| 摘要 |
A two-tiered classification system that can be integrated with the current algorithm used by pathologists for identification of the site of origin for 'malignancy with unknown primary ' is presented. In use, morphology, immunohistochemical (IHC) studies, and microarry-based top tier gene expression classifiers first subclassify cytokeratin positive carcinomas into adenocarcinoma, squamous cell carcinoma, neuroendocrine carcinoma and urothelial carcinoma. Subsequently, organ-specific IHC-markers, if available, are used in conjunction with microarray-based second tier gene expression classifiers to assign the primary site of origin to the sample. This new hybrid approach combines IHC with a hierarchy of quantitative gene expression based classifiers into an algorithmic method that can assist pathologists to further refine and support their decision making process.
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