Immunohistochemical Markers for Distinguishing Metastatic Breast Carcinoma from Other Common Malignancies: Update and Revisit

Ding, Qingqing; Huo, Lei; Peng, Yan; Yoon, Esther; Şahin, Ayşegül

doi:10.1053/j.semdp.2022.04.002

Cited by 15 publications

(9 citation statements)

References 87 publications

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“…SOX10 was only positive in 2 cases (3.5%). Moreover, SOX10 was negative in five of our six TNBC cases, despite prior reports highlighting its utility in TNBC with a reported sensitivity ranging from 40% to 80% 10,20,30–32 …”

Section: Discussioncontrasting

confidence: 61%

“…Moreover, SOX10 was negative in five of our six TNBC cases, despite prior reports highlighting its utility in TNBC with a reported sensitivity ranging from 40% to 80%. 10,20,[30][31][32] In addition to being less frequently positive than GATA3 in our cohort of MBC, we found that TRPS1 showed more variability in staining intensity and extent. As mentioned in our results, 73.2% of GATA3-positive cases had a CS of 6, while only 23.5% of TRPS1-positive cases showed such strong, diffuse expression.…”

Section: Discussionmentioning

confidence: 57%

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Comparative expression of TRPS1, GATA3, SOX10, mammaglobin, and GCDFP‐15 in effusion specimens with breast carcinoma

Bradt

Jing

Smola

et al. 2023

Diagnostic Cytopathology

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BackgroundTraditional immunohistochemistry (IHC) for breast carcinomas has shown low detection rates of metastatic breast carcinoma (MBC) in effusions. Although GATA3 has enhanced diagnostic accuracy in this realm, its limited utility in detecting triple‐negative breast carcinoma (TNBC) has been highlighted. TRPS1 has been introduced as a potentially sensitive and specific marker in detecting MBC on histologic samples. We investigate the utility of TRPS1 as a marker for MBC in effusion specimens and compare its performance to SOX10, GATA3, mammaglobin (MG), and GCDFP‐15.MethodsA database search identified malignant effusions involved by MBC between 2013 and 2021. Cases from unique patients with sufficient cellularity were evaluated for TRPS1, GATA3, SOX10, MG, and GCDFP‐15 IHC. The intensity and extent of tumor cells (TC) were scored by two pathologists. Any discrepancies were jointly reviewed for consensus.ResultsGATA3 showed the highest rate of positivity (98.2%), followed by TRPS1 (89.5%), MG (43.9%), GCDFP‐15 (21.1%), and SOX10 (3.5%). All GATA3‐positive cases showed intermediate to high expression. Comparatively, TRPS1 showed more variability in staining extent and intensity. In 13 (22.8%) cases, TRPS1 showed extensive background staining of inflammatory and mesothelial cells. Of six TNBCs, GATA3, and TRPS1 were positive in six (100%) and four (66.7%) cases, respectively.ConclusionsWhile TRPS1 shows a lower detection rate for MBC than GATA‐3, using a combination of these markers can enhance effusion cytology's performance in detecting MBC. However, variability in TRPS1 staining intensity and high background TRPS1 staining of inflammatory and mesothelial cells can increase difficulty in its evaluation.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 57%

Comparative expression of TRPS1, GATA3, SOX10, mammaglobin, and GCDFP‐15 in effusion specimens with breast carcinoma

Bradt

Jing

Smola

et al. 2023

Diagnostic Cytopathology

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“…TRPS1 is a recently identi ed breast marker with high sensitivity; however, it has also been found to be positive in 10%-14% of ovarian serous carcinoma (18). Thus, when patients have both breast and ovarian cancer, it can be a great challenge to determine tumor origin (42). In ovarian cancer, SOX17 and PAX8 were co-expressed at intermediate to high levels in 95% of serous, 90% of endometrioid, and 100% of clear cell and transitional cell carcinomas.…”

Section: Discussionmentioning

confidence: 99%

SOX17: a highly sensitive and specific marker for ovarian and endometrial carcinomas

