Fernandez-Flores A
Servicio de Anatomía Patologica, Hospital El Bierzo, Ponferrada, Spain;
Rom J Morphol Embryol. 2013;54(3 Suppl):695-9.
Recently, it has been demonstrated how apocrine glands, as well as several cutaneous apocrine tumors, do not express calretinin. In the current report, we studied calretinin immunoexpression in 33 cases of cutaneous metastases of ductal breast carcinoma, as well as in seven primary cutaneous apocrine tumors. We also tested the hormonal status of all cases for estrogen receptors (ER), progesterone receptors (PR), and ERRB2. From the 33 metastases, 26 (78.79%) cases were calretinin-negative and seven cases expressed the marker. Five (15.15%) cases were triple-negative (ER-, PR-, Herceptest-). Of these five cases, three cases were calretinin+ and two cases were calretinin-. Three out of the seven cases that expressed calretinin were triple-negative. From the seven primary cutaneous apocrine tumors, only one showed focal expression of calretinin, and six of them showed a triple-negative immunophenotype. Only the ER+, PR+ case showed morphologic features on an "in situ" apocrine carcinoma. We concluded that our findings support the value of calretinin in the differential diagnosis between a metastasis from breast carcinoma into the skin and a primary cutaneous apocrine carcinoma (CAC), especially in triple-negative cases. However, hormonal markers plus calretinin would not be sufficient to discriminate between both diagnostic possibilities, and they are probably better used when integrated in a wide immunohistochemical panel.
最近，已证实顶泌汗腺以及几种皮肤顶泌汗腺肿瘤不表达钙视网膜蛋白。在本报告中，我们研究了33例乳腺导管癌皮肤转移灶以及7例原发性皮肤顶泌汗腺肿瘤中的钙视网膜蛋白免疫表达情况。我们还检测了所有病例的雌激素受体（ER）、孕激素受体（PR）和ERBB2的激素状态。在33个转移灶中，26例（78.79%）钙视网膜蛋白呈阴性，7例表达该标志物。5例（15.15%）为三阴性（ER-、PR-、Herceptest-）。在这5例中，3例钙视网膜蛋白呈阳性，2例呈阴性。表达钙视网膜蛋白的7例病例中有3例为三阴性。在7例原发性皮肤顶泌汗腺肿瘤中，只有1例显示钙视网膜蛋白局灶性表达，其中6例显示三阴性免疫表型。只有ER+、PR+的病例表现出原位顶泌汗腺癌的形态学特征。我们得出结论，我们的研究结果支持钙视网膜蛋白在鉴别乳腺癌皮肤转移和原发性皮肤顶泌汗腺癌（CAC），尤其是三阴性病例中的价值。然而，激素标志物加钙视网膜蛋白不足以区分这两种诊断可能性，当它们整合到广泛的免疫组化检测组合中时可能会更好地发挥作用。
