El Sharouni Mary-Ann, Postma Emily L, van Diest Paul J
Department of Pathology, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Department of Surgery, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Virchows Arch. 2017 Dec;471(6):707-712. doi: 10.1007/s00428-017-2203-2. Epub 2017 Aug 4.
Invasive breast cancer comprises a spectrum of histological changes with purely lobular cancer on one side and purely ductal cancer on the other, with many mixed lesions in between. In a previous study, we showed that in patients with any percentage lobular component at core needle biopsy, preoperative MRI leads to the detection of clinically relevant additional findings in a substantial percentage of patients, irrespective of the percentage of the lobular component. Detection of a small lobular component may however not be reproducible among pathologists. Loss of membrane expression of E-cadherin or p120 is useful biomarkers of ILC and may therefore support a more objective diagnosis. All patients diagnosed with breast cancer containing a lobular component of any percentage between January 2008 and October 2012 were prospectively offered preoperative MRI. Clinically relevant additional findings on MRI were verified by pathology evaluation. Expression patterns of E-cadherin and p120 were evaluated by immunohistochemistry on the core needle biopsy. MRI was performed in 109 patients. The percentage of lobular component was significantly increased in cases with aberrant E-cadherin or p120 expression (both p = <0.001). However, aberrant expression of E-cadherin and p120 was not related to the probability of detecting relevant additional MRI findings. E-cadherin and p120 did not appear to be useful objective biomarkers for predicting additional relevant findings on MRI in patients with a lobular component in the core needle of their breast cancer.
浸润性乳腺癌包括一系列组织学变化,一端是纯小叶癌,另一端是纯导管癌,中间有许多混合性病变。在先前的一项研究中,我们表明,在粗针活检中有任何比例小叶成分的患者中,术前MRI能在相当比例的患者中检测到临床相关的额外发现,无论小叶成分的比例如何。然而,病理学家之间对小的小叶成分的检测可能无法重复。E-钙黏蛋白或p120的膜表达缺失是小叶原位癌的有用生物标志物,因此可能有助于更客观的诊断。2008年1月至2012年10月期间所有诊断为含有任何比例小叶成分的乳腺癌患者均被前瞻性地提供术前MRI检查。MRI上临床相关的额外发现通过病理评估进行验证。通过对粗针活检进行免疫组织化学评估E-钙黏蛋白和p120的表达模式。109例患者进行了MRI检查。E-钙黏蛋白或p120表达异常的病例中小叶成分的比例显著增加(两者p = <0.001)。然而,E-钙黏蛋白和p120的异常表达与检测到相关的额外MRI发现的可能性无关。对于乳腺癌粗针活检中有小叶成分的患者,E-钙黏蛋白和p120似乎不是预测MRI上额外相关发现的有用客观生物标志物。