51
|
Koh EH, Cho YW, Mun YJ, Ryu JH, Kim EJ, Choi DS, Maeng KY, Han J, Kang D. Upregulation of human mammaglobin reduces migration and invasion of breast cancer cells. Cancer Invest 2013; 32:22-9. [PMID: 24328556 DOI: 10.3109/07357907.2013.861473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Little is known about the biological role of human mammaglobin (hMAM) that is considered as a promising marker for breast cancer. Here, we investigated hMAM's role related to migration and invasion of human breast cancer cells (hBCC). Compared to normal cells, hBCC have high MAM mRNA expression levels. Of the hBCC tested, MAM mRNA expression levels were higher in noninvasive than in invasive cells. Overexpression of hMAM in breast cancer cells decreased migration and invasion, whereas knockdown of hMAM increased both. Taken together, these results suggest that metastasis of hBCC could be controlled by hMAM expression levels.
Collapse
Affiliation(s)
- Eun-Ha Koh
- Departments of 1Physiology, 2Laboratory Medicine, and 3Radiology, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, South Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
52
|
Patel KR, Solomon IH, El-Mofty SK, Lewis JS, Chernock RD. Mammaglobin and S-100 immunoreactivity in salivary gland carcinomas other than mammary analogue secretory carcinoma. Hum Pathol 2013; 44:2501-8. [PMID: 24029710 DOI: 10.1016/j.humpath.2013.06.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/14/2013] [Accepted: 06/21/2013] [Indexed: 11/23/2022]
Abstract
Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland tumor that has morphologic features similar to secretory carcinoma of the breast and that also harbors the same ETV6 translocation. Diffuse mammaglobin and S-100 immunoreactivity are used to differentiate MASC from its morphologic mimics, especially acinic cell carcinoma and adenocarcinoma, not otherwise specified. However, the combination of mammaglobin and S-100 immunoreactivity has not been well studied in other types of salivary gland carcinomas that may have focal areas reminiscent of MASC. Here we evaluated mammaglobin and S-100 immunoreactivity in 15 cases each of polymorphous low-grade adenocarcinoma, adenoid cystic carcinoma and mucoepidermoid carcinoma, and also in 2 cases of adenocarcinoma, not otherwise specified, and 1 mucinous adenocarcinoma. Cases with significant co-expression of mammaglobin and S-100 (moderate or strong immunoreactivity in >25% of tumor cells) were further analyzed by fluorescence in situ hybridization using the ETV6 (12p13) break-apart probe. Nine cases (60%) of polymorphous low-grade adenocarcinoma and two (13.3%) of adenoid cystic carcinoma met the criteria for significant co-expression of mammaglobin and S-100. All were negative for the ETV6 translocation by fluorescence in situ hybridization. Although mammaglobin and S-100 positivity was seen in the majority of polymorphous low-grade adenocarcinomas and a minority of adenoid cystic carcinomas, none were positive for the ETV6 translocation characteristic of MASC. This indicates a need for caution in the use of immunohistochemistry for diagnosing MASC, especially in the absence of cytogenetic confirmation.
Collapse
MESH Headings
- Adenocarcinoma/classification
- Adenocarcinoma/metabolism
- Adenocarcinoma/pathology
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Biopsy
- Breast Neoplasms/classification
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma/classification
- Carcinoma/metabolism
- Carcinoma/pathology
- Carcinoma, Adenoid Cystic/classification
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/classification
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Diagnosis, Differential
- Female
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Male
- Mammaglobin A/metabolism
- Middle Aged
- Proto-Oncogene Proteins c-ets/genetics
- Repressor Proteins/genetics
- S100 Proteins/metabolism
- Salivary Gland Neoplasms/classification
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
- Translocation, Genetic
- Young Adult
- ETS Translocation Variant 6 Protein
Collapse
Affiliation(s)
- Kalyani R Patel
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA
| | | | | | | | | |
Collapse
|
53
|
Mariano FV, dos Santos HT, Azañero WD, da Cunha IW, Coutinho-Camilo CM, de Almeida OP, Kowalski LP, Altemani A. Mammary analogue secretory carcinoma of salivary glands is a lipid-rich tumour, and adipophilin can be valuable in its identification. Histopathology 2013; 63:558-67. [PMID: 23931576 DOI: 10.1111/his.12192] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/15/2013] [Indexed: 01/20/2023]
Abstract
AIMS Mammary analogue secretory carcinoma (MASC) of salivary glands shows morphological similarities to milk-secreting mammary epithelial cells. The aim of this study was to analyse the immunohistochemical expression of adipophilin (a component of milk lipid globule membranes) and of proteins related to secretory mechanisms (STAT5a and mammaglobin) in MASC and other salivary tumours. METHODS AND RESULTS Ten cases of MASC (all with ETV6 translocation) and 83 other salivary carcinomas were studied. In all MASC cases, adipophilin stained numerous large lipid droplets. These droplets were minute in other salivary carcinomas, except for sebaceous carcinoma. Overexpression of STAT5a was detected in all MASC cases, but only occasionally in other carcinomas. Mammaglobin expression occurred frequently in MASC (70% of cases), whereas, in other carcinomas, it was uncommon and limited. Only MASC showed cytoplasmic reactivity for p63, particularly in papillary-cystic areas. Positivity for S100, vimentin and high molecular weight keratin was observed in 100% of MASC cases. CONCLUSIONS MASC is a lipid-rich tumour containing large lipid droplets covered by adipophilin. This finding can be included among its defining immunohistochemical features, and possibly represents lactation-like secretory differentiation. Strong expression of STAT5a and cytoplasmic p63 in MASC reinforces this hypothesis.
Collapse
Affiliation(s)
- Fernanda Viviane Mariano
- Department of Pathology, Medical Sciences Faculty, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
54
|
Bishop JA, Yonescu R, Batista D, Begum S, Eisele DW, Westra WH. Utility of mammaglobin immunohistochemistry as a proxy marker for the ETV6-NTRK3 translocation in the diagnosis of salivary mammary analogue secretory carcinoma. Hum Pathol 2013; 44:1982-8. [PMID: 23773480 DOI: 10.1016/j.humpath.2013.03.017] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/25/2013] [Accepted: 03/28/2013] [Indexed: 01/29/2023]
Abstract
Mammary analogue secretory carcinoma is a recently described salivary gland neoplasm defined by ETV6-NTRK3 gene fusion. Mammary analogue secretory carcinoma's morphology is not entirely specific and overlaps with other salivary gland tumors. Documenting ETV6 rearrangement is confirmatory, but most laboratories are not equipped to perform this test. As mammary analogue secretory carcinomas are positive for mammaglobin, immunohistochemistry could potentially replace molecular testing as a confirmatory test, but the specificity of mammaglobin has not been evaluated across a large and diverse group of salivary gland tumors. One hundred thirty-one salivary gland neoplasms were evaluated by routine microscopy, mammaglobin immunohistochemistry, and ETV6 break-apart fluorescent in situ hybridization. The cases included 15 mammary analogue secretory carcinomas, 44 adenoid cystic carcinomas, 33 pleomorphic adenomas, 18 mucoepidermoid carcinomas, 10 acinic cell carcinomas, 4 adenocarcinomas not otherwise specified, 3 polymorphous low-grade adenocarcinomas, 3 salivary duct carcinomas, and 1 low-grade cribriform cystadenocarcinoma. All 15 mammary analogue secretory carcinomas harbored the ETV6 translocation and were strongly mammaglobin positive. None of the 116 other tumors carried the ETV6 translocation; however, mammaglobin staining was present in 1 (100%) of 1 low-grade cribriform cystadenocarcinoma, 2 (67%) of 3 polymorphous low-grade adenocarcinomas, 2 (67%) of 3 salivary duct carcinomas, 2 (11%) of 18 mucoepidermoid carcinomas, and 2 (6%) of 33 pleomorphic adenomas. Mammaglobin is highly sensitive for mammary analogue secretory carcinoma, but immunostaining can occur in a variety of tumors that do not harbor the ETV6 translocation. Strategic use of mammaglobin immunostaining has a role in the differential diagnosis of salivary gland neoplasms, but it should not be indiscriminately used as a confirmatory test for mammary analogue secretory carcinoma.
