Stains - deltaNp63

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Stains

deltaNp63 (p40)

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 22 November 2012, last major update January 2012
Copyright: (c) 2012, PathologyOutlines.com, Inc.

General
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● One of 10 p63 isoforms (J Virol 2007;81:11569), important to classify non small cell lung cancer into adenocarcinoma (p40-) versus squamous cell carcinoma (p40+), which determines chemotherapy regimen
● Truncated, nontransactivating isoform highly specific for squamous/basal cells

Terminology
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● Also called ΔNp63, p40
● Note: different from these p40s:
- eukaryotic initiation factor 3 (eIF3-p40) (J Virol 2007;81:11569)
- interleukin 12 / cytokine p40 (J Biol Chem 2011;286:29806) or its antibodies used to treat psoriasis (Semin Cutan Med Surg 2010;29:48)
- lysosomal membrane p40 (Biochem J 2008;414:431)
- phagocyte NADPH oxidase subunit p40 phox (Blood 2009;114:3309)
- Klebsiella pneumoniae Toll-like receptor2 ligand P40 (J Immunother 2009;32:875)
- Lactobacillus casei BL23 (J Mol Microbiol Biotechnol 2010;19:231)
- Mycoplasma p40 (Microbiology 2011;157:473)
- Saccharomyces cerevisiae p40/ARPC1 (J Biol Chem 2010;285:8481)

Clinical features
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● Mutations cause ectrodactyly-ectodermal dysplasia-cleft syndrome, ankyloblepharon-ectodermal dysplasia-clefting syndrome, nonsyndromic split-hand/split-foot malformation (J Cell Sci 2011;124:2200)

Uses by pathologists
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● Classify non-small cell lung carcinoma on small biopsies or cell blocks: adenocarcinoma (deltaNp63- or <2% of cells with weak staining), squamous cell carcinoma (deltaNp63+ [strong] & >50% of cells, TTF1-), adenosquamous (deltaNp63 strong and less than 50%, J Thorac Oncol 2011 Nov 8 [Epub ahead of print])
● May help classify large cell lung carcinoma as part of panel (Am J Clin Pathol 2011;136:773)

Micro images
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Hidradenocarcinoma, metastatic to lymph node

Lung: adenocarcinoma is p40-

Lung: various tumors

Oral preneoplastic lesions (OPL)

Pancreas: various images

Positive staining - normal
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● Breast myoepithelial cells (Am J Surg Pathol 2001;25:1054), cytotrophoblast (Am J Surg Pathol 2004;28:1177), prostate myoepithelial cells

Positive staining - disease
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● Esophagus: precancerous and cancerous squamous lesions (Hum Pathol 2003;34:850)
● Lung: squamous cell carcinomas (100%)
● Salivary gland: adenoid cystic, mucoepidermoid, myoepithelial carcinomas (Hum Pathol 2005;36:821)

Negative staining
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● Normal pancreatic ducts (Mod Pathol 2005;18:1193)
● Lung: adenocarcinoma (5% are positive, but in <5% of cells, Mod Pathol 2012;25:405)
● Lymphoma: large cell
● Pancreas: squamous differentiation (Mod Pathol 2005;18:1193)

End of Stains > deltaNp63 (p40)

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