免疫组化在三阴性乳腺癌和高级别浆液性癌鉴别诊断中的应用:新旧标记物。

IF 1.3 4区 医学 Q3 ANATOMY & MORPHOLOGY Applied Immunohistochemistry & Molecular Morphology Pub Date : 2024-11-01 Epub Date: 2024-11-07 DOI:10.1097/PAI.0000000000001232
Pragya Virendrakumar Jain, Mariel Molina, Michelle Moh, Erin Bishop, Janet S Rader, Julie M Jorns
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引用次数: 0

摘要

由于非特异性的形态和免疫组化(IHC)特征,将乳腺转移瘤与乳腺原发癌,尤其是高级别三阴性乳腺癌(TNBC)区分开来具有挑战性。在乳腺转移瘤中,来源于缪勒管的高级别浆液性癌(HGSC)最容易被误诊为 TNBC。我们评估了TNBC和HGSC的乳腺和苗勒氏标记物,包括角蛋白7、角蛋白20、GATA3、GCDFP15、mammaglobin、p53、PAX8(MRQ50和BC12克隆)、TRPS1、SOX10和WT1。在151个TNBC病例中,TRPS1的敏感性最高,在149个病例(98.7%)中均有表达,其次是SOX10(110/151;72.8%)、GATA3(102/151;67.5%)、GCDFP15(29/151;19.2%)和mammaglobin(27/151;17.9%)。40.4%的TNBC(61/151)通过MRQ50克隆检测出PAX8阳性,但通过BC12克隆检测出的PAX8均为阴性。在185例HGSC病例中,通过MRQ50克隆检测的PAX8最敏感(179/185;96.8%),其次是WT1(171/185;92.4%)和通过BC12克隆检测的PAX8(164/185;88.6%)。此外,在 75 例 HGSC(40.5%)中发现了 TRPS1 阳性。64.9%的TNBC(98/151)和94.1%的HGSC(174/185)出现p53模式异常。HGSC中的TRPS1阳性和TNBC中通过MRQ50克隆的PAX8阳性是评估高级别癌的潜在隐患,其鉴别诊断包括TNBC和HGSC。不过,有了这些知识,利用乳腺和苗勒氏管标记物面板,包括优先使用 PAX8 BC12 克隆,可以促进准确诊断。
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Immunohistochemistry in the Differential Diagnosis of Triple Negative Breast Carcinoma and High-grade Serous Carcinoma: Old and New Markers.

Distinction of metastasis to the breast from a breast primary, particularly high-grade triple-negative breast cancer (TNBC), can be challenging due to nonspecific morphology and immunohistochemical (IHC) profiles. Among metastases to the breast, high-grade serous carcinoma (HGSC) of müllerian origin is most likely to be misdiagnosed as TNBC. We assessed breast and müllerian markers on TNBC and HGSC, including keratin 7, keratin 20, GATA3, GCDFP15, mammaglobin, p53, PAX8 (MRQ50 and BC12 clones), TRPS1, SOX10, and WT1. Of 151 TNBC cases, TRPS1 had the highest sensitivity, showing expression in 149 (98.7%) cases, followed by SOX10 (110/151; 72.8%), GATA3 (102/151; 67.5%), GCDFP15 (29/151; 19.2%), and mammaglobin (27/151; 17.9%). PAX8 positivity was seen in 40.4% (61/151) of TNBC via the MRQ50 clone but was negative in all via the BC12 clone. Of 185 HGSC cases, PAX8 via the MRQ50 clone was the most sensitive (179/185; 96.8%), followed by WT1 (171/185; 92.4%) and PAX8 via the BC12 clone (164/185; 88.6%). In addition, TRPS1 positivity was seen in 75 HGSC cases (40.5%). Aberrant p53 patterns were seen in 64.9% (98/151) of TNBC and 94.1% (174/185) of HGSC. TRPS1 positivity in HGSC and PAX8 positivity via the MRQ50 clone in TNBC represent potential pitfalls in assessing high-grade carcinoma for which the differential diagnosis includes TNBC and HGSC. However, with this knowledge, utilization of a panel of breast and müllerian markers, including preferential use of the PAX8 BC12 clone, can facilitate accurate diagnosis.

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来源期刊
Applied Immunohistochemistry & Molecular Morphology
Applied Immunohistochemistry & Molecular Morphology ANATOMY & MORPHOLOGY-MEDICAL LABORATORY TECHNOLOGY
CiteScore
3.20
自引率
0.00%
发文量
153
期刊介绍: ​Applied Immunohistochemistry & Molecular Morphology covers newly developed identification and detection technologies, and their applications in research and diagnosis for the applied immunohistochemist & molecular Morphologist. Official Journal of the International Society for Immunohistochemisty and Molecular Morphology​.
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