背景:确定恶性积液细胞学(MEC)标本中的转移性乳腺癌(mBC)至关重要,因为这将决定患者的预后和治疗管理。乳腺癌(BC)与其他肿瘤实体的细胞形态学特征重叠使得非常需要使用敏感和特定的标志物。最近的研究已经报道了1型三尖瓣综合征(TRPS1)作为原发性BC和mBC的敏感和特异性标志物。我们旨在研究TRPS1在mBC及其最常见的诊断模拟物中的表达。
方法:从病理档案中进行回顾性检索,确定了82个MEC。分析了TRPS1在mBC中的表达,并将结果与苗勒起源的转移性癌(mMC)和转移性肺腺癌(mPAC)的结果进行了比较。TRPS1免疫过氧化物酶在细胞自旋或细胞块制剂上进行,并且p<0.05被认为是显著的。
结果:评估TRPS1的核表达并评分为阳性(≥1%的肿瘤细胞)或阴性。在100%(30/30)mBC中可见核TRPS1表达,72%(18/25)mMC,7%(2/27)mPAC。这导致了敏感性,特异性,正预测值,阴性预测值为100%,61%,60%,100%,分别。
结论:TRPS1是mBC的敏感标志物,可以在细胞学标本上可靠地进行。TRPS1表达也在显著比例的mMC中被鉴定,制造潜在的诊断陷阱.因此,使用TRPS1评估mBC的MEC时应谨慎。因此,在这种情况下,应采用免疫过氧化物酶组合。
BACKGROUND: Identifying metastatic breast carcinoma (mBC) in malignant effusion cytology (MEC) specimens is critical, as this will determine the patient\'s prognosis and therapeutic management. Overlapping cytomorphologic features of breast carcinoma (BC) with other neoplastic entities makes the use of sensitive and specific markers highly desirable. Recent studies have reported trichorhinophalangeal syndrome type 1 (TRPS1) as a sensitive and specific marker for primary BC and mBC. We aimed to investigate TRPS1 expression in MEC of mBC and its most common diagnostic mimickers.
METHODS: A retrospective search from the pathology archives identified 82 MEC. TRPS1 expression in mBC was analyzed, and the results were compared to those in metastatic carcinoma of Müllerian origin (mMC) and metastatic pulmonary adenocarcinoma (mPAC). TRPS1 immunoperoxidase was performed on cytospin or cell block preparations, and p < 0.05 was considered significant.
RESULTS: Nuclear expression for TRPS1 was evaluated and scored as positive (≥1% of tumor cells) or negative. Nuclear TRPS1 expression was seen in 100% (30/30) mBC, 72% (18/25) mMC, and 7% (2/27) mPAC. This resulted in sensitivity, specificity, positive predictive value, and negative predictive values of 100%, 61%, 60%, and 100%, respectively.
CONCLUSIONS: TRPS1 is a sensitive marker for mBC and can be reliably performed on cytology specimens. TRPS1 expression was also identified in a significant proportion of mMC, creating a potential diagnostic pitfall. Therefore, caution should be exercised when evaluating MEC of mBC with TRPS1. Consequently, a combination of immunoperoxidase panels should be employed in this setting.