RÉSUMÉ
AIM: To immunohistochemically evaluate the expression of MAGE-A1, MAGE-A, and NY-ESO-1 cancer/testis (C/T) tumor antigens in medullary breast cancer (MBC) tumor samples and to analyze it in relation to the clinicopathological features. METHODS: This retrospective study included samples from 49 patients: 40 with typical MBC and 9 with atypical MBC. Tumor specimens were obtained from patients operated on in the University Hospital for Tumors and the Sisters of Mercy University Hospital, Zagreb, Croatia, from 1999 to 2005. Standard immunohistochemistry was used on archival paraffin-embedded MBC tissues. RESULTS: MAGE-A1, MAGE-A, and NY-ESO-1 antigens were expressed in 33% (16/49), 33% (16/49), and 22% (11/49) of patients, respectively. No difference between the groups with and without C/T tumor antigen expression in age at diagnosis, tumor size, axillary lymph node metastasis, adjuvant therapy, and HER-2 expression was identified. Significantly more patients died in the MAGE-A-positive group than in the MAGE-A-negative group (P=0.010), whereas a borderline significance was found between MAGE-A1-positive and the MAGE-A1-negative group (P=0.079) and between NY-ESO-1-positive and NY-ESO-1-negative group (P=0.117). Overall survival, as evaluated by the Kaplan-Meier curves, was lower in MAGE-A1- (P=0.031), MAGE-A- (P=0.004), NY-ESO-1-positive groups (P=0.077). CONCLUSION: Expression of C/T antigens may represent a marker of potential prognostic relevance in MBC.
Sujet(s)
Antigènes néoplasiques/analyse , Antigènes/génétique , Antigènes/immunologie , Tumeurs du sein/immunologie , Carcinome médullaire/immunologie , Régulation de l'expression des gènes tumoraux/immunologie , Protéines membranaires/analyse , Protéines tumorales/analyse , Fragments peptidiques/analyse , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Antigènes néoplasiques/génétique , Antigènes néoplasiques/immunologie , Croatie , Femelle , Humains , Immunohistochimie , Protéines membranaires/génétique , Protéines membranaires/immunologie , Adulte d'âge moyen , Protéines tumorales/génétique , Protéines tumorales/immunologie , Fragments peptidiques/génétique , Fragments peptidiques/immunologie , Études rétrospectives , Analyse de survieRÉSUMÉ
AIMS AND BACKGROUND: Recent publications of breast cancer classification based on gene expression profile analyses indicate that medullary breast carcinomas (MBC) may be considered part of the basal-like carcinoma spectrum made up of ER-negative, PR-negative and HER-2-negative cells ("triple-negative phenotype"). On the other hand, there are also data showing that a proportion of MBC and atypical MBC (AMBC) is ER, PR and/or HER-2 positive. Therefore, we have decided to immunohistochemically analyze ER, PR, HER-2 and basal/myoepithelial markers CK 5/6, p63 and EGFR expression in our archival paraffin-embedded MBC and AMBC samples from 48 patients. METHODS: Immunohistochemical evaluation of samples which were derived from patients operated on at our two hospitals between 1999 and 2005. RESULTS: Typical MBC was found in 39 patients and AMBC in 9 patients. The patients ranged in age from 32 to 84 years (median 55). Modified radical mastectomy with axillary dissection was performed in 30/48 patients (63%) while breast segmentectomy with axillary dissection was performed in 18/48 patients (37%). Metastases in axillary lymph nodes were observed in 15/48 patients (31%). ER positivity was present in 3/48 patients (6%), PR positivity in 8/48 (17%), and a positive HER-2 reaction was present in 14/48 patients (29%). CK 5/6 was positive in 20/48, p63 in 24/48 and EGFR in 8/48 patients. Adjuvant therapy was applied in all but 2 patients. Alive were 45/48 (94%) of patients. With the exception of PR expression, 39 patients with typical MBC and 9 patients with AMBC were comparable in the analyzed parameters. Positive HER-2 antigen expression in the analyzed sample was not found to be associated to a statistically significant degree with the MBC or AMBC histological tumor type, tumor size, axillary lymph node metastases, ER and PR status nor with patient survival. CONCLUSIONS: The data from our study seem to be generally comparable with the relatively scarce published data on clinicopathological parameters of MBC and AMBC.
Sujet(s)
Marqueurs biologiques tumoraux/métabolisme , Tumeurs du sein/métabolisme , Carcinome médullaire/métabolisme , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Aisselle/chirurgie , Tumeurs du sein/anatomopathologie , Tumeurs du sein/chirurgie , Carcinome médullaire/secondaire , Carcinome médullaire/chirurgie , Récepteurs ErbB/métabolisme , Récepteur alpha des oestrogènes/métabolisme , Femelle , Humains , Techniques immunoenzymatiques , Kératine-5/métabolisme , Kératine-6/métabolisme , Métastase lymphatique , Mastectomie , Protéines membranaires/métabolisme , Adulte d'âge moyen , Pronostic , Récepteur ErbB-2/métabolisme , Récepteurs à la progestérone/métabolisme , Études rétrospectives , Taux de survieRÉSUMÉ
The report covers the first case of insular thyroid cancer recorded in Croatian medical literature. A 71-year old female patient presented to our hospital with symptoms of inspiratory stridor. Clinical examination disclosed an expansive tumor mass. US guided FNA indicated anaplastic cancer and total thyroidectomy was accordingly indicated. Pathohistological analysis of H/E biopsies disclosed a tumor mass with a characteristic insular growth pattern of monomorphic tumor cells. Immunohistochemical analysis confirmed diagnosis by a diffuse positive reaction to thyreoglobulin, focally to TTF-1, and scant to cytokeratin, while calcitonin, FVIII, CD34 and LCA were clearly negative. P53 and bcl-2 were expressed in 35.9% and 85% of tumor cells, respectively. The proliferation index for Ki-67 was 4.19. According to our survey we suggest a panel of immunohistochemistry for diagnosing insular cancer. Even if partly present, insular cancer should be mentioned in the pathohistological description because of its prognostic meaning.