Collapse
Affiliation(s)
- Justin A Bishop
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD 21231.
| | | | | | | | | | | |
Collapse
|
55
|
Hagemann IS, Pfeifer JD, Cao D. Mammaglobin expression in gynecologic adenocarcinomas. Hum Pathol 2013; 44:628-35. [DOI: 10.1016/j.humpath.2012.07.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 07/12/2012] [Accepted: 07/18/2012] [Indexed: 12/27/2022]
|
56
|
Luo MH, Huang YH, Ni YB, Tsang JYS, Chan SK, Shao MM, Tse GM. Expression of mammaglobin and gross cystic disease fluid protein-15 in breast carcinomas. Hum Pathol 2013; 44:1241-50. [PMID: 23332923 DOI: 10.1016/j.humpath.2012.10.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/03/2012] [Accepted: 10/10/2012] [Indexed: 01/01/2023]
Abstract
Immunohistochemical analysis of gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin (MGB) is frequently used in routine practice for assessment of metastases or regional recurrences of breast origin. Breast cancer is highly heterogeneous. Expression of these 2 markers in various breast cancer subtypes has not been well studied. In addition, the usefulness of these two markers in combination in detecting breast origin has not been explored. In this study, a large cohort of breast cancers was evaluated for GCDFP-15 and MGB expression, both individually and combined. Their expression was correlated with cancer subtypes, other biomarkers and clinicopathologic parameters. A higher sensitivity for MGB (42.3%) than GCDFP-15 (31.6%) in detecting cancers of breast origin was observed. Combining both increased the sensitivity further, both for primary tumor (53.0%) and for nodal metastases (69.0%). GCDFP-15 was associated significantly with a breast cancer profile of good prognosis tumors, including lower grade (P < .001), pN (P = .029) and Ki-67 (P < .001) as well as negative basal markers expression (P = .043, .009, and .049 for c-Kit, CK5/6 and epidermal growth factor receptor, respectively) and, thus, may not be sensitive for detection of poor prognosis tumors. MGB has the highest expression in HER2-overexpressing cancers (56.6%), and may be a potentially useful marker for this subtype. Nonetheless, both markers showed low expression in the basal like (BLBC) subtype (11.9% and 21.4% for GCDFP-15 and MGB respectively), therefore, the detection of BLBC remains problematic. Negative results need to be interpreted with caution, and correlation with other clinical findings may be required to exclude the possibility of metastatic BLBC.
Collapse
Affiliation(s)
- Ming-Hua Luo
- Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, China 518036
| | | | | | | | | | | | | |
Collapse
|
57
|
Classen-Linke I, Moss S, Gröting K, Beier HM, Alfer J, Krusche CA. Mammaglobin 1: not only a breast-specific and tumour-specific marker, but also a hormone-responsive endometrial protein. Histopathology 2012; 61:955-65. [DOI: 10.1111/j.1365-2559.2012.04290.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
58
|
Huo L, Zhang J, Gilcrease MZ, Gong Y, Wu Y, Zhang H, Resetkova E, Hunt KK, Deavers MT. Gross cystic disease fluid protein-15 and mammaglobin A expression determined by immunohistochemistry is of limited utility in triple-negative breast cancer. Histopathology 2012; 62:267-74. [PMID: 22963676 DOI: 10.1111/j.1365-2559.2012.04344.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS In addition to oestrogen and progesterone receptors, gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin A (MAM) are the most common markers used to identify breast origin by immunohistochemistry. GCDFP-15 expression has been reported in approximately 60% of breast carcinomas and MAM expression in approximately 80%. Data on their expression in triple-negative breast cancer (TNBC) are very limited. The aim of this study was to examine the expression of these markers in TNBC to determine their utility in pathological diagnosis. METHODS AND RESULTS We studied the immunohistochemical (IHC) expression of GCDFP-15 and MAM in 63 primary and 118 metastatic TNBCs. GCDFP-15 staining was present in 14% of primary and 21% of metastatic TNBCs. MAM staining was present in 25% of primary and 41% of metastatic TNBCs. The frequency of expression of GCDFP-15 and/or MAM was 30% in primary and 43% in metastatic TNBCs, and many positive tumours had only focal staining. CONCLUSIONS Staining for GCDFP-15 and/or MAM in triple-negative carcinomas helps to confirm breast origin, but most tumours in this subgroup of breast carcinomas lack expression of either marker.
Collapse
Affiliation(s)
- Lei Huo
- Department of Pathology, The University of Texas MD Anderson Cancer Centre, 1515 Holcombe Blvd., Houston, TX 77030, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
59
|
Ordóñez NG. Application of immunohistochemistry in the diagnosis of epithelioid mesothelioma: a review and update. Hum Pathol 2012; 44:1-19. [PMID: 22963903 DOI: 10.1016/j.humpath.2012.05.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 05/14/2012] [Accepted: 05/16/2012] [Indexed: 01/12/2023]
Abstract
A large number of immunohistochemical markers that can assist in the differential diagnosis of epithelioid mesotheliomas are currently available. Because these markers are expressed differently in the various types of carcinomas that can metastasize to the serosal membranes and can potentially be confused with epithelioid mesothelioma, their selection for inclusion in a diagnostic panel largely depends on the differential diagnosis, as well as on which ones work the best in a given laboratory. Traditionally, the panels used in the differential diagnosis of epithelioid mesothelioma have consisted of a combination of positive mesothelioma markers and broad-spectrum carcinoma markers. At present, a wide variety of organ-associated carcinoma markers such as thyroid transcription factor-1 and napsin A for the lung, PAX 8 and PAX 2 for the kidney, and Müllerian-derived tumors; gross cystic disease fluid protein-15 and mammaglobin for the breast; and CDX2 for intestinal differentiation are available, which can assist in establishing the site of origin of an adenocarcinoma when included in a diagnostic panel. This article provides updated information on the composition of the panels of markers recommended in the various differential diagnoses.
Collapse
Affiliation(s)
- Nelson G Ordóñez
- The University of Texas MD Anderson Cancer Center, Department of Pathology, Houston, TX 77030, USA.
| |
Collapse
|
60
|
Abstract
Breast cancer is a common source of systemic metastatic disease. Distinguishing metastatic breast cancer from other types of malignancies can be diagnostically challenging but is important for correct treatment and prognosis. Nonmammary tumors can also metastasize to the breast, although this is a rare phenomenon. Differentiating a metastasis to the breast from a primary breast cancer can likewise be difficult. Knowledge of the clinical history and careful morphologic evaluation are the cornerstones of diagnosis. A panel of immunohistochemical stains tailored to the differential diagnosis at hand can provide helpful information in ambiguous cases.
