Immunohistochemical expression of Ki-67, p53, and CD10 in phyllodes tumor and their correlation with its histological grade

Abstract

CONTEXT: Phyllodes tumors (PTs) are the fibroepithelial neoplasms of the breast. Histologically, PTs are divided into three subgroups according to their clinicopathological behavior: benign, borderline, and malignant. It is at times difficult to ascertain the grade of PT on morphological criteria alone, especially borderline PT may be at times difficult to distinguish from its benign or malignant counterparts. AIMS: This study was undertaken to evaluate an immunohistochemical panel of Ki-67, p53, and CD10 in PT and to determine their expression in PT in correlation with its grade. SETTINGS AND DESIGN: This was a retrospective study. SUBJECTS AND METHODS: The study included six malignant, six borderline, and twelve benign PT. Expressions of Ki-67, p53, and CD10 were evaluated on all the 12 cases and compared in these three categories. STATISTICAL ANALYSIS USED: Chi-square test was applied, and P < 0.05 was taken as statistically significant. RESULTS: Stromal expression of Ki-67 and p53 between the benign and borderline/malignant group showed a statistically significant difference. Neither CD10 expression nor epithelial expressions of Ki-67 and p53 were found significant. Periepithelial accentuation of Ki-67 and p53 immunostaining was noted in all positive cases. CONCLUSIONS: Ki-67 labeling index and p53 immunostaining can be a useful adjunct to determine the grade in difficult cases. However, no single immunomarker can reliably distinguish between benign and borderline phyllodes in all cases.

Gene Expression Profiling of Fibroepithelial Lesions of the Breast

“…A variety of biomarkers such as Ki-67 and p53 protein expression have been proposed to help with subclassi cation of phyllodes tumors (13,14), and the expression of c-kit (CD117), phospho-histone3, MDM2, ERG, CD31, CD34 have been reported to be predictive of malignant behavior of PT (13,15,16). However, these ancillary studies have not been shown to be independent predictive and prognostic biomarkers (17).…”

Diagnostic difficulties in giant benign phyllodes tumor

“…This fact has been reported in a retrospective study which analyzed the link between the expression of three immunomarkers (Ki67, p53 and CD10) and the HP grade of the PTs. The expression of these markers was evaluated both in the stroma and in the epithelium [ 40 ]. There was a statistically significant difference of the immunomarkers’ expression in the stroma between the three types of PTs, but not in the epithelium.…”

“…Stromal Ki67 labeling index were at least double in malignant phyllodes compared with benign phyllodes. The immunohistochemical evaluation might play an important role in differentiation benign form malignant PTs, thus Ki67 and p53 could be prognostic biomarkers [ 40 , 41 ]. In only four of the revised cases, including our own, immunohistochemical examination was performed on the post-operative specimen and none on the core needle biopsies.…”

Periductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis

“…Additionally, CD10 expression in PT strongly correlates with tumor grade as per the WHO grading system. [14][15][16] Chen et al found that among malignant PT, 75% were positive for KIT% and 67% for SMA. 17 By comparison and similar to this study, in our cohort 75% of the PST were positive for KIT% and 75% were positive for SMA; 100% were positive for CD10.…”