Molecular diagnosis of the tissue of origin in cancer of unknown primary site: useful in patient management.

摘要: Cancer of unknown primary site (CUP) is a clinicopathologic syndrome consisting many types cancer and accounting for approximately 3 % all patients with advanced cancers. This has frustrated physicians decades, because or tissue origin not been possible to identify clinically, despite the presence metastatic tumor. Favorable subsets (approximately 20 CUP) presumptive occult have recognized several decades based on clinical standard pathologic features; site-specific therapy in these improves their survival compared majority other 80 %) CUP patients. These patients, most adenocarcinomas, difficult treat was unknown. Broad-spectrum empiric chemotherapy became approach past 30 years. More recently, new diagnostic technology (evolving immunohistochemistry emergent gene-expression profiling) enabled us establish accurately (90 %+) Gene-expression profiling assays complement pathology biopsy specimens origin; studies supported value site-directed therapy. When doubt after examination, gene expression assay frequently diagnostic, outcome improved The era ended favor therapy, precise diagnosis tumor type present each patient.