Collapse
Affiliation(s)
- Alessandro Bombonati
- Department of Pathology, Thomas Jefferson University Hospitals, Methodist Division, 2301 South Broad Street, Philadelphia, PA 19148, USA
| | - Melinda F Lerwill
- James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Department of Pathology, Harvard Medical School, 25 Shattuck street, Boston, MA 02115, USA.
| |
Collapse
|
61
|
Noriega M, Paesani F, Perazzo F, Lago N, Krupitzki H, Nieto S, Garcia A, Avagnina A, Elsner B, Denninghoff VC. Immunohistochemical characterization of neoplastic cells of breast origin. Diagn Pathol 2012; 7:73. [PMID: 22726568 PMCID: PMC3468373 DOI: 10.1186/1746-1596-7-73] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 06/22/2012] [Indexed: 11/17/2022] Open
Abstract
Background After skin cancer, breast cancer is the most common malignancy in women. Tumors of unknown origin account for 5-15% of malignant neoplasms, with 1.5% being breast cancer. An immunohistochemical panel with conventional and newer markers, such as mammaglobin, was selected for the detection of neoplastic cells of breast origin. The specific objectives are: 1) to determine the sensitivity and specificity of the panel, with a special emphasis on the inclusion of the mammaglobin marker, and 2) to compare immunohistochemistry performed on whole tissue sections and on Tissue Micro-Array. Methods Twenty-nine metastatic breast tumors were included and assumed as tumors of unknown origin. Other 48 biopsies of diverse tissues were selected and assumed as negative controls. Tissue Micro-Array was performed. Immunohistochemistry for mammaglobin, gross cystic disease fluid protein-15, estrogen receptor, progesterone receptor and cytokeratin 7 was done. Results Mammaglobin positive staining was observed in 10/29 cases, in 13/29 cases for gross cystic disease fluid protein-15, in 20/29 cases for estrogen receptor, in 9/29 cases for progesterone receptor, and in 25/29 cases for cytokeratin 7. Among the negative controls, mammaglobin was positive in 2/48, and gross cystic disease fluid protein-15 in 4/48. Conclusions The inclusion of MAG antibody in the immunohistochemical panel for the detection of tumors of unknown origin contributed to the detection of metastasis of breast cancer. The diagnostic strategy with the highest positive predictive value (88%) included hormone receptors and mammaglobin in serial manner. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1366310812718988
Collapse
Affiliation(s)
- Mariadelasmercedes Noriega
- Centro de Educación Medica e Investigaciones Clínicas "Norberto Quirno" (CEMIC), Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
62
|
Vermeulen JF, van Brussel ASA, van der Groep P, Morsink FHM, Bult P, van der Wall E, van Diest PJ. Immunophenotyping invasive breast cancer: paving the road for molecular imaging. BMC Cancer 2012; 12:240. [PMID: 22695343 PMCID: PMC3430576 DOI: 10.1186/1471-2407-12-240] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 05/31/2012] [Indexed: 01/24/2023] Open
Abstract
Background Mammographic population screening in The Netherlands has increased the number of breast cancer patients with small and non-palpable breast tumors. Nevertheless, mammography is not ultimately sensitive and specific for distinct subtypes. Molecular imaging with targeted tracers might increase specificity and sensitivity of detection. Because development of new tracers is labor-intensive and costly, we searched for the smallest panel of tumor membrane markers that would allow detection of the wide spectrum of invasive breast cancers. Methods Tissue microarrays containing 483 invasive breast cancers were stained by immunohistochemistry for a selected set of membrane proteins known to be expressed in breast cancer. Results The combination of highly tumor-specific markers glucose transporter 1 (GLUT1), epidermal growth factor receptor (EGFR), insulin-like growth factor-1 receptor (IGF1-R), human epidermal growth factor receptor 2 (HER2), hepatocyte growth factor receptor (MET), and carbonic anhydrase 9 (CAIX) 'detected' 45.5% of tumors, especially basal/triple negative and HER2-driven ductal cancers. Addition of markers with a 2-fold tumor-to-normal ratio increased the detection rate to 98%. Including only markers with >3 fold tumor-to-normal ratio (CD44v6) resulted in an 80% detection rate. The detection rate of the panel containing both tumor-specific and less tumor-specific markers was not dependent on age, tumor grade, tumor size, or lymph node status. Conclusions In search of the minimal panel of targeted probes needed for the highest possible detection rate, we showed that 80% of all breast cancers express at least one of a panel of membrane markers (CD44v6, GLUT1, EGFR, HER2, and IGF1-R) that may therefore be suitable for molecular imaging strategies. This study thereby serves as a starting point for further development of a set of antibody-based optical tracers with a high breast cancer detection rate.
Collapse
Affiliation(s)
- Jeroen F Vermeulen
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
63
|
Reyes C, Gomez-Fernández C, Nadji M. Metaplastic and medullary mammary carcinomas do not express mammaglobin. Am J Clin Pathol 2012; 137:747-52. [PMID: 22523213 DOI: 10.1309/ajcp5w5sezsehuhe] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Mammaglobin A (MG-A) is purportedly useful for detecting metastatic carcinomas suspected to be of breast origin and has been advocated as a useful marker of micrometastasis in sentinel lymph nodes and minimal residual tumor in bone marrow. Little is known about its expression frequency in histologic subtypes of breast cancer. Excisional biopsy specimens from 1,079 untreated invasive mammary carcinomas were evaluated for immunohistochemical expression of MG-A. In addition to estrogen (ER) and progesterone receptors (PR) and HER2, staining for p63 and HLA-DR was used to further characterize histologic subtypes. Of the carcinomas, 36 were classified as metaplastic (based on morphologic features, ER-/PR-/HER2-, p63+), 38 as medullary (ER-/PR-/HER2-, HLA-DR+), and 1,005 as ductal, no special type (NST). All metaplastic and medullary carcinomas were negative for MG-A. Of 1,005 ductal carcinomas, NST, 492 (49.0%) were MG-A+, 62.0% with a reaction in fewer than 25% of the cells. MG-A immunohistochemical studies failed to detect all medullary and metaplastic cancers and more than 50% of ductal carcinomas, NST. In two thirds of MG-A+ ductal carcinomas, the reaction was only focal and usually in a minority of cells. These findings suggest that MG-A has limited value in identifying the mammary origin of carcinomas, particularly in small biopsy specimens used to detect metastasis or minimal residual disease.
Collapse
|
64
|
Pérez-Montiel D, Serrano-Olvera A, Salazar LC, Cetina-Pérez L, Candelaria M, Coronel J, Montalvo LAH, de León DC. Adenocarcinoma metastatic to the uterine cervix: a case series. J Obstet Gynaecol Res 2012; 38:541-9. [PMID: 22353422 DOI: 10.1111/j.1447-0756.2011.01747.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The objectives of this report are, first, to describe the clinical behavior of cases of carcinoma metastatic to the uterine cervix treated at our institution in order to carry out a systematic review to establish the behavioral patterns of the most frequent metastases to the cervix and, second, to generate guidelines for their diagnosis and treatment. METHODS At the National Institute of Cancer of Mexico (INCan), we performed a review of the clinical files with a diagnosis of malignant neoplasm metastatic to the uterine cervix between 1990 and 2009. For a systematic review, we conducted a PubMed search between the years 1970 and 2009 of case reports and series of cases of patients with metastatic gastric, breast, ovarian and colorectal cancer. We analyzed each report individually and extracted the patients' clinical data from our cases and reports, including the primary tumor, cervical metastases and survival rates. RESULTS There were 10 cases of tumors metastatic to the uterine cervix. Metastasis was documented in one-half of the patients during follow up, with two of these cases having the cervix as the only site. We included the following reports in the systematic review: 13 reports of gastric-associated cancer, 30 related to breast cancer, nine with ovarian-associated cancer and 10 related to colorectal cancer. CONCLUSIONS Metastatic cervical activity is an infrequent event. The prognosis of survival is poor in the presence of gastric or ovarian cancer and cervical metastases.
