BerEP4 / EpCAM

Author: Nat Pernick, M.D. (see Authors page)

Revised: 29 October 2015, last major update August 2015

Copyright: (c) 2003-2015,, Inc.

PubMed Search: BerEP4 / EpCAM
Definition / General
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

Images hosted on other servers:

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
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