Fiel M I, Cernaianu G, Burstein D E, Batheja N
Department of Pathology, Mount Sinai Medical Center, New York, New York 10029, USA.
Acta Cytol. 1996 Jul-Aug;40(4):637-41. doi: 10.1159/000333931.
The diagnosis of metastatic mammary carcinoma by morphologic criteria alone can be difficult, depending on the site of metastasis and state of cell differentiation. Numerous histopathologic studies have shown GCDFP-15 (BRST-2) to be a specific marker for breast cancer in surgical specimens. To date, no studies have been done to evaluate its utility in cytologic preparations.
To evaluate the usefulness of GCDFP-15 as a marker in the cytologic diagnosis of breast carcinoma, we studied 23 cases of mammary carcinoma and compared them with 20 cases of tumors of nonmammary origin (lung, ovary, liver, colon, stomach and bladder). "Bench top" fine needle aspirates from unfixed surgical specimens of breast carcinoma, cytocentrifuge samples from body cavity fluids and cerebrospinal fluids with morphologically proven metastatic carcinoma were studied.
Expression of BRST-2 was found in 56.5% of primary and recurrent or metastatic breast carcinomas. All the nonmammary carcinomas studied were negative. Staining was found to be strongly dependent on the means of cell fixation. Slides fixed in 10% formalin and Bouin's solution gave optimal results. Except in two cases, which showed focal immunostaining, all specimens fixed in alcohol were negative.
Our results support the diagnostic value of GCDFP-15 in recognizing tumors of breast origin and suggest that in clinical situations in which metastatic breast carcinoma is suspected, a portion of the cytologic specimen should be fixed with an optimal fixative for BRST-2 detection.
仅依靠形态学标准诊断转移性乳腺癌可能存在困难，这取决于转移部位和细胞分化状态。众多组织病理学研究表明，GCDFP-15（BRST-2）是手术标本中乳腺癌的特异性标志物。迄今为止，尚未有研究评估其在细胞学标本中的效用。
为评估GCDFP-15作为乳腺癌细胞学诊断标志物的有用性，我们研究了23例乳腺癌病例，并将其与20例非乳腺来源肿瘤（肺、卵巢、肝、结肠、胃和膀胱）进行比较。研究了来自乳腺癌未固定手术标本的“台式”细针穿刺抽吸物、来自体腔液和脑脊液且形态学证实为转移性癌的细胞离心涂片。
在56.5%的原发性、复发性或转移性乳腺癌中发现了BRST-2的表达。所有研究的非乳腺癌均为阴性。发现染色强烈依赖于细胞固定方式。用10%福尔马林和波恩氏液固定的玻片效果最佳。除两例显示局灶性免疫染色外，所有用酒精固定的标本均为阴性。
我们的结果支持GCDFP-15在识别乳腺来源肿瘤方面的诊断价值，并表明在怀疑有转移性乳腺癌的临床情况下，应将一部分细胞学标本用最佳固定剂固定以检测BRST-2。
