p63 expression in breast cancer - A highly sensitive and specific marker of metoplastic carcinoma
p63 expression in breast cancer - A highly sensitive and specific marker of metoplastic carcinoma
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DOI：
10.1097/01.pas.0000138183.97366.fd
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发表时间：
2004-11-01
影响因子：
5.6
通讯作者：
Kleer, CG
中科院分区：
文献类型：
--
作者：
Koker, MM;Kleer, CG
p63是p53基因家族的成员，参与细胞分化，在正常乳腺导管和小叶的肌上皮细胞的细胞核中表达。尽管 p63 在乳腺癌化生性癌中已有报道，但其在乳腺癌和肉瘤中的表达模式尚未得到充分表征，其潜在的诊断效用尚未确定。在这项研究中，我们测定了大量乳腺癌（包括化生性癌）以及叶状肿瘤和肉瘤中的 p63 表达。我们使用抗 p63 抗体（克隆 4A4，Neomarkers）检查了 189 例浸润性乳腺癌，包括 15 例化生性癌、10 例叶状肿瘤和 5 例纯乳腺肉瘤的 p63 染色模式和强度。 p63 在 15 例化生性癌中的 13 例中强表达（86.7%）。 p63 在所有具有梭形细胞和/或鳞状细胞分化的化生性癌中呈阳性（12 例中的 12 例），并且在 3 例具有软骨病灶的化生性癌中的 I 例中呈阳性。形成鲜明对比的是，174 例非化生性浸润性癌中只有 1 例 (0.6%) p63 呈阳性。所有叶状肿瘤和肉瘤的 p63 表达始终呈阴性。 p63作为化生性癌诊断标志物的敏感性和特异性分别为86.7%和99.4%。我们建议将 p63 作为具有挑战性的乳腺梭形细胞肿瘤诊断检查的一部分，作为化生性癌的高度特异性标志物。
p63, a member of the p53 gene family, is involved in cellular differentiation and is expressed in the nuclei of myoepithelial cells of normal breast ducts and lobules. Although p63 has been reported in metaplastic carcinomas of the breast, its expression pattern in breast carcinomas and sarcomas has not been fully characterized, and its potential diagnostic utility has not been defined. In this study, we determined p63 expression in a large number of breast carcinomas, including metaplastic carcinomas, and in Phyllodes tumors and sarcomas. We examined 189 invasive breast carcinomas, including 15 metaplastic carcinomas, as well as 10 Phyllodes tumors, and 5 pure sarcomas of the breast for pattern and intensity of p63 staining using an anti-p63 antibody (clone 4A4, Neomarkers). p63 was strongly expressed in 13 of 15 metaplastic carcinomas (86.7%). p63 was positive in all the metaplastic carcinomas with spindle cell and/or squamous differentiation (12 of 12), and in I of 3 metaplastic carcinomas with cartilage foci. In stark contrast, only 1 of 174 (0.6%) nonmetaplastic invasive carcinomas was positive for p63. All Phyllodes tumors and sarcomas were consistently negative for p63 expression. The sensitivity and specificity of p63 as a diagnostic marker for metaplastic carcinoma was 86.7% and 99.4%, respectively. We propose the inclusion of p63 as part of the diagnostic workup of challenging spindle cell tumors of the breast as a highly specific marker for metaplastic carcinomas.