{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:06:26Z","timestamp":1792433186428,"version":"4.5.0"},"reference-count":38,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background.<\/jats:italic>\n                    \u2014Expression of cytokeratins 7 (CK7) and 20 (CK20) may help distinguish the site of origin for metastatic carcinomas. Little is known regarding their expression in biliary tract and pancreatic carcinomas. Our aim was to study the expression of CK7 and CK20 in these tumors.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design.<\/jats:italic>\n                    \u2014Fifty-three carcinomas of the extrahepatic bile ducts (n = 8), ampulla of Vater (n = 7), gallbladder (n = 11), and pancreas (n = 27), were retrieved from the surgical pathology files of the University of Massachusetts Medical Center. Formalin-fixed, paraffin-embedded sections were immunostained with mouse monoclonal antibodies to CK7 and CK20 using an avidin-biotin immunoperoxidase technique with microwave antigen retrieval. The percentage of cells positive for each antibody was assessed on a scale of 0 to 3 (0, &lt;10%; 1+, 10% to 50%; 2+, 51% to 90%; 3+, &gt;90%).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results.<\/jats:italic>\n                    \u2014The majority of carcinomas in all groups were positive for CK7 (CK7+) and negative for CK20 (CK20\u2212). Of the CK7+ tumors, the majority of tumors in each group were 3+ positive.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    \u2014(1) Carcinomas of the extrahepatic biliary tract and pancreas are strongly positive for CK7 and negative for CK20 and can be included in the differential diagnosis of other carcinomas with this profile in metastatic sites. (2) The CK7\/CK20 immunostaining profile will not identify the site of origin for tumors with extensive growth in the porta hepatis region.\n                  <\/jats:p>","DOI":"10.5858\/2000-124-1196-eocaic","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T21:26:29Z","timestamp":1611869189000},"page":"1196-1200","source":"Crossref","is-referenced-by-count":77,"title":["Expression of Cytokeratins 7 and 20 in Carcinomas of the Extrahepatic Biliary Tract, Pancreas, and Gallbladder"],"prefix":"10.5858","volume":"124","author":[{"given":"Jennie V.","family":"Duval","sequence":"first","affiliation":[{"name":"From the Department of Pathology, UMass Memorial Health Care, Worcester, Mass. Dr Duval is now with the Institute of Forensic Sciences, Dallas, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Savas","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, UMass Memorial Health Care, Worcester, Mass. Dr Duval is now with the Institute of Forensic Sciences, Dallas, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara F.","family":"Banner","sequence":"additional","affiliation":[{"name":"Reprints: Barbara F. Banner, MD, Department of Pathology, UMass Memorial Health Care, 55 Lake Ave N, Worcester, MA 01655."},{"name":"From the Department of Pathology, UMass Memorial Health Care, Worcester, Mass. Dr Duval is now with the Institute of Forensic Sciences, Dallas, Tex."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"key":"i1543-2165-124-8-1196-b1","series-title":"J Pathol","first-page":"215","article-title":"A series of 14 new monoclonal antibodies to keratins: characterization and value in diagnostic histopathology.","volume":"164","author":"Bartek, J.","year":"1991","unstructured":"Bartek, J., B.Vojtesek, and Z.Staskova. et al. A series of 14 new monoclonal antibodies to keratins: characterization and value in diagnostic histopathology.J Pathol1991. 164:215\u2013224."},{"key":"i1543-2165-124-8-1196-b2","series-title":"Am J Pathol","first-page":"427","article-title":"Cytokeratin 20 in human carcinomas. A new histodiagnostic marker detected by monoclonal antibodies.","volume":"140","author":"Moll, R.","year":"1992","unstructured":"Moll, R., A.Lowe, J.Laufer, and W. W.Franke. Cytokeratin 20 in human carcinomas. 