We assessed the value of cytokeratin 17 (CK17) expression for the differential diagnosis between primary ovarian mucinous tumors and metastases from the gastrointestinal tract (GIT) and the significance of CK17 expression in a broad spectrum of primary ovarian tumors with respect to their prognosis. The sample set consisted of 554 primary ovarian tumors and 255 GIT tumors. In the primary ovarian tumors, a higher CK17 expression (in > 10% of tumors cells) was present only in 0-11.4% of all tumors (including mucinous tumors, micropapillary serous borderline tumors, clear cell, endometrioid, and high-grade serous carcinomas). The only exception was low-grade serous carcinoma, where higher CK17 expression was present in 24% of cases. Concerning GIT tumors, the higher levels of CK 17 expression (in > 10% of tumor cells) were observed in the upper GIT tumors (68.5% of pancreatic ductal adenocarcinoma, 61.6% of gallbladder adenocarcinoma, and 46% of gastric adenocarcinoma), which differs substantially not only from most of the primary ovarian tumors, but also from colorectal carcinoma (3.7%; p < 0.001). The results of our study suggest that expression of CK17 can potentially be used as an adjunct marker in differential diagnosis between primary ovarian mucinous tumors and metastases from the upper GIT, but not from colorectal carcinoma. However, in GIT tumors, CK17 can be used in the differential diagnosis between adenocarcinomas of the upper and lower GIT. Statistical analysis did not reveal strong association of CK17 expression with clinicopathological variables or patient outcomes in any primary ovarian tumors.

Department of Cellular Pathology Barts Health NHS Trust and Blizard Institute of Core Pathology Queen Mary University of London London UK

Department of Oncological Pathology Masaryk Memorial Cancer Institute Brno Czech Republic

Department of Pathology 3rd Faculty of Medicine Charles University University Hospital Kralovske Vinohrady 10034 Prague Czech Republic

Department of Pathology and Molecular Medicine 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Department of Pathology and Molecular Medicine 3rd Faculty of Medicine Charles University Thomayer Hospital Prague Czech Republic

Department of Pathology Belfast Health and Social Care Trust Belfast UK

Department of Pathology Faculty of Medicine University of Debrecen 4032 Debrecen Hungary

Department of Pathology General Hospital Graz 2 Graz Austria

Department of Pathology Leiden University Medical Center Leiden Netherlands

Department of Pathology Pharmacy Sciences and Technology of Targu Mures University of Medicine Targu Mures Romania

Department of Pathology University Hospital Brno and Medical Faculty Masaryk University Brno Czech Republic

Department of Pathology University of California San Diego San Diego CA USA

Institute of Pathology 1st Faculty of Medicine Charles University and General University Hospital Prague Studničkova 2 12800 Prague 2 Czech Republic

Johannes Kepler University Linz Linz Austria

Šikl's Department of Pathology The Faculty of Medicine and Faculty Hospital in Pilsen Charles University Pilsen Czech Republic

The Fingerland Department of Pathology Charles University Faculty of Medicine in Hradec Králové and University Hospital in Hradec Králové Hradec Králové Czech Republic

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