Collapse
Affiliation(s)
- Delia Pérez-Montiel
- Department of Pathology, National Institute of Cancer of Mexico, Mexico City, Mexico
| | | | | | | | | | | | | | | |
Collapse
|
65
|
Safety of ovarian tissue autotransplantation for cancer patients. Obstet Gynecol Int 2011; 2012:495142. [PMID: 22253631 PMCID: PMC3255286 DOI: 10.1155/2012/495142] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 11/22/2011] [Indexed: 01/01/2023] Open
Abstract
Cancer treatments can induce premature ovarian failure in almost half of young women suffering from invasive neoplasia. Cryopreservation of ovarian cortex and subsequent autotransplantation of frozen-thawed tissue have emerged as promising alternatives to conventional fertility preservation technologies. However, human ovarian tissue is generally harvested before the administration of gonadotoxic treatment and could be contaminated with malignant cells. The safety of autotransplantation of ovarian cortex remains a major concern for fertility preservation units worldwide. This paper discusses the main tools for detecting disseminated cancer cells currently available, their limitations, and clinical relevance.
Collapse
|
66
|
Koyama T, Sekine S, Taniguchi H, Tsuda H, Ikegami M, Hano H, Kushima R. Hepatocyte nuclear factor 4A expression discriminates gastric involvement by metastatic breast carcinomas from primary gastric adenocarcinomas. Hum Pathol 2011; 42:1777-84. [PMID: 21733563 DOI: 10.1016/j.humpath.2011.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Revised: 03/16/2011] [Accepted: 04/06/2011] [Indexed: 01/13/2023]
Abstract
Breast carcinomas sometimes metastasize to the stomach, and the histopathologic distinction of such metastases from primary gastric adenocarcinomas is often difficult. We characterized the clinicopathologic features of 21 breast carcinomas that had metastasized to the stomach and examined the use of a panel of antibodies, including hepatocyte nuclear factor 4A, for distinguishing the metastases from primary gastric diffuse-type adenocarcinomas. Histologically, all the metastatic breast carcinomas showed a poorly differentiated and/or signet ring cell morphology. Although most metastatic breast and primary gastric carcinomas contained signet ring cell components, the cases that were predominantly or exclusively composed of univacuolated-type signet ring cells were limited to metastatic breast carcinomas. Immunohistochemically, hepatocyte nuclear factor 4A was expressed in all 33 primary gastric carcinomas that were examined but was never expressed in metastatic breast carcinomas. Previously reported markers for breast and gastric carcinomas also showed a high specificity, but their sensitivities were quite variable. Estrogen receptor α, progesterone receptor, mammaglobin, and gross cystic disease fluid protein 15 were expressed in 76%, 33%, 52%, and 62%, respectively, of the metastatic breast carcinomas, whereas none of the primary gastric carcinomas expressed these antigens. CDX2, MUC5AC, MUC6, and CK20 were expressed in 36%, 85%, 27%, and 55%, respectively, of the primary gastric carcinomas. All the metastatic breast carcinomas were negative for these antibodies except for 1 case that expressed MUC5AC. Overall, the use of immunohistochemistry efficiently discriminated metastatic breast carcinomas from primary gastric carcinomas. In particular, the present study identified hepatocyte nuclear factor 4A as an excellent marker for differentiating the 2 lesions.
Collapse
Affiliation(s)
- Taiga Koyama
- Pathology and Clinical Laboratory Division, National Cancer Center Hospital, 104-0045 Tokyo, Japan
| | | | | | | | | | | | | |
Collapse
|
67
|
Li G, Zhang J, Jin K, He K, Wang H, Lu H, Teng L. Human mammaglobin: a superior marker for reverse-transcriptase PCR in detecting circulating tumor cells in breast cancer patients. Biomark Med 2011; 5:249-60. [PMID: 21473729 DOI: 10.2217/bmm.11.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Breast cancer is the most frequent cancer in women in the USA and the second most common cause of death in females who develop cancer. Recently, the detection of circulating tumor cells has emerged as a promising tool for monitoring the progression of clinically occult micrometastases in breast cancer patients. Sensitive molecular techniques, primarily based upon the reverse-transcriptase PCR, using various molecules as markers, have been developed to detect circulating tumor cells. Among those molecules, human mammaglobin mRNA has been found to be the most specific marker for the hematogenous spread of breast cancer cells. In this article, we review the current knowledge regarding the use of reverse-transcriptase PCR for detecting human mammaglobin mRNA as a biomarker for circulating tumor cells in breast cancer patients, and evaluate the clinical implications of human mammaglobin since it was first isolated in 1996.
Collapse
Affiliation(s)
- GuangLiang Li
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, China
| | | | | | | | | | | | | |
Collapse
|
68
|
Lewis GH, Subhawong AP, Nassar H, Vang R, Illei PB, Park BH, Argani P. Relationship between molecular subtype of invasive breast carcinoma and expression of gross cystic disease fluid protein 15 and mammaglobin. Am J Clin Pathol 2011; 135:587-91. [PMID: 21411781 DOI: 10.1309/ajcpmfr6oa8ichnh] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We investigated the expression of gross cystic disease fluid protein 15 (GCDFP) and mammaglobin (MGB) by immunohistochemical analysis in 71 invasive breast carcinomas (IBCs) subtyped into luminal (A and B), HER2, basal-like carcinoma (BLC), and unclassified triple-negative carcinoma (UTNC) by established surrogate immunohistochemical profiles. GCDFP and MGB were less likely to be expressed in BLC than in HER2 cancers (P = .000021 and P = .013, respectively) or luminal cancers (P = .00002 and P = .00008, respectively). However, the difference in GCDFP or MGB expression between HER2 and luminal cancers was not significant (P = 1.0 and P = .671, respectively). Our results suggest that luminal cancers demonstrate similar degrees of apocrine differentiation as HER2 cancers. Most BLCs and UTNCs are negative for MGB and GCDFP. Correlation with clinical findings may be needed to exclude the possibility of a metastasis to the breast when BLCs or UTNCs are encountered in a limited sample such as a core biopsy sample.
