کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
8807493 1606633 2018 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Differentiating breast carcinoma with signet ring features from gastrointestinal signet ring carcinoma: assessment of immunohistochemical markers
ترجمه فارسی عنوان
اختلال کارسینومای پستان با علائم حلقوی مهره از کارسینوم عروق گوارشی: ارزیابی مارکرهای ایمونوهیستوشیمی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی آسیب‌شناسی و فناوری پزشکی
چکیده انگلیسی
Signet ring morphology is recognized throughout the gastrointestinal tract. However, this pattern may be observed in other primary sites giving rise to diagnostic challenges in the work-up of metastases. Relatively newer immunohistochemical markers have not been evaluated in this context. We assessed expression patterns of several common immunohistochemical markers in tumors with Signet ring morphology to delineate a pragmatic approach to this differential diagnosis. Primary breast and gastrointestinal carcinomas showing Signet ring features were reviewed. Non-mammary and non-gastrointestinal tumors with this morphology were included for comparison. Estrogen receptor (ER), progesterone receptor (PR), E-cadherin, CK7, CK20, GCDFP-15, mammaglobin, CDX2, GATA-3, and HepPar-1 immunohistochemistry was performed. Expression patterns were compared between breast and gastrointestinal tumors as well as lobular breast and gastric tumors. Ninety-three cases were identified: 33 breast carcinomas including 13 lobular, 50 gastrointestinal tumors including 23 gastric, and 10 from other sites. ER (sensitivity=81.8%, specificity = 100%, positive predictive value (PPV) = 100%, negative predictive value (NPV) = 89.3%) and GATA-3 (sensitivity = 100%, specificity = 98%, PPV = 96.8%, NPV = 100%) expression were associated with breast origin. CK20 (sensitivity = 66.7%, specificity=93.3%, PPV = 94.1%, NPV = 63.6%) and CDX2 (sensitivity = 72%, specificity = 100%, PPV = 100%, NPV = 68.9%) demonstrated the strongest discriminatory value for gastrointestinal origin. These markers exhibited similar discriminatory characteristics when comparing lobular and gastric signet ring carcinomas. In a limited trial on metastatic breast and gastric cases, these markers successfully discriminated between breast and gastric primary sites in 15 of 16 cases. ER and GATA-3 are most supportive of mammary origin and constitute an effective panel for distinguishing primary breast from primary gastrointestinal Signet ring tumors when combined with CK20 and CDX2 immunohistochemistry.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Human Pathology - Volume 77, July 2018, Pages 11-19
نویسندگان
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