of the large bowel in a low incidence population J Surg Oncol 2014;109:245–9.

Nitsche U, Zimmermann A, Späth C, Müller T, Maak M, Schuster T, et al. Mucinous and Signet-Ring Cell Colorectal Cancers Differ from Classical Adenocarcinomas in Tumor Biology and Prognosis. Ann Surg. 2013;258(5):775–83.

Terada T. An immunohistochemical study of primary signet-ring cell carcinoma of the stomach and colorectum: I. Cytokeratin profile in 42 cases. Int J Clin Exp Pathol. 2013;6(4):703-10.

Takami H, Sentani K, Matsuda M, Oue N, Sakamoto N, Yasui W. Cytokeratin expression profiling in gastric carcinoma: clinicopathologic significance and comparison with tumor-associated molecules. Pathobiology. 2012;79(3):154-61.

Park SY, Kim HS, Hong EK, Kim WH. Expression of cytokeratins 7 and 20 in primary carcinomas of the stomach and colorectum and their value in the differential diagnosis of metastatic carcinomas to the ovary. Hum Pathol. 2002;33(11):1078-85.