Collapse
|
69
|
Primary cutaneous apocrine carcinoma versus metastasis, a plea to the dermatopathology community. Am J Dermatopathol 2011; 32:853-4. [PMID: 20431390 DOI: 10.1097/dad.0b013e3181bbc473] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
70
|
Tafreshi NK, Enkemann SA, Bui MM, Lloyd MC, Abrahams D, Huynh AS, Kim J, Grobmyer SR, Carter WB, Vagner J, Gillies RJ, Morse DL. A mammaglobin-A targeting agent for noninvasive detection of breast cancer metastasis in lymph nodes. Cancer Res 2011; 71:1050-9. [PMID: 21169406 PMCID: PMC4130564 DOI: 10.1158/0008-5472.can-10-3091] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pathologic axillary lymph node (ALN) status is an important prognostic factor for staging breast cancer. Currently, status is determined by histopathology following surgical excision of sentinel lymph node(s), which is an invasive, time consuming, and costly procedure with potential morbidity to the patient. Here, we describe an imaging platform for noninvasive assessment of ALN status, eliminating the need for surgical examination of patients to rule out nodal involvement. A targeted imaging probe (MamAb-680) was developed by conjugation of a mammaglobin-A-specific monoclonal antibody to a near-infrared fluorescent dye. Using DNA and tissue microarray, mammaglobin-A was validated as a cell-surface target that is expressed in ALN-positive patient samples but is not expressed in normal lymph nodes. In vivo selectivity was determined by i.v. injection of MamAb-680 into mice with mammaglobin-A-positive and -negative mammary fat pad (MFP) tumors; and by peritumoral MFP injection of the targeted imaging probe in mice with spontaneous ALN metastases. Fluorescence imaging showed that probe was only retained in positive tumors and metastases. As few as 1,000 cells that endogenously express mammaglobin-A were detected in ALN, indicating high sensitivity of this method. Translation of this approach offers considerable potential as a noninvasive clinical strategy to stage breast cancer.
Collapse
Affiliation(s)
- NK Tafreshi
- Dept. Functional & Molecular Imaging, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - SA Enkemann
- Microarray Core Facility, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - MM Bui
- Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Analytic Microscopy Core Facility, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - MC Lloyd
- Analytic Microscopy Core Facility, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - D Abrahams
- Division of Comparative Medicine, University of South Florida, Tampa, FL
| | - AS Huynh
- Dept. Functional & Molecular Imaging, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - J Kim
- Biostatistics Core Facility, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - SR Grobmyer
- Department of Surgery, University of Florida, Gainesville, FL
| | - WB Carter
- Breast Department, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - J Vagner
- BIO5 Institute, University of Arizona, Tucson, AZ
| | - RJ Gillies
- Dept. Functional & Molecular Imaging, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - DL Morse
- Dept. Functional & Molecular Imaging, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| |
Collapse
|
71
|
Koike S, Kodera Y, Nakao A, Iwata H, Yatabe Y. Absence of the caveolin-1 P132L mutation in cancers of the breast and other organs. J Mol Diagn 2010; 12:712-7. [PMID: 20581046 DOI: 10.2353/jmoldx.2010.090180] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Caveolin-1 belongs to a family of scaffolding proteins, and the P132L point mutation of this gene has been found in up to 16% of all examined breast cancers. Subsequent studies have revealed that the P132L mutation exerts a dominant negative effect through misfolding during caveolin-1 oligomerization. However, this mutation has not been validated in other series of breast cancer samples. Contradictory to the suggested tumor suppressor function, overexpression of caveolin-1 is common in various cancer types. To clarify these inconsistent results, we examined the caveolin-1 mutation in a large series of breast cancer specimens. We first used a standard direct sequencing method and found that none of the 99 breast cancers tested had this mutation. Then we developed a sensitive method for a paraffin section that could detect the mutant allele at a rate of as little as 0.1% among wild-type allele copies. Even when using this sensitive method, none of the 80 estrogen receptor-positive breast tumors had the P132L mutation. Furthermore, 270 cancers in various organs were examined, and no caveolin-1 mutations were detected. These results raise doubt about the presence of the caveolin-1 P132L mutation in breast cancer and other cancer types, and thus further studies are warranted.
Collapse
Affiliation(s)
- Shinya Koike
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Chikusa-ku, Nagoya, Japan
| | | | | | | | | |
Collapse
|
72
|
Yang M, Nonaka D. A study of immunohistochemical differential expression in pulmonary and mammary carcinomas. Mod Pathol 2010; 23:654-61. [PMID: 20173733 DOI: 10.1038/modpathol.2010.38] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The risk of developing a second primary cancer is increased in patients with breast cancer, and the lung is one of the major sites involved. Moreover, the lung is the major metastatic site for breast cancers. A distinction between metastatic breast cancer and primary lung cancer can be histologically difficult, and both show an overlapping CK7+/CK20- immunoprofile in a majority of cases. The degree of difficulty increases with poorly differentiated tumors. We investigated differential expressions of TTF-1, Napsin A, surfactant apoprotein A, estrogen receptor, GATA-3, mammaglobin, and GCDFP-15 immunostains in 197 pulmonary carcinomas (158 adenocarcinomas, 39 squamous) and 115 invasive mammary carcinomas (91 ductal, 24 lobular type). In mammary carcinomas, estrogen receptor, GATA-3, mammaglobin, and GCDFP-15 were expressed in 74, 72, 64, and 62%, respectively, whereas TTF-1, Napsin A, and surfactant apoprotein A were all negative. The expressions were diffuse in estrogen receptor and GATA-3, and variable in mammaglobin and GCDFP-15. For a combination of estrogen receptor/mammaglobin or GATA-3/mammaglobin, 83% of mammary carcinomas were positive, and the detection rate was not improved by using all three markers. All lung squamous cell carcinomas were negative for all markers studied. TTF-1, Napsin A, and surfactant apoprotein A were positive in 80, 77, and 45% of pulmonary adenocarcinomas. None of the TTF-1-negative tumors expressed surfactant apoprotein A. GCDFP-15 was focally expressed in 2.5% of pulmonary adenocarcinomas, and estrogen receptor was focally expressed in one case (1.2%) of pulmonary adenocarcinoma. When metastasis from breast cancer is suspected in the lung, a combination of either estrogen receptor/mammaglobin or GATA-3/mammaglobin as breast markers, and a combination of TTF-1 and Napsin A as lung markers may be helpful for differentiating between the two. Caution should be taken in the interpretation of GCDFP-15 due to its occasional expression in pulmonary adenocarcinomas.
Collapse
Affiliation(s)
- Michael Yang
- Department of Pathology, New York University School of Medicine, New York, NY 10016, USA
| | | |
Collapse
|
73
|
Jung J, Ryu T, Hwang Y, Lee E, Lee D. Prediction of extracellular matrix proteins based on distinctive sequence and domain characteristics. J Comput Biol 2010; 17:97-105. [PMID: 20078400 DOI: 10.1089/cmb.2008.0236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Extracellular matrix (ECM) proteins are secreted to the exterior of the cell, and function as mediators between resident cells and the external environment. These proteins not only support cellular structure but also participate in diverse processes, including growth, hormonal response, homeostasis, and disease progression. Despite their importance, current knowledge of the number and functions of ECM proteins is limited. Here, we propose a computational method to predict ECM proteins. Specific features, such as ECM domain score and repetitive residues, were utilized for prediction. Based on previously employed and newly generated features, discriminatory characteristics for ECM protein categorization were determined, which significantly improved the performance of Random Forest and support vector machine (SVM) classification. We additionally predicted novel ECM proteins from non-annotated human proteins, validated with gene ontology and earlier literature. Our novel prediction method is available at biosoft.kaist.ac.kr/ecm.
