Evidence map›Paper›PMID 40970686›Full record

ArticleHistopathology2026

A 5-marker immunohistochemical panel of CK17, MEP1A, PAX8, SMAD4, and CDX2 to distinguish ovarian mucinous carcinoma from metastatic pancreatic ductal adenocarcinoma.

Astrid De Boeck, Eun Young Kang, Nicola S Meagher, Kylie L Gorringe, Cheng Han Lee, Parham Minoo, Martin Köbel

Abstract read
In one paragraph

Article in Histopathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Astrid De BoeckDepartment of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
Eun Young KangDepartment of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
Nicola S MeagherSchool of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-9134-2118
Kylie L GorringePeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-5681-2022
Cheng Han LeeDepartment of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada.ORCID https://orcid.org/0000-0003-2094-1222
Parham MinooDepartment of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
Martin KöbelDepartment of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID https://orcid.org/0000-0002-6615-2037

Funding

Alberte Precision Laboratory Internal Research RS20-602Cancer Institute NSW Early Career Fellowship 2024/ECF 2024/1005Ovarian Cancer Research Alliance MIG-2025-2-1954
6 · The paper itself

Abstract

aimsMetastatic pancreatic adenocarcinoma (PDAC), albeit uncommon, may involve the ovary, and distinction from primary ovarian mucinous tumours (OMT) poses a diagnostic challenge. Our aim was to develop an ancillary immunohistochemical (IHC) panel to aid in diagnosis and to validate the morphological features of metastatic PDAC. METHODS AND

resultsSix IHC markers (CDX2, CK17, MEP1A, MUC2, PAX8, SMAD4) selected based on a literature review were stained on tissue microarrays containing 256 PDAC, 102 mucinous ovarian carcinomas (MC) and 58 mucinous borderline ovarian tumours (MBOT). Detailed morphological features were reviewed in 16 ovarian metastases from PDAC, 25 MC, and 9 MBOT. We confirmed that tumours with a size less than 13 cm, bilaterality, ovarian surface involvement, low-power nodularity, infiltrative invasion, pseudomyxoma ovarii despite cystadenoma or borderline areas, and moderate nuclear atypia should raise suspicion for metastatic PDAC and prompt evaluation with the recommended IHC panel. A 5-marker panel consisting of CK17, MEP1A, PAX8, SMAD4, and CDX2 had an overall accuracy of 91.8% (95% CI 88.8%-94.3%) using recursive partitioning, with the highest weight resting on CK17. CK17 was expressed in 80.9% of PDAC compared to 18.6% of MC and 1.7% of MBOT, respectively.

conclusionsThis is the first ancillary IHC panel to distinguish between PDAC and OMT with high accuracy. These results inform further studies on diagnostic workflows tailored to the complexity of metastatic presentations of tumours at the ovary.

Indexed as

Adenocarcinoma, MucinousBiomarkers, TumorCarcinoma, Pancreatic DuctalOvarian NeoplasmsPancreatic NeoplasmsAdultAgedAged, 80 and overCDX2 Transcription FactorDiagnosis, DifferentialFemaleHumansImmunohistochemistryKeratin-17Middle AgedPAX8 Transcription FactorBiomarkers, TumorCDX2 protein, humanCDX2 Transcription FactorKeratin-17PAX8 protein, humanPAX8 Transcription FactorSmad4 ProteinSMAD4 protein, humanCK17MEP1Ametastatic pancreatic adenocarcinomamucinous borderline tumourovarian mucinous carcinomaSMAD4

Identifiers

PMID40970686
PMCPMC12703427

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