Department of Pathology, Magee Women's Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15213, USA.
Int J Gynecol Pathol. 2009 Nov;28(6):570-8. doi: 10.1097/PGP.0b013e3181a76fa2.
Ovarian serous papillary carcinoma, although rarely metastasizing to the breast, is often challenging based on morphology alone, particularly from the micropapillary variant of breast carcinoma. Gross cystic disease fluid protein-15, although a specific marker, can be negative in up to 50% of breast carcinomas. Wilm's tumor gene 1 (WT-1) has been identified as a useful marker to differentiate metastatic ovarian serous papillary carcinoma from primary breast carcinoma; however, it has recently been shown in the micropapillary variant of the primary breast carcinoma making it a less specific marker. PAX 2, a nuclear transcription factor, was recently observed in ovarian serous papillary carcinomas. In this study of 89 breast carcinoma cases, 26 micropapillary carcinoma, and 63 nonmicropapillary carcinoma types were retrieved from our pathology archives, represented on a single tissue microarray (TMA) with a 3-fold redundancy (TMA-1, TMA-2). In addition, whole tissue sections of a variety of benign and neoplastic müllerian tissues were surveyed with the PAX 2 immunostain. All cases were stained with rabbit polyclonal PAX 2 antibody and, in addition, the 5 metastatic ovarian serous carcinoma cases were stained with WT-1 as well for comparison. Only nuclear staining was considered positive. All primary breast carcinomas represented on TMA-1 and TMA-2 were entirely negative for PAX 2 100% (89/89), whereas 100% (5/5) of all metastatic ovarian serous carcinomas showed moderate-to-strong staining. PAX 2 expression was comparable with WT-1 as well in the metastatic ovarian serous carcinoma group. We therefore conclude that PAX 2 is a promising new, sensitive, and specific müllerian immunomarker for ovarian serous carcinomas (primary and metastatic).
卵巢浆液性乳头状癌虽然很少转移到乳腺，但仅根据形态学表现常常难以诊断，尤其是对于乳腺微乳头状癌。尽管 gross cystic disease fluid protein-15（GCDFP-15）是一种特异性标志物，但在多达 50%的乳腺癌中可能为阴性。Wilms 肿瘤基因 1（WT-1）已被确定为一种有用的标志物，可用于鉴别转移性卵巢浆液性乳头状癌与原发性乳腺癌；然而，最近在原发性乳腺微乳头状癌中也发现了 WT-1，使其成为一种特异性较低的标志物。PAX2 是一种核转录因子，最近在卵巢浆液性乳头状癌中被观察到。在这项对 89 例乳腺癌病例的研究中，我们从病理档案中检索到 26 例微乳头状癌和 63 例非微乳头状癌类型，并在单个组织微阵列（TMA）上以 3 倍冗余性（TMA-1、TMA-2）表示。此外，还对各种良性和肿瘤性 Müllerian 组织的全组织切片进行了 PAX2 免疫染色。所有病例均用兔多克隆 PAX2 抗体染色，此外，还对 5 例转移性卵巢浆液性癌病例用 WT-1 染色进行比较。只有核染色被认为是阳性的。TMA-1 和 TMA-2 上代表的所有原发性乳腺癌病例的 PAX2 染色均为 100%（89/89）阴性，而所有转移性卵巢浆液性癌病例的染色均为 100%（5/5）中度至强阳性。PAX2 的表达与转移性卵巢浆液性癌组中的 WT-1 相当。因此，我们得出结论，PAX2 是一种有前途的新的、敏感的、特异性的 Müllerian 免疫标志物，可用于卵巢浆液性癌（原发性和转移性）。