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A cytokeratin immunohistochemical study of cholestatic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.Histopathology1989. 15:125\u2013135."},{"key":"i1543-2165-124-8-1196-b9","series-title":"Histopathology","first-page":"605","article-title":"A cytokeratin immunohistochemical study of alcoholic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.","volume":"13","author":"van Eyken, P.","year":"1988","unstructured":"van Eyken, P., R.Sciot, and V. J.Desmet. A cytokeratin immunohistochemical study of alcoholic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.Histopathology1988. 13:605\u2013617."},{"key":"i1543-2165-124-8-1196-b10","series-title":"Virchows Arch A","first-page":"63","article-title":"Keratin immunohistochemistry in normal human liver. 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Changes in the distribution of intermediate filament proteins and collagen IV in fetal and adult human pancreas.Histochemistry1991. 96:271\u2013277."},{"key":"i1543-2165-124-8-1196-b12","series-title":"Histopathology","first-page":"35","article-title":"OV-TL 12\/30 (keratin 7 antibody) is a marker of glandular differentiation in lung cancer.","volume":"22","author":"van de Molengraft, F. J.","year":"1993","unstructured":"van de Molengraft, F. J., C. C.van Niekerk, P. H.Jap, and L. G.Poels. OV-TL 12\/30 (keratin 7 antibody) is a marker of glandular differentiation in lung cancer.Histopathology1993. 22:35\u201338."},{"key":"i1543-2165-124-8-1196-b13","series-title":"Am J Surg Pathol","first-page":"698","article-title":"Mucinous cystadenocarcinoma of the breast.","volume":"22","author":"Koenig, C.","year":"1998","unstructured":"Koenig, C. and F. A.Tavassoli. Mucinous cystadenocarcinoma of the breast.Am J Surg Pathol1998. 22:698\u2013703."},{"key":"i1543-2165-124-8-1196-b14","series-title":"Appl Immunohistochem","first-page":"99","article-title":"Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas.","volume":"3","author":"Wang, N. P.","year":"1995","unstructured":"Wang, N. P., S.Zee, R. J.Zarbo, C. E.Bacchi, and A. M.Gown. Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas.Appl Immunohistochem1995. 3:99\u2013107."},{"key":"i1543-2165-124-8-1196-b15","series-title":"Hum Pathol","first-page":"852","article-title":"Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary.","volume":"26","author":"Wauters, C. C. A. P.","year":"1995","unstructured":"Wauters, C. C. A. P., F.Smedts, L. G. M.Gerrits, F. T.Bosman, and F. C. S.Ramaekers. Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary.Hum Pathol1995. 26:852\u2013855."},{"key":"i1543-2165-124-8-1196-b16","series-title":"Path Res Pract","first-page":"488","article-title":"Cytokeratin profiles and mucin secretion in combined hepatocellular-cholangiocarcinoma.","volume":"192","author":"Hauben, E.","year":"1996","unstructured":"Hauben, E., N.Struyf, P.Michielsen, and E.van Marck. Cytokeratin profiles and mucin secretion in combined hepatocellular-cholangiocarcinoma.Path Res Pract1996. 192:488\u2013491."},{"key":"i1543-2165-124-8-1196-b17","series-title":"Am J Clin Pathol","first-page":"257","article-title":"The applicability of a keratin 7 monoclonal antibody in routinely papanicolaou-stained cytologic specimens for the differential diagnosis of carcinomas.","volume":"101","author":"Baars, J. H.","year":"1994","unstructured":"Baars, J. H., J. L. M.De Ruijter, and F.Smedts. et al. The applicability of a keratin 7 monoclonal antibody in routinely papanicolaou-stained cytologic specimens for the differential diagnosis of carcinomas.Am J Clin Pathol1994. 101:257\u2013261."},{"key":"i1543-2165-124-8-1196-b18","series-title":"Mod Pathol","first-page":"384","article-title":"Keratin 20: immunohistochemical marker for gastrointestinal, urothelial, and Merkel cell carcinomas.","volume":"8","author":"Miettinen, M.","year":"1995","unstructured":"Miettinen, M.