“Identification of Immunohistochemical Markers Differentiating Metastatic Breast Carcinoma in the Stomach from Primary Gastric Adenocarcinoma"
Project no. 21577 · Status: Kapanmış (Yayın bekleniyor) · 2020
Summary
<p>Summary</p><p>“Identification of Immunohistochemical Markers Differentiating Metastatic Breast Carcinoma in the Stomach from Primary Gastric Adenocarcinoma"</p><p>Introduction:</p><p>Gastric tumors are typically diagnosed through small biopsies obtained endoscopically. However, in these small biopsies, the tumor is often confined to a very limited portion of the sample. The majority of primary gastric tumors are adenocarcinomas. Nevertheless, metastases to the stomach from other primary sites, particularly the breast, are possible. Distinguishing between a metastatic adenocarcinoma and a primary gastric adenocarcinoma can be extremely challenging at the histological level. Breast carcinoma is one of the most frequent tumors to metastasize to the stomach. The primary aim of this study is to determine, using an immunohistochemical panel, whether the tumor observed in gastric endoscopic biopsies is of primary gastric origin or a metastasis from breast carcinoma.</p><p>Methodology:</p><p>This study includes 300 cases of female patients from the archives of the Department of Medical Pathology at Ege University Medical School, from 2001 to 2011. The cohort consists of 150 cases who underwent gastric resection due to gastric adenocarcinoma and the other 150 cases who underwent mastectomy due to breast carcinoma. The following immunohistochemical markers were applied: estrogen receptor ER, GATA3, HNF4A, CDX2, and MUC5AC.</p><p>Results:</p><p>ER and GATA3 staining was negative in all gastric tumors, while they demonstrated positivity in 77.3% and 92% of breast carcinomas, respectively. On the other hand, CDX2 and HNF4A were negative in all breast carcinomas, but were positive in 79.3% and 88.7% of gastric tumors, with focal positivity observed in 4% and 8% of cases, respectively. The differential expression patterns of ER and GATA3 versus HNF4A and CDX2 serve as a reliable indicator for distinguishing breast carcinoma metastases from primary gastric adenocarcinoma.</p><p>Conclusion:</p><p>Our study demonstrates that an immunohistochemical panel composed of ER, GATA3, HNF4A, and CDX2 may provide an effective method for differentiating between metastatic breast carcinoma to stomach and primary gastric adenocarcinoma. This panel offers valuable diagnostic insight, particularly in cases where histological differentiation is difficult, and supports a more accurate diagnosis.</p><p>Key words: ER, GATA3, HNF4A, CDX2, MUCK5AC, gastric adenocarcinoma, breast carcinoma, metastatic breast carcinoma to stomach</p>