Lee A H S, Paish E C, Marchio C, Sapino A, Schmitt F C, Ellis I O, Reis-Filho J S
Department of Histopathology, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK.
Histopathology. 2007 Dec;51(6):824-8. doi: 10.1111/j.1365-2559.2007.02884.x.
Metastases from ovarian serous papillary carcinoma to the breast and primary invasive micropapillary carcinoma of the breast are histologically similar. The distinction is clinically important to ensure appropriate management. Wilms' tumour-1 (WT1) and Ca125 are frequently expressed in serous papillary carcinomas, and uncommonly in unselected mammary carcinomas. One previous study found Ca125 expression in 69% of invasive micropapillary carcinomas. The aim was to assess the frequency of expression of WT1 and Ca125 in invasive micropapillary carcinoma.
Twenty-five of 34 invasive micropapillary carcinomas showed no nuclear expression of WT1. The remaining nine tumours showed weak to moderate immunoreactivity in 1-10% of nuclei. Six of these nine tumours also contained ductal carcinoma in situ, which expressed WT1 in five of the six. Membranous or cytoplasmic expression of Ca125 was found in seven tumours.
Nuclear WT1 expression is present in a minority of invasive micropapillary carcinomas and, when present, expression is focal. The frequency of expression of Ca125 was similar to the results in unselected mammary carcinoma. Thus, these markers are useful members of the immunohistochemical panel for the distinction of mammary invasive micropapillary carcinoma from ovarian serous papillary carcinoma.
卵巢浆液性乳头状癌转移至乳腺与乳腺原发性浸润性微乳头状癌在组织学上相似。这种区分对于确保恰当的治疗管理在临床上很重要。威尔姆斯瘤-1（WT1）和癌抗原125（Ca125）在浆液性乳头状癌中经常表达，而在未经选择的乳腺癌中不常见。一项既往研究发现69%的浸润性微乳头状癌中有Ca125表达。目的是评估WT1和Ca125在浸润性微乳头状癌中的表达频率。
34例浸润性微乳头状癌中有25例未显示WT1的核表达。其余9个肿瘤在1%至10%的细胞核中显示弱至中度免疫反应性。这9个肿瘤中有6个还包含原位导管癌，其中6个中的5个原位导管癌表达WT1。7个肿瘤中发现有Ca125的膜性或细胞质表达。
少数浸润性微乳头状癌存在核WT1表达，且一旦存在，表达呈局灶性。Ca125的表达频率与未经选择的乳腺癌的结果相似。因此，这些标志物是免疫组织化学检测组中用于区分乳腺浸润性微乳头状癌与卵巢浆液性乳头状癌的有用成员。