\n          \n          Keratin 20: immunohistochemical marker for gastrointestinal, urothelial, and Merkel cell carcinomas.\n          Mod Pathol\n          1995. 8:384\u2013388."},{"key":"i1543-2165-124-8-1196-b19","series-title":"Gastroenterology","first-page":"920","article-title":"Retinoic acid receptor regulates growth and differentiation in human pancreatic carcinoma cells.","volume":"113","author":"Kaiser, A.","year":"1997","unstructured":"Kaiser, A., H.Herbst, and G.Fisher. et al. Retinoic acid receptor regulates growth and differentiation in human pancreatic carcinoma cells.Gastroenterology1997. 113:920\u2013929."},{"key":"i1543-2165-124-8-1196-b1","series-title":"J Pathol","first-page":"215","article-title":"A series of 14 new monoclonal antibodies to keratins: characterization and value in diagnostic histopathology.","volume":"164","author":"Bartek, J.","year":"1991","unstructured":"Bartek, J., B.Vojtesek, and Z.Staskova. et al. A series of 14 new monoclonal antibodies to keratins: characterization and value in diagnostic histopathology.J Pathol1991. 164:215\u2013224."},{"key":"i1543-2165-124-8-1196-b2","series-title":"Am J Pathol","first-page":"427","article-title":"Cytokeratin 20 in human carcinomas. A new histodiagnostic marker detected by monoclonal antibodies.","volume":"140","author":"Moll, R.","year":"1992","unstructured":"Moll, R., A.Lowe, J.Laufer, and W. W.Franke. Cytokeratin 20 in human carcinomas. A new histodiagnostic marker detected by monoclonal antibodies.Am J Pathol1992. 140:427\u2013447."},{"key":"i1543-2165-124-8-1196-b3","series-title":"Mod Pathol","first-page":"426","article-title":"Cytokeratins 7 and 20 and carcinoembryonic antigen in ovarian and colonic carcinoma.","volume":"9","author":"Berezowski, K.","year":"1996","unstructured":"Berezowski, K., J. F.Stastny, and M. J.Kornstein. Cytokeratins 7 and 20 and carcinoembryonic antigen in ovarian and colonic carcinoma.Mod Pathol1996. 9:426\u2013429."},{"key":"i1543-2165-124-8-1196-b4","series-title":"Pancreas","first-page":"123","article-title":"Characterization of the cytokeratins of human colonic, pancreatic, and gastric adenocarcinoma cell lines.","volume":"7","author":"Rafiee, P.","year":"1992","unstructured":"Rafiee, P., S. B.Ho, R. S.Bresalier, E. J.Bloom, J. H.Kim, and Y. S.Kim. Characterization of the cytokeratins of human colonic, pancreatic, and gastric adenocarcinoma cell lines.Pancreas1992. 7:123\u2013131."},{"key":"i1543-2165-124-8-1196-b5","series-title":"Virchows Arch B","first-page":"71","article-title":"Evidence for a hepatocellular lineage in a combined hepatocellular-cholangiocarcinoma of transitional type.","volume":"56","author":"Fisher, H. P.","year":"1988","unstructured":"Fisher, H. P., W.Doppl, M.Osborn, and M.Altmannsberger. Evidence for a hepatocellular lineage in a combined hepatocellular-cholangiocarcinoma of transitional type.Virchows Arch B1988. 56:71\u201376."},{"key":"i1543-2165-124-8-1196-b6","series-title":"Hepato-Gastroenterology","first-page":"151","article-title":"Application of keratin immunocytochemistry and sirius red staining in evaluating intrahepatic changes with acute extrahepatic cholestasis due to hepatic duct carcinoma.","volume":"36","author":"James, J.","year":"1989","unstructured":"James, J., N. J.Lygidakis, and P.van Eyken. et al.Application of keratin immunocytochemistry and sirius red staining in evaluating intrahepatic changes with acute extrahepatic cholestasis due to hepatic duct carcinoma.Hepato-Gastroenterology1989. 36:151\u2013155."},{"key":"i1543-2165-124-8-1196-b7","series-title":"Hepatology","first-page":"1586","article-title":"The development of the intrahepatic bile ducts in man: a keratin-immunohistochemical study.","volume":"8","author":"van Eyken, P.","year":"1988","unstructured":"van Eyken, P., R.Sciot, F.Callea, K.van Der Steen, P.Moerman, and V. J.Desmet. The development of the intrahepatic bile ducts in man: a keratin-immunohistochemical study.Hepatology1988. 