Collapse
Affiliation(s)
- Juhyun Jung
- Department of Bio and Brain Engineering , KAIST, Daejeon, Korea
| | | | | | | | | |
Collapse
|
74
|
Chia SY, Thike AA, Cheok PY, Tan PH. Utility of mammaglobin and gross cystic disease fluid protein-15 (GCDFP-15) in confirming a breast origin for recurrent tumors. Breast 2010; 19:355-9. [PMID: 20347310 DOI: 10.1016/j.breast.2010.02.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 02/09/2010] [Accepted: 02/18/2010] [Indexed: 11/25/2022] Open
Abstract
There are limited data that compare the utility of immunohistochemical detection of mammaglobin with Gross Cystic Disease Fluid Protein-15 (GCDFP-15) in locally recurrent and metastatic breast cancers. Forty-three local and 72 distant recurrences of breast cancer, 8 metastatic lesions to the breast from other organs, and 30 metastases from non-breast primaries were immunohistochemically stained with mammaglobin and GCDFP-15 antibodies. Mammaglobin was expressed in 55 (47.8%) and GCDFP-15 detected in 13 (11.3%) locally and distantly recurrent breast cancers. A higher percentage of tumor cells was stained with mammaglobin at greater staining intensity than GCDFP-15, for both metastatic and locally recurrent breast cancers. The difference in staining intensity as well as mean percentage of tumor cells stained for both markers was statistically significant (p < 0.005). Metastases to the breast from other organs and metastatic lesions from non-breast primaries were uniformly negative for both mammaglobin and GCDFP-15. Our study demonstrates that immunohistochemical analysis of mammaglobin is superior to GCDFP-15 in detecting a tumor of breast origin, and can be incorporated into immunohistochemical panels evaluating tumors from unknown primary sites.
Collapse
Affiliation(s)
- Shi Yun Chia
- Department of Pathology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore
| | | | | | | |
Collapse
|
75
|
Wei S, Said-Al-Naief N, Hameed O. Estrogen and Progesterone Receptor Expression is not Always Specific for Mammary and Gynecologic Carcinomas. Appl Immunohistochem Mol Morphol 2009; 17:393-402. [DOI: 10.1097/pai.0b013e31819faa07] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
76
|
Vollmer RT. Primary lung cancer vs metastatic breast cancer: a probabilistic approach. Am J Clin Pathol 2009; 132:391-5. [PMID: 19687315 DOI: 10.1309/ajcpdip12iugvrqr] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
In this study, a mathematical and probabilistic model is used to study the probability that a lung tumor is a primary vs a metastasis from cancer of the breast. The model uses information from immunohistochemical stains for thyroid transcription factor (TTF)-1, mammaglobin, p63, and estrogen receptor and epidemiologic data about primary lung and metastatic breast cancers in women. The results demonstrate that these 4 stains can yield nearly certain diagnoses in approximately 80% of tumors falling into the pool of this differential diagnosis. Nevertheless, uncertainty of diagnosis remains for the 19% of tumors in the pool that are negative for TTF-1, mammaglobin, and p63.
Collapse
Affiliation(s)
- Robin T. Vollmer
- Laboratory Medicine, Veterans Affairs and Duke University Medical Centers, Durham, NC
| |
Collapse
|
77
|
Yan Z, Gidley J, Horton D, Roberson J, Eltoum IE, Chhieng DC. Diagnostic utility of mammaglobin and GCDFP-15 in the identification of metastatic breast carcinoma in fluid specimens. Diagn Cytopathol 2009; 37:475-8. [DOI: 10.1002/dc.21039] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
78
|
Sánchez-Serrano M, Novella-Maestre E, Roselló-Sastre E, Camarasa N, Teruel J, Pellicer A. Malignant cells are not found in ovarian cortex from breast cancer patients undergoing ovarian cortex cryopreservation. Hum Reprod 2009; 24:2238-43. [PMID: 19491203 DOI: 10.1093/humrep/dep196] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Breast cancer is a frequent indication for ovarian cortex cryopreservation due to its high incidence. The main concern of this procedure is the possibility of reintroducing metastatic cells within the implant, an issue that has not been addressed systematically. Thus, a study was designed to analyse the presence of ovarian metastases in breast cancer patients undergoing ovarian tissue cryopreservation. METHODS Morphological and immunohistochemical studies following the concept of the sentinel lymph node (SLN) were performed on 100 cortical ovarian biopsies obtained from 63 patients and on six frozen-thawed entire cortex from patients with the diagnosis of infiltrating ductal breast carcinoma undergoing ovarian cortex extraction and cryopreservation. The antibody panel included Cytokeratin CAM 5.2, Gross Cystic Disease Fluid Protein-15 (GCDFP15), Wilms' tumour antigen-1 (WT1) and Mammaglobin 1. RESULTS Employing only morphologic criteria, suspicious neoplastic cells were detected in five biopsies, but in none of the six entire cortex analysed. These five cases were reclassified as hyperplasic surface epithelium-inclusion cysts (CAM 5.2+, WT1+) or apoptotic granulosa cells (CAM 5.2-, GCDFP15+, WT1-). CONCLUSIONS Using the methodology of the SLN our data suggest the absence of tumour cells in biopsies obtained from patients undergoing ovarian cortex cryopreservation to preserve their fertility potential, although future methods of cancer screening may change our perception of this procedure.
Collapse
Affiliation(s)
- María Sánchez-Serrano
- Department of Obstetrics and Gynaecology, Hospital Universitario Dr Peset, Av Gaspar Aguilar 90, 46017 Valencia, Spain
| | | | | | | | | | | |
Collapse
|
79
|
Abstract
The pathologic approach to metastases of unknown primary cancer (UPC) is stepwise and uses the clinical context, morphology, and, where necessary, immunohistochemistry (IHC). This review covers the initial approach to a UPC biopsy; the diagnosis of malignancy and broad tumor typing into carcinoma, melanoma, lymphoma, or sarcoma; and further subtyping of carcinoma into germ cell (broadly included), squamous, neuroendocrine, and solid organ including liver and renal, and adenocarcinomas. Finally, for adenocarcinoma, the prediction of primary tumor site, including lung, pancreas, stomach, colon, ovary, prostate, and breast, is discussed. For each tumor type, the morphologic features are presented alongside established useful IHC markers, with a description of their staining patterns and common diagnostic dilemmas. Optimal tissue handling and IHC interpretation, quality assurance, and limitations also are discussed. The target readership is oncologists, but other clinicians and trainee pathologists also may find the content of use.
Collapse
Affiliation(s)
- Karin A Oien
- Division of Cancer Sciences and Molecular Pathology, Faculty of Medicine, University of Glasgow, United Kingdom.