Zhang

Niu

et al. 2022

Preprint

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A major challenge in diagnostic pathology is to identify sensitive and specific markers for tumor origin. Although PAX8 is the most widely used marker for gynecological tumors, it is not entirely specific, which makes it difficult to determine the origin of some tumors with high confidence. Through mining The Cancer Genome Atlas mRNA expression profile data, we identified SOX17 as a potential specific marker at the mRNA level for gynecological tumors. To test SOX17 expression at the protein level, we performed immunochemical staining in a large cohort of ovarian and endometrial cancer cases (n = 402) together with a large cohort of solid tumors from other organs (n = 1269). Similar to PAX8, SOX17 was highly expressed in all subtypes of ovarian carcinoma (97.5% for SOX17 vs. 97% for PAX8 in serous, 90% vs. 90% in endometrioid, and 100% vs. 100% in clear cell and transitional cell types) except for mucinous carcinoma (0% vs 27%), and also highly expressed in endometrial endometrioid carcinoma (88% vs 84%). However, SOX17 was completely negative in thyroid carcinoma and renal cell carcinoma, whereas PAX8 expression was high (86% and 85%, respectively). In addition, SOX17 had no expression in breast carcinoma, lung carcinoma, pancreatic adenocarcinoma, colonic and gastric adenocarcinomas, salivary ductal carcinoma, hepatocellular carcinoma, and cholangiocarcinoma. Our data indicate that SOX17 is not only a sensitive but also a specific marker for the origin of ovarian and endometrial carcinomas.

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“… 21 Biopsy of the metastasis is an essential step to determine the potential origin of the cancer and direct treatment choices. Extensive IHC analysis should be performed in order to narrow the range of diagnostic possibilities using antibodies directed against proteins, such as CK7, CK20, CK8/18, mammaglobin, GCDFP‐15, TRPS1, 22 HER2, ER and PR. 23 However, IHC has occasionally failed to offer an unequivocal diagnosis.…”

Section: Diagnostic Work‐up Of Axillary Lymph Node Metastases Of Carc...mentioning

confidence: 99%

Next‐generation sequencing in breast pathology: real impact on routine practice over a decade since its introduction

Nourieh

Vibert²,

Saint-Ghislain

et al. 2022

Histopathology

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The diagnosis, histomolecular classes of breast cancers (luminal A, luminal B, HER2‐enriched, and basal‐like), and accurate prediction of prognosis are commonly determined using morphological and phenotypical analyses in clinical practice worldwide. Therapeutic strategies are mostly based on the disease stage and molecular subclasses of breast cancer. Targeted therapies, such as anti‐HER2s, poly‐ADP ribose polymerase inhibitors or, to a lesser extent, phosphatidylinositol 3 kinase inhibitors, have substantially improved breast cancer patient prognosis over the past decades. Human epidermal growth factor receptor 2 (HER2) overexpression is widely determined based on immunohistochemistry, while next‐generation sequencing (NGS) is currently employed to assess the presence of molecular alterations, including breast cancer gene 1 (BRCA1) and 2 or phosphatidylinositol‐4,5‐bisphosphate 3‐kinase catalytic subunit alpha (PIK3CA) mutations, which are targets of these new approved therapies. In addition, next‐generation sequencing (NGS) can aid the pathologist in challenging situations, such as a diagnostic workup for a metastatic carcinoma in lymph nodes of unknown origin, differential diagnosis of spindle cell tumourtumor in the breast between metaplastic carcinoma, malignant PT and sarcoma, o, as well as determining relatedness between primary breast cancers and recurrences. NGS offers a powerful tool that enables the pathologist to combine morphological analyses together with molecular alterations in challenging diagnostic situations.

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Immunohistochemical Markers for Distinguishing Metastatic Breast Carcinoma from Other Common Malignancies: Update and Revisit

Cited by 15 publications

References 87 publications

Comparative expression of TRPS1, GATA3, SOX10, mammaglobin, and GCDFP‐15 in effusion specimens with breast carcinoma

Comparative expression of TRPS1, GATA3, SOX10, mammaglobin, and GCDFP‐15 in effusion specimens with breast carcinoma

SOX17: a highly sensitive and specific marker for ovarian and endometrial carcinomas

Next‐generation sequencing in breast pathology: real impact on routine practice over a decade since its introduction

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