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[The initial CUP situation and CUP syndrome: pathological diagnostics].

¹Institut für Pathologie, Philipps-Universität Marburg und Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Baldingerstr, 35033 Marburg. mollr@med.uni-marburg.de

|October 10, 2009

Summary

Immunohistochemistry aids in identifying the primary tumor in cancer of unknown primary (site) (CUP) cases. However, true CUP syndrome often presents anomalies, highlighting the need for further research into tumor biology and novel therapies.

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Area of Science:

Oncology
Histopathology
Diagnostic Pathology

Context:

Cancer of Unknown Primary (CUP) presents diagnostic challenges in histopathology.
Immunohistochemistry (IHC) is a cost-efficient tool for initial CUP investigation.
True CUP syndrome is heterogeneous, poorly understood, with often anomalous marker profiles.

Purpose:

To evaluate the role of immunohistochemistry in the diagnostic algorithm for Cancer of Unknown Primary (CUP).
To highlight the utility of IHC in phenotypical classification and identifying therapy-responsive subsets within CUP.
To discuss the limitations of current methods and the need for further research into CUP etiology and treatment.

Summary:

Immunohistochemistry, particularly a two-step algorithm involving keratins and selective markers, is crucial in the initial assessment of CUP.
While IHC can identify primary tumors and classify CUP, it rarely identifies the primary site in true CUP syndrome.
Gene expression profiling is a novel approach for CUP subtyping requiring further validation; IHC remains vital for current clinical practice.

Impact:

Immunohistochemistry remains the most important special method for phenotypical classification and identifying favorable subsets in CUP.
Further research is essential to understand CUP biology and improve the prognosis through novel therapeutic strategies.
Novel methods like gene expression profiling need evaluation for potential diagnostic application in CUP.