| |
Collapse
|
80
|
Ceballos P, Ghersevich S. Perspectivas en cáncer de mama: detección de células tumorales circulantes mediante mamaglobina A. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2008. [DOI: 10.1016/s0210-573x(08)75105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
81
|
Ignatiadis M, Kallergi G, Ntoulia M, Perraki M, Apostolaki S, Kafousi M, Chlouverakis G, Stathopoulos E, Lianidou E, Georgoulias V, Mavroudis D. Prognostic value of the molecular detection of circulating tumor cells using a multimarker reverse transcription-PCR assay for cytokeratin 19, mammaglobin A, and HER2 in early breast cancer. Clin Cancer Res 2008; 14:2593-600. [PMID: 18451221 DOI: 10.1158/1078-0432.ccr-07-4758] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the prognostic value of the molecular detection of circulating tumor cells (CTCs) using three markers [cytokeratin 19 (CK19), mammaglobin A (MGB1), and HER2] in early breast cancer. EXPERIMENTAL DESIGN CK19mRNA+, MGB1mRNA+, and HER2mRNA+ cells were detected using real-time (CK19) and nested (MGB1 and HER2) reverse transcription-PCR in the peripheral blood of 175 women with stage I to III breast cancer before the initiation of adjuvant chemotherapy. The detection of CTCs was correlated with clinical outcome. In 10 patients, immunofluorescence staining experiments were done to investigate the coexpression of cytokeratin, MGB1, and HER2 in CTCs. RESULTS CK19mRNA+, MGB1mRNA+, and HER2mRNA+ cells were detected in 41.1%, 8%, and 28.6% of the 175 patients, respectively. Patients had one of the following molecular profiles: CK19mRNA+/MGB1mRNA+/HER2mRNA+ (n = 8), CK19mRNA+/MGB1mRNA+/HER2mRNA- (n = 1), CK19mRNA+/MGB1mRNA-/HER2mRNA+ (n = 42), CK19mRNA+/MGB1mRNA-/HER2mRNA- (n = 21), CK19mRNA-/MGB1mRNA+/HER2mRNA- (n = 5), and CK19mRNA-/MGB1mRNA-/HER2mRNA- (n = 98). Double-immunofluorescence experiments confirmed the following CTC phenotypes: CK+/MGB1+, CK+/MGB1-, CK-/MGB1+, CK+/HER2+, CK+/HER2-, MGB1+/HER2-, and MGB1+/HER2+. In univariate analysis, the detection of CK19mRNA+, MGB1mRNA+, and HER2mRNA+ cells was associated with shorter disease-free survival (DFS; P < 0.001, P = 0.001, and P < 0.001, respectively), whereas the detection of CK19mRNA+ and MGB1mRNA+ cells was associated with worse overall survival (P = 0.044 and 0.034, respectively). In multivariate analysis, estrogen receptor-negative tumors and the detection of CK19mRNA+ and MGB1mRNA+ cells were independently associated with worse DFS. CONCLUSION The detection of peripheral blood CK19mRNA+ and MGB1mRNA+ cells before adjuvant chemotherapy predicts poor DFS in women with early breast cancer.
Collapse
Affiliation(s)
- Michail Ignatiadis
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Crete, Greece.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
82
|
Okasaka T, Usami N, Mitsudomi T, Yatabe Y, Matsuo K, Yokoi K. Stepwise examination for differential diagnosis of primary lung cancer and breast cancer relapse presenting as a solitary pulmonary nodule in patients after mastectomy. J Surg Oncol 2008; 98:510-4. [DOI: 10.1002/jso.21149] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
83
|
|
84
|
Beasley MB. Immunohistochemistry of pulmonary and pleural neoplasia. Arch Pathol Lab Med 2008; 132:1062-72. [PMID: 18605762 DOI: 10.5858/2008-132-1062-iopapn] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT The use of immunohistochemical stains has several applications in the evaluation of pulmonary and pleural neoplasms. The number of available immunohistochemical stains is continually expanding and, although these stains are an important diagnostic adjunct, their use is not without limitations and pitfalls. OBJECTIVE To review and summarize the primary immunohistochemical applications with regard to the most common pulmonary and pleural neoplasms and discuss newly developed markers and common pitfalls. DATA SOURCES Pertinent peer-reviewed literature emphasizing immunohistochemical applications in common lung and pleural tumors, unusual and problematic staining patterns in frequently encountered subtypes/histologic variants, and recently developed immunohistochemical stains of potential promise. CONCLUSIONS Immunohistochemical stains provide the greatest aid in establishing the site of origin of adenocarcinomas encountered in the lung and in separating epithelioid mesothelioma from adenocarcinoma. Certain subtypes of pulmonary adenocarcinomas may exhibit unusual staining patterns that may be potentially problematic. Immunohistochemistry has a more limited role in separating small cell carcinoma from non-small cell carcinoma, and extreme caution must be used in the situation of crushed biopsy specimens.
Collapse
Affiliation(s)
- Mary Beth Beasley
- Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, USA.
| |
Collapse
|
85
|
Mammaglobin Expression in the Female Genital Tract: Immunohistochemical Analysis in Benign and Neoplastic Endocervix and Endometrium. Int J Gynecol Pathol 2008; 27:418-25. [DOI: 10.1097/pgp.0b013e31815d05ec] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
86
|
Jagirdar J. Application of immunohistochemistry to the diagnosis of primary and metastatic carcinoma to the lung. Arch Pathol Lab Med 2008; 132:384-96. [PMID: 18318581 DOI: 10.5858/2008-132-384-aoittd] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2007] [Indexed: 11/06/2022]
Abstract
CONTEXT Immunohistochemistry is a very valuable and often used tool in the differential diagnosis of lung carcinomas whether primary or secondary to the lung. The most useful application is in distinguishing primary lung tumors from metastatic tumors to the lung from common sites (colon, breast, prostate, pancreas, stomach, kidney, bladder, ovaries, and uterus). Immunohistochemistry also aids in the separation of small cell carcinoma from non-small cell carcinoma and carcinoids particularly in small biopsy specimens limited by artifact. Although there is no "lung-specific tumor marker," with the help of a relatively restricted marker, thyroid transcription factor 1, it is possible to separate a lung primary from a metastasis with a reasonable degree of certainty. Another lung-specific marker on the horizon is napsin A, which appears to complement thyroid transcription factor 1 in defining a lung primary. OBJECTIVE To present a practical review and to critique commonly used markers in the differential diagnosis of lung neoplasms and to list valuable immunohistochemical prognostic markers that the pathologist is called on to perform and interpret. DATA SOURCES A comprehensive PubMed data search and personal practical experience. CONCLUSIONS With a panel of immunohistochemical markers, it is possible to distinguish or narrow down most lung neoplasms and separate them into meaningful therapeutic categories. In the future as more proteomic and genomic data surface, immunohistochemical markers to newly discovered antigens may become a routine part of prognostication.
Collapse
Affiliation(s)
- Jaishree Jagirdar
- Department of Pathology, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78230, USA.
| |
Collapse
|
87
|
Bahrami A, Truong LD, Ro JY. Undifferentiated tumor: true identity by immunohistochemistry. Arch Pathol Lab Med 2008; 132:326-48. [PMID: 18318577 DOI: 10.5858/2008-132-326-uttibi] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2007] [Indexed: 11/06/2022]
Abstract
CONTEXT "Undifferentiated tumor" refers to a heterogeneous group of neoplasms with little or no evidence of differentiation on routine light microscopic morphology. OBJECTIVE To identify the true identity of undifferentiated tumors by immunohistochemical analysis. DATA SOURCES Review of the pertinent literature and the authors' experience. CONCLUSIONS For treatment and prognostic evaluation, it is crucial to delineate whether an undifferentiated neoplasm is epithelial, mesenchymal, melanocytic, or hematopoietic in nature. Application of a screening panel to demonstrate the expression of markers of major lineages is fundamental for determination of the broad category of neoplasia. Because poorly differentiated carcinomas and in particular sarcomatoid carcinomas are known to be heterogeneous in their antigen expression, several epithelial markers in combination may be required to establish the carcinomatous nature of tumor. A diagnostic misinterpretation as a consequence of occasional aberrant or unexpected antigen expression is best avoided by using a broad panel that includes both antibodies that are anticipated to be positive and those that are expected to be negative. In this treatise, the immunohistochemical dissection of undifferentiated tumors on the basis of their morphologic features is outlined, supplemented with algorithmic immunohistochemical analysis for each morphologic category of small round cell tumors, carcinomatous tumors, sarcomatous (or sarcoma-like) tumors, and tumors with histologically overlapping features, including hematolymphoid malignancies, melanoma, and sarcomas with epithelioid appearance. The utility of several organ- or tissue-specific markers in the context of undifferentiated tumors is reviewed.
