Sailer Verena, Lüders Christine, Kuhn Walther, Pelzer Volker, Kristiansen Glen
Institute of Pathology, University of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany,
Virchows Arch. 2015 Jul;467(1):67-70. doi: 10.1007/s00428-015-1766-z. Epub 2015 Apr 8.
As a result of breast cancer screening programs, high-grade ductal carcinoma in situ (DCIS) of the breast is diagnosed more often. Frequently, a DCIS diagnosis can only be made using immunohistochemical stains to visualize the myoepithelial layer in order to assess microinvasion. Standard markers for myoepithelial cells are CK5/6 and p63. An isoform of the latter, ∆Np63, is recognized by a recently developed antibody, p40. Here, we compare the standard myoepithelial markers CK5/6 and p63 with p40. We immunostained full sections of tissue samples of 35 high-grade DCIS and compared the staining pattern of CK5/6, p63 and p40 in tumour tissue and in normal glands. Staining patterns of myoepithelial cells for p63 and p40 were similar in terms of the percentage of stained nuclei. In all cases, p63 was strongly expressed, while this was the case for p40 in 31 (89%) and moderately in 4 (11%) cases. All but one case (97%) showed a similar percentage of stained myoepithelial cells in comparing CK5/6 and p40 staining. CK5/6 expression was heterogeneous and strong/moderate/weak in 60, 34 and 6 % respectively. Compared to surrounding normal glands, staining of myoepithelial cells for all three markers in the neoplastic lesion was attenuated. In high-grade DCIS, p40 staining is highly specific for myoepithelial cells. Its staining pattern and intensity are equal to p63, which opens up its use for daily practice. Staining with p40 is less heterogeneous than that for CK5/6.
由于乳腺癌筛查项目，乳腺高级别导管原位癌（DCIS）的诊断更为常见。通常，DCIS的诊断只能通过免疫组化染色来观察肌上皮层，以评估微浸润情况。肌上皮细胞的标准标志物是CK5/6和p63。后者的一种异构体∆Np63可被一种新开发的抗体p40识别。在此，我们将标准的肌上皮标志物CK5/6和p63与p40进行比较。我们对35例高级别DCIS组织样本的全切片进行免疫染色，并比较了肿瘤组织和正常腺体中CK5/6、p63和p40的染色模式。就染色细胞核的百分比而言，p63和p40的肌上皮细胞染色模式相似。在所有病例中，p63均强烈表达，而p40在31例（89%）中强烈表达，4例（11%）中中度表达。除1例（97%）外，在比较CK5/6和p40染色时，所有病例的肌上皮细胞染色百分比相似。CK5/6的表达具有异质性，分别在60%、34%和6%的病例中呈强/中/弱表达。与周围正常腺体相比，肿瘤病变中所有三种标志物的肌上皮细胞染色均减弱。在高级别DCIS中，p40染色对肌上皮细胞具有高度特异性。其染色模式和强度与p63相当，这使其可用于日常实践。p40染色的异质性低于CK5/6染色。
