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BerEP4 / EpCAM

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 7 November 2014, last major update April 2012
Copyright: (c) 2002-2014, PathologyOutlines.com, Inc.


● Antibody to cell membrane glycoproteins expressed on healthy epithelia and in various carcinomas
● Also known as epithelial cell adhesion molecule, BerEp4 (Ber-EP4, J Clin Pathol 1990;43:213), MOC31 (MOC-31, Acta Neuropathol 1991;83:46), CD326, TACSTD1 protein
● MOC31 and BerEP4 are both anti-EpCAM antibodies, MOC31 appears to be superior (Appl Immunohistochem Mol Morphol 2009;17:202)
● Anti-EpCam antibodies are in clinical trials for patients with cancer (Br J Cancer 2007;96:417)

Uses by pathologists

● Membranous staining
● Sensitive and specific for lung adenocarcinoma (positive) vs. mesothelioma (negative, Am J Surg Pathol 2001;25:43)
● May help distinguish, as part of a panel, hepatocellular carcinoma (usually negative) from metastatic adenocarcinoma to liver or cholangiocarcinoma (usually positive, Mod Pathol 2002;15:1279)
● Immunoexpression may predict poor survival in carcinomas of breast, gallbladder (Am J Clin Pathol 2008;129:424), ovary, pancreas

Micro images

Basaloid squamous cell carcinoma is BerEP4+

Breast: ductal and lobular carcinoma - primary and metastases (EpCAM)

Breast cancer: increased EpCAM expression in metastases

Colon: loss of EPCAM expression in cancers associated with Lynch syndrome caused by heterozygous EPCAM germline deletions

Esophagus: normal and Barrett's metaplasia; gastric mucosa

Ovarian serous carcinoma is MOC31+ (fig E); lung adenocarcinoma is BerEP4+ (fig F)

Unknown site: adenocarcinoma (MOC31)

Cytology images

Reactive mesothelial cells (BerEP4 / MOC31 negative) versus metastatic adenocarcinoma (positive)

Positive staining - normal

● Basolateral surface of epithelial cells

Positive staining - disease

● Most carcinomas (Hum Pathol 2004;35:122, J Clin Pathol 2011;64:415)
● Barrett's metaplasia (J Clin Pathol 2006;59:260)
● Chromophobe renal cell carcinoma (75%), papillary renal cell carcinoma (55%), clear cell renal carcinoma (18%), metastatic renal cell carcinoma (14%, Am J Surg Pathol 2005;29:83
● Synovial sarcoma

Negative staining

● Epidermal keratinocytes, gastric parietal cells, hepatocytes, myoepithelial cells, squamous epithelia, thymic cortical epithelium (Front Biosci 2008;13:3096)
● Lymphoma, mesothelioma, most soft tissue sarcomas
● Adenomatoid tumor; renal oncocytoma

End of Stains > BerEP4 / EpCAM

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