ArticleHuman pathology2009
Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation.
Article in Human pathology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.
- Clinicopathological and prognostic significance of mucin signatures in lower gastrointestinal cancer-a systematic review and meta-analysis.British journal of cancer · 2026Pooled it
- Spontaneous Regression of Poorly Differentiated Carcinoma in the Transverse Colon with Deficient Mismatch Repair: A Case Report and Review.Surgical case reports · 2026Article
- Medullary Carcinoma of the Ascending Colon in an Older Woman: A Case Report.Surgical case reports · 2026Article
- Medullary Carcinoma of the Colon: Not as Favourable as Previously Thought?Journal of gastrointestinal cancer · 2025Article
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- Four Surgical Cases of Medullary Carcinoma of the Colon.Surgical case reports · 2025Article
- Medullary carcinomas of the nonampullary small intestine: association with coeliac disease, mismatch repair deficiency, PD-L1 expression, and favourable prognosis.Histopathology · 2025Article
- Primary medullary adenocarcinoma of the colon: Literature review and case series.Surgery in practice and science · 2024Article
- CALB2 drives pancreatic cancer metastasis through inflammatory reprogramming of the tumor microenvironment.Journal of experimental & clinical cancer research : CR · 2024Article
- Risk factor analysis and nomogram development and verification for medullary carcinoma of the colon using SEER database.Scientific reports · 2024Article
- Pathologic Features of Primary Colon, Rectal, and Anal Malignancies.Cancer treatment and research · 2024Review
- Article
- Medullary carcinoma of the duodenum treated with pembrolizumab: a case report.Journal of gastrointestinal oncology · 2023Article
- Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.PloS one · 2023Article
- Cerebral Metastases in Appendiceal Cancer: Comprehensive Review and Report of Rare Medullary Carcinoma Histology.Brain tumor research and treatment · 2022Article
- Diagnostic and Prognostic Roles of CDX2 Immunohistochemical Expression in Colorectal Cancers.Diagnostics (Basel, Switzerland) · 2022Article
- Review
- Sidedness determines clinical characteristics and survival outcomes in medullary adenocarcinoma of the colon.Scientific reports · 2021Article
- Medullary Carcinoma of the Gastrointestinal Tract: Report on Two Cases with Immunohistochemical and Molecular Features.Diagnostics (Basel, Switzerland) · 2021Article
- Advances in Intracellular Calcium Signaling Reveal Untapped Targets for Cancer Therapy.Biomedicines · 2021Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
Undifferentiated or medullary carcinoma is characterized by its distinct histologic appearance and relatively better prognosis compared to poorly differentiated colonic carcinoma. These 2 entities may be difficult to differentiate by light microscopy alone. Only limited immunohistochemical studies investigating medullary carcinoma have been reported. These studies suggest a loss of intestinal differentiation, exemplified by a high percentage of CDX2 negativity. Our aim was to further characterize the immunohistochemical profile of medullary carcinoma, with particular emphasis on intestinal markers. Paraffin blocks from 16 cases of medullary carcinoma and 33 cases of poorly differentiated colonic carcinoma were retrieved, and tissue microarrays were constructed and stained with an immunohistochemical panel including CDX2, CK7, CK20, p53, intestinal trefoil factor 3, chromogranin, synaptophysin, MLH-1, MUC-1, MUC-2, and calretinin. A significantly higher proportion of medullary carcinomas, as opposed to poorly differentiated colonic carcinomas, showed loss of staining for MLH-1 and for the intestinal transcription factor CDX2, in accordance with previous studies. MLH-1 staining was present in only 21% of medullary carcinoma cases compared with 60% of the poorly differentiated colonic carcinoma cases (P = .02), whereas CDX2 was positive in 19% of medullary carcinomas and 55% of poorly differentiated colonic carcinomas (P = .03). Interestingly, calretinin staining was strongly positive in 73% of medullary carcinomas compared to only 12% of poorly differentiated colonic carcinomas (P < .0001). Evidence of intestinal differentiation by MUC-1, MUC-2, and TFF-3 staining was seen in 67%, 60%, and 53% of the medullary carcinomas, respectively. These 3 markers were frequently positive in many of the CDX2-negative medullary carcinoma cases. Medullary carcinoma of the colon retains a significant degree of intestinal differentiation as evidenced by its high percentage of staining for MUC-1, MUC-2, and TFF-3. Calretinin, MLH-1, and CDX2 may help to differentiate medullary carcinoma from poorly differentiated colonic carcinoma of the colon.
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