BerEp4
BerEp4 is a monoclonal antibody that is used as an immunohistochemical stain in pathology. It is specifically directed against epithelial cell adhesion molecule (EpCAM), which is a cell surface protein expressed on most normal epithelial cells and overexpressed in several types of cancer. BerEp4 is utilized in the differential diagnosis of various tumors, particularly in distinguishing between epithelial tumors and non-epithelial tumors.
Clinical Significance
BerEp4 is of significant clinical importance in the diagnosis and research of cancer. It is used to identify cells that express the EpCAM antigen, which includes most carcinomas. This makes BerEp4 a valuable tool in distinguishing carcinomas from other tumors such as melanoma, lymphoma, and sarcoma, which do not typically express EpCAM. For example, in the differential diagnosis of a metastatic carcinoma of unknown primary, BerEp4 can help confirm an epithelial origin of the tumor.
Applications
In the laboratory, BerEp4 is applied to tissue sections in the process of immunohistochemistry. This technique allows pathologists to visualize the presence of EpCAM on the surface of cells within tissue samples, aiding in the diagnosis of various types of cancers. BerEp4 staining is particularly useful in the evaluation of effusions, where the presence of carcinoma cells can be confirmed through positive staining. It is also employed in the study of adenocarcinomas and mesotheliomas, helping to differentiate between these two entities, as mesotheliomas typically do not express EpCAM and thus do not stain with BerEp4.
Limitations
While BerEp4 is a powerful tool in the diagnosis of epithelial tumors, it is not without limitations. The expression of EpCAM can vary among different types of tumors and even within different areas of the same tumor. Therefore, the interpretation of BerEp4 staining should always be performed in conjunction with other diagnostic tests and clinical information. False positives and negatives can occur, and thus, a panel of antibodies is often used in practice to increase diagnostic accuracy.
Conclusion
BerEp4 is an essential immunohistochemical marker in the field of pathology, particularly in the diagnosis and differentiation of epithelial tumors from non-epithelial tumors. Its specificity for EpCAM makes it a valuable tool in the arsenal of diagnostic techniques available to pathologists. However, like all diagnostic tests, BerEp4 staining must be interpreted in the context of a comprehensive diagnostic workup.
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Contributors: Prab R. Tumpati, MD