Cell blocks allow reliable evaluation of expression of basal (CK5/6) and luminal (CK8/18) cytokeratins and smooth muscle actin (SMA) in breast carcinoma

Objective:Gene expression studies have revealed several molecular subtypes of breast carcinoma with distinct clinical and biological behaviours. DNA microarray studies correlated with immunohistochemical profiling of breast carcinomas using cytokeratin (CK) markers, Her2/neu, oestrogen receptor (ER), and basal myoepithelial cell markers have identified five breast tumour subtypes: (i) luminal A (ER+; Her2/neu-), (ii) luminal B (ER+; Her2/neu+), (iii) Her2 overexpression (ER-; Her2/neu+), (iv) basal-like (ER-; Her2/neu-, CK5/6 and 14+), and (v) negative for all markers. Luminal carcinomas express cytokeratins in a luminal pattern (CK8/18), and the basal-like type expresses CK5/6 and CK14 or basal epithelial cell markers. CK5/6, CK8/18, and smooth muscle actin (SMA) expression were assessed in cell blocks and compared with expression in surgical specimens.Methods:Sixty-two cases of breast carcinoma diagnosed by fine needle aspiration cytology with cell blocks and available surgical specimens were included. Cell blocks containing at least 10 high-power fields each with at least 10 tumour cells and surgical specimens were immunostained for CK5/6, CK8/18 and SMA.Results:Percentage sensitivity, specificity, positive predictive value, negative predictive value and accuracy were, respectively, 77, 100, 100, 92 and 94 for CK5/6; 98, 66, 96, 80 and 95 for CK8/18; and 92, 96, 85, 98 and 95 for SMA.Conclusion:The identification of CK5/6, CK8/18 and SMA by immunohistochemistry in cell blocks can be a reliable method that yields results close to those obtained in surgical specimens, and can contribute to the classification of breast carcinomas with luminal and basal expression patterns, providing helpful information in the choice of treatment and in the evaluation of prognostic and predictive factors.

Estudo imuno-histoquímico da co-expressão de citoqueratinas, vimentina e actina em neoplasias de glândula salivar

Human salivary gland tumors originated from intercalated ducts present a broad range of histologic and cytologic patterns, mainly due to the presence of myoepithelial cells. The aim of this study is to verify the differentiation grade of neoplastic cells and a possible relation between myoepithelial cell differentiation and the presence of luminal secretory contents. The expression of vimentin and cytokeratin (CK) intermediate filaments, actin myofilament and epithelial membrane antigen (EMA) was investigated by double labeling immunocytochemical technique, in thirty salivary gland neoplasms: 5 pleomorphic adenomas, 5 myoepitheliomas, 3 basal cell adenomas, 7 adenoid cystic carcinomas (ACC) and 10 polimorphous low grade adenocarcinomas (PLGA). Tumors with intercalated duct differentiation (pleomorphic adenomas, basal cell adenomas and ACC) express CKs 7, 8, 18 and 19 in the luminal cells and coexpress eventually CK14 with these CKs. Some luminal cells stained with anti-EMA antibody, mainly where a secretory content in the lumen was observed. Outer ductal cells and other myoepithelial-like cells express vimentin, sometimes coexpressing actin and/or CK14 with vimentin. Plasmacytoid cells in myoepitheliomas and pleomorphic adenomas express vimentin and rarely CKs 7, 8, 18 and 19, sometimes coexpressing these CKs with CK14 but they are negative for the remaining antigens. Tumors without intercalated duct differentiation (solid basal cell adenoma and PLGA) express vimentin and CKs 7, 8, 14 and 18, sometimes coexpressing CKs 8 and 18 with CK14. In conclusion, in tumors with intercalated duct differentiation, myoepithelial cells express vimentin and sometimes coexpress actin and/or CK14 with vimentin, never coexpressing other CKs with vimentin. CK14 and actin are independently expressed by myoepithelial cells, so their expression is probably induced by different stimulus. However, the secretory function of luminal cells, visualized by EMA staining, ....

Influência das células mioepiteliais neoplásicas benignas de adenoma pleomórfico na produção de MMPs -1, -2, - 8, -9 e -13 por células epiteliais malignas e sua possível relação com o índice de invasão

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

CD10 (Neutral Endopeptidase) expression in myoepithelial cells of salivary neoplasms

CD10 is a cell surface peptidase expressed in a wide variety of normal and neoplastic tissues, including breast myoepithelial cells. In salivary glands, expression of CD10 has only been used to identify neoplastic myoepithelial cells of pleomorphic adenomas and myoepithelial carcinomas. However, its accuracy in other salivary tumors with myoepithelial component has yet to be analyzed. We examined 72 salivary tumors with myoepithelial differentiation using immunohistochemical technique to detect CD10. In salivary glands, CD10 expression was not detected in myoepithelial cells. Only fibrocytes within the intralobular stroma were CD10 positive. In neoplastic myoepithelial cells, CD10 expression was found in 25.71% of benign and 32.43% of malignant neoplasms. When the different groups of tumors were compared, epithelial-myoepithelial carcinomas (EMEC) showed a stark contrast with the others (83.3% of cases with CD10 expression). Surprisingly, adenoid cystic carcinomas and basal cell adenomas were negative in 100% of the cases. Myoepitheliomas, pleomorphic adenomas, and myoepithelial carcinomas were positive in 27.7%, 30.0%, and 40% of the cases, respectively. In conclusion, salivary neoplastic myoepithelial cells gain CD10 expression in relation to their normal counterparts. However, the gain of this protein is not a sensitive marker for detecting myoepithelial cells in the majority of the tumors, except for EMEC. The high expression of CD10 by this carcinoma can be a valuable tool to separate EMEC from the tubular variant of adenoid cystic carcinomas in small incisional biopsies, where the precise diagnosis may be impossible.