Tse Gary M, Tan Puay-Hoon, Chaiwun Benjaporn, Putti Thomas C, Lui Philip C W, Tsang Alex K H, Wong Fiona C L, Lo Anthony W I
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Chinese University of Hong Kong.
Pathology. 2006 Feb;38(1):16-20. doi: 10.1080/00313020500444625.
p63 has been recently reported to be expressed in sarcomatoid/metaplastic carcinoma of the breast, in addition to its role as a myoepithelial marker. A large series of 34 metaplastic carcinomas, including cases with pure epithelial component (squamous cell and adenosquamous carcinomas), biphasic tumours with carcinomatous and sarcomatoid components and monophasic tumours with only spindle cell component, were evaluated for p63 expression with respect to the different cellular components.
All of the metaplastic carcinomas were assessed for p63 and conventional epithelial and mesenchymal markers of AE1/3, CAM5.2 and vimentin by immunohistochemistry.
All of the different categories of metaplastic carcinomas showed similar clinico-pathological features (patient age, tumour size, nuclear grade, mitotic activity, lymph node status and hormonal receptor status). For metaplastic carcinoma with epithelial component only, p63 was only expressed in the squamous cell component, but not the adenocarcinoma component. Eight of the 10 tumours were positive for p63. For the tumours with sarcomatoid component, either singly or together with carcinomatous component, p63 was positive in 14 of 24 cases. Pure sarcomas and carcinomas were all negative for p63 staining by immunohistochemistry, thus rendering p63 staining highly specific for diagnosing metaplastic carcinoma.
Using p63 for diagnosis of metaplastic carcinoma gives a sensitivity of 65%, a specificity of 96%, a positive predictive value of 96%, and a negative predictive value of 66% and an accuracy of 78%. p63 may be used as an adjunct marker in the diagnosis of metaplastic carcinoma.
最近有报道称，p63除了作为肌上皮标志物外，还在乳腺肉瘤样/化生癌中表达。本研究对34例大样本化生癌进行评估，这些化生癌包括纯上皮成分（鳞状细胞癌和腺鳞癌）、具有癌性和肉瘤样成分的双相肿瘤以及仅具有梭形细胞成分的单相肿瘤，以研究p63在不同细胞成分中的表达情况。
通过免疫组织化学对所有化生癌进行p63以及传统上皮和间充质标志物AE1/3、CAM5.2和波形蛋白的评估。
所有不同类型的化生癌均表现出相似的临床病理特征（患者年龄、肿瘤大小、核分级、有丝分裂活性、淋巴结状态和激素受体状态）。对于仅具有上皮成分的化生癌，p63仅在鳞状细胞成分中表达，而腺癌成分中不表达。10例肿瘤中有8例p63呈阳性。对于具有肉瘤样成分的肿瘤，无论是单独存在还是与癌性成分同时存在，24例中有14例p63呈阳性。纯肉瘤和癌通过免疫组织化学p63染色均为阴性，因此p63染色对诊断化生癌具有高度特异性。
使用p63诊断化生癌的敏感性为65%，特异性为96%，阳性预测值为96%，阴性预测值为66%，准确性为78%。p63可作为化生癌诊断的辅助标志物。
