Immunophenotypical categorization of omental and liver metastatic tumours in Lagos, Nigeria.
Quarterly Journal of Hospital Medicine
INTRODUCTION:Immunohistochemistry(IHC), used routinely in developed countries to identify primary sites of metastatic tumours has scarcely available I Nigeria where majority of patients present with advanced metastases. This study was aimed at evaluating the use of immunohistochemistry in differential diagnosis of omental and liver metastases. MATERIALS AND METHODS:Materials consisted of the formalin fixed paraffin embedded blocks of omental and liver metastatic tumours diagnosed in Lagos between January 1995 and February 2007. Ethical clearance was obtained and sections were stained with CK 7, CK20, CA-125, ER, PSA, and TTF1 antibodies at the research Laboratory of The Leeds General Infirmary, United Kingdom following standard procedure. RESULTS:A total of 83 cases of omental (67) and liver (16) metastatic tumours were identified representing 11.6% of all gastrointestinal (GIT) malignancies. Immunostaining was carried out on 44 cases (53%) consisting of 32 (75%) of omental and 11 (25%) of liver tumours; M: F of 1.4:1 and mean age of 43 years. They were categorized as arising from the upper GIT (CK7 +/CK20-) in 17(38.6%), lower GIT (CK20+/CK7-) in 16 (36.3%), gynaecological (CA-125+/ER+) in 4 (9.1%). One case each was categorized as arising from the prostate (PSA+) and breast (ER+) and lung (TTF-1+) while one with histological appearance of neuro-endocrine was focally positive for both CK7 and CK20. Three liver metastases negative for all the 6 antibodies could not be classified. CONCLUSION:This study has further corroborated previous studies that adenocarcinoma is the most common metastatic omental and liver metastases and the common primary sites are within the gastrointestinal tract. Since many patients in Africa present late with advanced metastases, immunohistochemistry is will be useful in identifying primary sites before initiating specific treatment.
Nigerian Quarterly Journal of Hospital Medicine, 01 Oct 2008, 18(4):198-201 DOI: 10.4314/nqjhm.v18i4.45028 PMID: 19391319