8:1586\u20131595."},{"key":"i1543-2165-124-8-1196-b8","series-title":"Histopathology","first-page":"125","article-title":"A cytokeratin immunohistochemical study of cholestatic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.","volume":"15","author":"van Eyken, P.","year":"1989","unstructured":"van Eyken, P., R.Sciot, and V. J.Cesmet. A cytokeratin immunohistochemical study of cholestatic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.Histopathology1989. 15:125\u2013135."},{"key":"i1543-2165-124-8-1196-b9","series-title":"Histopathology","first-page":"605","article-title":"A cytokeratin immunohistochemical study of alcoholic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.","volume":"13","author":"van Eyken, P.","year":"1988","unstructured":"van Eyken, P., R.Sciot, and V. J.Desmet. A cytokeratin immunohistochemical study of alcoholic liver disease: evidence that hepatocytes can express \u2018bile duct-type\u2019 cytokeratins.Histopathology1988. 13:605\u2013617."},{"key":"i1543-2165-124-8-1196-b10","series-title":"Virchows Arch A","first-page":"63","article-title":"Keratin immunohistochemistry in normal human liver. 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Mucinous cystadenocarcinoma of the breast.Am J Surg Pathol1998. 22:698\u2013703."},{"key":"i1543-2165-124-8-1196-b14","series-title":"Appl Immunohistochem","first-page":"99","article-title":"Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas.","volume":"3","author":"Wang, N. P.","year":"1995","unstructured":"Wang, N. P., S.Zee, R. J.Zarbo, C. E.Bacchi, and A. M.Gown. Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas.Appl Immunohistochem1995. 3:99\u2013107."},{"key":"i1543-2165-124-8-1196-b15","series-title":"Hum Pathol","first-page":"852","article-title":"Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary.","volume":"26","author":"Wauters, C. C. A. P.","year":"1995","unstructured":"Wauters, C. C. A. P., F.Smedts, L. G. M.Gerrits, F. T.Bosman, and F. C. S.Ramaekers. Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary.Hum Pathol1995. 26:852\u2013855."},{"key":"i1543-2165-124-8-1196-b16","series-title":"Path Res Pract","first-page":"488","article-title":"Cytokeratin profiles and mucin secretion in combined hepatocellular-cholangiocarcinoma.","volume":"192","author":"Hauben, E.","year":"1996","unstructured":"Hauben, E., N.Struyf, P.Michielsen, and E.van Marck. Cytokeratin profiles and mucin secretion in combined hepatocellular-cholangiocarcinoma.Path Res Pract1996. 192:488\u2013491."},{"key":"i1543-2165-124-8-1196-b17","series-title":"Am J Clin Pathol","first-page":"257","article-title":"The applicability of a keratin 7 monoclonal antibody in routinely papanicolaou-stained cytologic specimens for the differential diagnosis of carcinomas.","volume":"101","author":"Baars, J. H.","year":"1994","unstructured":"Baars, J. H., J. L. M.De Ruijter, and F.Smedts. et al. The applicability of a keratin 7 monoclonal antibody in routinely papanicolaou-stained cytologic specimens for the differential diagnosis of carcinomas.Am J Clin Pathol1994. 101:257\u2013261."},{"key":"i1543-2165-124-8-1196-b18","series-title":"Mod Pathol","first-page":"384","article-title":"Keratin 20: immunohistochemical marker for gastrointestinal, urothelial, and Merkel cell carcinomas.","volume":"8","author":"Miettinen, M.","year":"1995","unstructured":"Miettinen, M.\n          \n          Keratin 20: immunohistochemical marker for gastrointestinal, urothelial, and Merkel cell carcinomas.\n          Mod Pathol\n          1995. 8:384\u2013388."},{"key":"i1543-2165-124-8-1196-b19","series-title":"Gastroenterology","first-page":"920","article-title":"Retinoic acid receptor regulates growth and differentiation in human pancreatic carcinoma cells.","volume":"113","author":"Kaiser, A.","year":"1997","unstructured":"Kaiser, A., H.Herbst, and G.Fisher. et al. 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