Collapse
Affiliation(s)
- Armita Bahrami
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | | | | |
Collapse
|
88
|
Moritani S, Ichihara S, Hasegawa M, Endo T, Oiwa M, Yoshikawa K, Sato Y, Aoyama H, Hayashi T, Kushima R. Serous papillary adenocarcinoma of the female genital organs and invasive micropapillary carcinoma of the breast. Are WT1, CA125, and GCDFP-15 useful in differential diagnosis? Hum Pathol 2008; 39:666-71. [PMID: 18339419 DOI: 10.1016/j.humpath.2007.09.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 09/08/2007] [Accepted: 09/14/2007] [Indexed: 10/22/2022]
Abstract
Serous papillary adenocarcinoma of the female genital organs and invasive micropapillary carcinoma of the breast have close histologic similarities. Thus, when these cancers occur synchronously or metachronously in the same patient, it is difficult to determine the primary site. We examined 23 serous papillary adenocarcinomas (16 ovarian, 5 endometrial, and 2 peritoneal) and 37 invasive micropapillary carcinomas of the breast (12 pure and 25 mixed types) on immunohistochemical expression of Wilm's tumor antigen-1 (WT1), CA125, and gross cystic disease fluid protein-15 (GCDFP-15), which have been reported to be useful in the differential diagnosis of primary ovarian carcinomas versus metastatic breast cancer to the ovary. The positive rates of WT1, CA125, and GCDFP-15 in serous papillary adenocarcinomas were 78%, 78%, and 0%, respectively, and the corresponding rates in invasive micropapillary carcinomas were 3%, 40%, and 38%. The CA125-positive rate of invasive micropapillary carcinoma was higher than the rate reported for other types of breast carcinomas. We consider CA125 to be not always useful in the differential diagnosis of serous papillary adenocarcinoma and invasive micropapillary carcinoma. Although the positive rate of WT1 was significantly higher in serous papillary adenocarcinoma than in invasive micropapillary carcinoma, WT1 expression in endometrial serous papillary adenocarcinoma was infrequent (20%). WT1 and GCDFP-15 could be useful markers for the differential diagnosis of ovarian and peritoneal serous papillary adenocarcinoma versus breast invasive micropapillary adenocarcinoma. However, the availability of GCDFP-15 is limited because of the low positive rate of GCDFP-15 in invasive micropapillary carcinomas.
Collapse
Affiliation(s)
- Suzuko Moritani
- Department of Pathology and Clinical Laboratories, Nagoya Medical Center, Nagoya, Aichi 460-0001, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
89
|
Takeda Y, Tsuta K, Shibuki Y, Hoshino T, Tochigi N, Maeshima AM, Asamura H, Sasajima Y, Ito T, Matsuno Y. Analysis of expression patterns of breast cancer-specific markers (mammaglobin and gross cystic disease fluid protein 15) in lung and pleural tumors. Arch Pathol Lab Med 2008; 132:239-43. [PMID: 18251583 DOI: 10.5858/2008-132-239-aoepob] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2007] [Indexed: 11/06/2022]
Abstract
CONTEXT The lung is the most common site of metastasis during the natural history of malignant tumors. Breast carcinoma has a propensity for distant metastasis, and the lung and pleura are among the most common metastatic sites. Although it is often difficult to make a clear-cut differential diagnosis between the two, distinguishing primary lung carcinoma from breast carcinoma metastatic to the lung is important because the treatment modalities are different. OBJECTIVE To elucidate the utility of mammaglobin and gross cystic disease fluid protein 15 (GCDFP-15), which are known to be breast-specific antigens, in distinguishing various primary lung and pleural tumors from breast carcinoma metastasizing to the lung. DESIGN A total of 20 cases of breast carcinoma metastatic to the lung and 263 tumors of nonbreast origin located in the lung and pleura were analyzed. RESULTS Of the 20 cases of breast carcinoma metastatic to the lung, 10 (50.0%) were immunoreactive for mammaglobin and 9 (45.0%) for GCDFP-15, the frequency of positivity being slightly higher for the former than for the latter. The area immunopositive for mammaglobin showed more diffuse staining than the area immunopositive for GCDFP-15. Furthermore, the specificity of mammaglobin for breast carcinoma metastatic to the lung was superior (98.9%) to that of GCDFP-15 (91.8%). CONCLUSION The sensitivity of mammaglobin is equal or superior to that of GCDFP-15 for investigation of breast carcinoma. Immunopositivity for mammaglobin is more diffuse than that for GCDFP-15. In terms of practical diagnosis, mammaglobin immunohistochemistry can serve as a differential marker of breast carcinoma and should be added to the immunohistochemical panel.
Collapse
Affiliation(s)
- Yuji Takeda
- Clinical Laboratory Department, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo 104-0045, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
90
|
Viehl CT, Frey DM, Phommaly C, Chen T, Fleming TP, Gillanders WE, Eberlein TJ, Goedegebuure PS. Generation of mammaglobin-A-specific CD4 T cells and identification of candidate CD4 epitopes for breast cancer vaccine strategies. Breast Cancer Res Treat 2007; 109:305-14. [PMID: 17653857 DOI: 10.1007/s10549-007-9657-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Accepted: 06/11/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Mammaglobin-A (MGB) is a breast cancer-associated antigen that is an attractive target for immune intervention. MGB has been shown to induce a specific CD8 T cell response in breast cancer patients, but little is known about a possible MGB-specific CD4 T cell response. METHODS Peripheral blood-derived CD4(+)CD25(-) T cells were stimulated in vitro with MGB-pulsed antigen-presenting cells (APC). The MGB and human leukocyte antigen (HLA) class II specificity of the CD4 T cell lines was confirmed by cytokine release following restimulation with autologous and allogenic APC pulsed with MGB from different sources. Candidate HLA class II-restricted epitopes were identified by computer algorithm and validated in cytokine release assays. RESULTS MGB-specific CD4 T cells were successfully generated in cultures from six of seven donors. Restimulation of MGB-specific CD4 T cells with MGB-pulsed APC induced significantly higher levels of interferon (IFN)-gamma release than APC pulsed with an irrelevant protein (P = 0.0004). Cultures from five of seven donors showed a pure Th1 type response as evidenced by the absence of interleukin (IL)-4. MGB-specific CD4 T cells recognized both recombinant and naturally processed MGB presented by APC. This recognition was HLA class II-restricted, as HLA-DR mismatched APC were not recognized. MGB-specific CD4 T cells from three of four donors recognized MGB-derived, HLA class II-restricted peptides pulsed onto APC. CONCLUSIONS We have successfully generated MGB-specific CD4 T cell cultures and identified candidate MGB HLA class II epitopes. These studies should facilitate study of the CD4 T cell response to MGB, and the development and monitoring of vaccine strategies targeting this unique antigen.
Collapse
Affiliation(s)
- Carsten T Viehl
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | | | | | | | | | | | | |
Collapse
|