ABSTRACT
BACKGROUND: This meta-analysis presents evidence regarding the diagnostic accuracy of mammaglobin detected using the RT-PCR technique, related to the presence of sentinel node metastasis in breast cancer patients. METHODS: The following databases were consulted: Cochrane, Lilacs, Scielo, Hinary, PubMed, Elsevier, Embase, ProQuest, the Universidad del Rosario´s Centro de Recursos Para el Aprendizaje y la Investigación (CRAI-UR) [Resource Center for Learning and Research], and the Google Scholar search engine. The quality of the studies was assessed using the QUADAS-2 and CASpe tools. The selected studies presented the necessary data to calculate diagnostic validity index of mammaglobin detection using RT-PCR, compared with the reference standard test. Global values for the sensitivity, specificity, positive predictive value, negative predictive value, probability ratios, diagnostic ORs, and summary ROC curves of this meta-analysis were obtained using the Meta-DiSc 1.4 program. RESULTS: Initially, 731 articles were obtained; but only 25 were included in the meta-analysis. Sensitivity was 84% (95% CI: 83% - 86%), and specificity was 92% (95% CI: 91% - 93%). Positive and negative predictive values were 9.26 (95% CI: 6.47-13.26) and 0.17 (95% CI: 0.13-0.23), respectively. The diagnostic OR was 66.34 (95% CI: 42.52-103.52). The predictive area under the sROC curve was 94.78 (Q = 0.8876). CONCLUSIONS: The evaluated diagnostic index showed that the expression of the mammaglobin biomarker has diagnostic prediction for detecting lymph node metastasis in breast cancer patients, when analyzed using RT-PCR, although more than 50% heterogeneity was found.
Subject(s)
Biomarkers, Tumor/metabolism , Breast Neoplasms/metabolism , Lymphatic Metastasis , Mammaglobin A/metabolism , Breast Neoplasms/pathology , Cluster Analysis , Female , Gene Expression Regulation, Neoplastic , Humans , Observational Studies as Topic , Polymerase Chain Reaction , Predictive Value of Tests , Prognosis , ROC Curve , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND: Polymorphous low-grade adenocarcinoma (PLGA) remains a diagnostic challenge for most pathologists due to its large spectrum of histological patterns. In this study, the expression of two new markers recently described for salivary gland tumors was studied in PLGA. METHODS: The morphology of 33 cases of PLGA was carefully evaluated using hematoxylin-and-eosin-stained sections and confirmed by immunohistochemistry for cytokeratin 7, vimentin, and S-100. Periodic acid-Schiff with diastase digestion was also used. The expression of mammaglobin and DOG-1 was carried out using the EnVision System. Mammaglobin was assessed according to the percentage of positively stained tumor cells, while DOG-1 was evaluated according to its presence and site. For MCM-2 and Ki-67, markers of proliferation, the labeling index of cell nuclei positivity was evaluated using total cell number. The ETV6-NTRK3 fusion was examined by fluorescence in situ hybridization analysis. RESULTS: The histological patterns of the tumor were classified as lobular or non-lobular. For the non-lobular pattern, tubular, cribriform, glomeruliform, trabecular, and papillary patterns were observed. Mammaglobin was present in all PLGA cases, and its expression was stronger (P = 0.01) in the lobular than in the non-lobular pattern. The expression of DOG-1 was present in the apical portion and cytoplasm of the cells. Proliferation markers were low for all cases independent of histological pattern. CONCLUSIONS: Polymorphous low-grade adenocarcinoma has been confirmed to originate from the intercalated duct and to feature high expression of mammaglobin in its lobular pattern resembling that of mammary secretory analogue carcinoma, except for the ETV6 gene rearrangement.
Subject(s)
Adenocarcinoma/metabolism , Anoctamin-1/metabolism , Biomarkers, Tumor/metabolism , Mammaglobin A/metabolism , Neoplasm Proteins/metabolism , Salivary Gland Neoplasms/metabolism , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Immunohistochemistry , Male , Middle Aged , Salivary Gland Neoplasms/pathologyABSTRACT
Liver metastasis is common for breast cancer. In breast cancer patients, differentiation between metastasis and intrahepatic cholangiocarcinoma (ICC) is crucial but not always possible, especially when estrogen receptor (ER) is negative. Villin and mammaglobin are gastrointestinal and breast markers, respectively, but were considered not useful in cholangiocarcinoma. The aim of this study was to reevaluate these 2 markers in the differential diagnosis between breast ductal carcinoma and ICC. Fifty-two cases of breast ductal carcinoma (including ER positive and negative, in situ, and invasive carcinomas), 27 cases of ICC, and 19 cases of extrahepatic bile duct adenocarcinoma were retrieved. Immunohistochemical staining for villin and mammaglobin was performed. The results showed that villin was negative in all breast cancers with a specificity of 100%, and positive in all ICCs with a sensitivity of 100%. Its sensitivity in extrahepatic bile duct adenocarcinoma was 63.2%. Mammaglobin was positive in a smaller percentage of breast cancers with no relationship to ER status. Discordant mammaglobin expression among matched invasive, in situ, and metastatic carcinomas of the same patient was common. Mammaglobin was negative in all ICCs with a specificity of 100%, when care was taken not to misinterpret patchy staining in adjacent normal hepatocytes as positive. In conclusion, the data showed that villin expression was highly accurate in the differential diagnosis between ICC and breast ductal carcinoma, which was particularly useful in ER-negative cases. Mammaglobin may be useful when it is positive.