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Luminal cytokeratin expression profiles of breast papillomas and papillary carcinomas and the utility of a cytokeratin 5/p63/cytokeratin 8/18 antibody cocktail in their distinction.
Mod Pathol. 2011 Feb; 24(2):185-93.MP

Abstract

Luminal cytokeratin (CK) expression in breast papillary lesions, and its potential diagnostic utility among other markers in distinguishing between papillomas and papillary carcinomas, has not been previously evaluated. Such expression was determined in 42 papillary lesions (18 papillary carcinomas and 24 papillomas) by immunostaining with a CK5/p63/CK8/18 antibody cocktail. The mean CK8/18 intensity score and percentage of positive cells were significantly higher in papillary carcinomas (227 and 95%, respectively, vs 86 and 42% in papillomas; both P-values <0.0001), whereas the mean CK5 intensity score and percentage of positive cells were significantly lower (7 and 5%, respectively, vs 107 and 58% in papillomas; both P-values <0.0001). Half (9/18) of the papillary carcinomas expressed p63 vs all (24/24) of the papillomas (P = 0.0001). P63 expression in papillary carcinoma was always (9/9; 100%) focal/limited in nature (expression in <10% of cells), whereas focal expression was seen in only four (17%) papillomas (P<0.0001). Both differential CK (CK8/18 and CK5) expression and p63 were equally sensitive (100%) for the diagnosis of papillary carcinoma, but differential CK expression was more specific (96 vs 83%), resulting in a greater accuracy. However, the best discriminatory power in the distinction from papilloma was achieved when all three markers were used in combination, resulting in 100% sensitivity and specificity values. It is concluded that breast papillary lesions have differential CK expression profiles that, especially in combination with p63, can be useful for their stratification, potentially also in needle biopsy material, in which more accurate and reproducible characterization is needed.

Authors+Show Affiliations

Department of Pathology, University of Alabama at Birmingham, 35294-6823, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21076459

Citation

Reisenbichler, Emily S., et al. "Luminal Cytokeratin Expression Profiles of Breast Papillomas and Papillary Carcinomas and the Utility of a Cytokeratin 5/p63/cytokeratin 8/18 Antibody Cocktail in Their Distinction." Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc, vol. 24, no. 2, 2011, pp. 185-93.
Reisenbichler ES, Balmer NN, Adams AL, et al. Luminal cytokeratin expression profiles of breast papillomas and papillary carcinomas and the utility of a cytokeratin 5/p63/cytokeratin 8/18 antibody cocktail in their distinction. Mod Pathol. 2011;24(2):185-93.
Reisenbichler, E. S., Balmer, N. N., Adams, A. L., Pfeifer, J. D., & Hameed, O. (2011). Luminal cytokeratin expression profiles of breast papillomas and papillary carcinomas and the utility of a cytokeratin 5/p63/cytokeratin 8/18 antibody cocktail in their distinction. Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc, 24(2), 185-93. https://doi.org/10.1038/modpathol.2010.197
Reisenbichler ES, et al. Luminal Cytokeratin Expression Profiles of Breast Papillomas and Papillary Carcinomas and the Utility of a Cytokeratin 5/p63/cytokeratin 8/18 Antibody Cocktail in Their Distinction. Mod Pathol. 2011;24(2):185-93. PubMed PMID: 21076459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Luminal cytokeratin expression profiles of breast papillomas and papillary carcinomas and the utility of a cytokeratin 5/p63/cytokeratin 8/18 antibody cocktail in their distinction. AU - Reisenbichler,Emily S, AU - Balmer,Nicole N, AU - Adams,Amy L, AU - Pfeifer,John D, AU - Hameed,Omar, Y1 - 2010/11/12/ PY - 2010/11/16/entrez PY - 2010/11/16/pubmed PY - 2011/7/1/medline SP - 185 EP - 93 JF - Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc JO - Mod Pathol VL - 24 IS - 2 N2 - Luminal cytokeratin (CK) expression in breast papillary lesions, and its potential diagnostic utility among other markers in distinguishing between papillomas and papillary carcinomas, has not been previously evaluated. Such expression was determined in 42 papillary lesions (18 papillary carcinomas and 24 papillomas) by immunostaining with a CK5/p63/CK8/18 antibody cocktail. The mean CK8/18 intensity score and percentage of positive cells were significantly higher in papillary carcinomas (227 and 95%, respectively, vs 86 and 42% in papillomas; both P-values <0.0001), whereas the mean CK5 intensity score and percentage of positive cells were significantly lower (7 and 5%, respectively, vs 107 and 58% in papillomas; both P-values <0.0001). Half (9/18) of the papillary carcinomas expressed p63 vs all (24/24) of the papillomas (P = 0.0001). P63 expression in papillary carcinoma was always (9/9; 100%) focal/limited in nature (expression in <10% of cells), whereas focal expression was seen in only four (17%) papillomas (P<0.0001). Both differential CK (CK8/18 and CK5) expression and p63 were equally sensitive (100%) for the diagnosis of papillary carcinoma, but differential CK expression was more specific (96 vs 83%), resulting in a greater accuracy. However, the best discriminatory power in the distinction from papilloma was achieved when all three markers were used in combination, resulting in 100% sensitivity and specificity values. It is concluded that breast papillary lesions have differential CK expression profiles that, especially in combination with p63, can be useful for their stratification, potentially also in needle biopsy material, in which more accurate and reproducible characterization is needed. SN - 1530-0285 UR - https://www.unboundmedicine.com/medline/citation/21076459/Luminal_cytokeratin_expression_profiles_of_breast_papillomas_and_papillary_carcinomas_and_the_utility_of_a_cytokeratin_5/p63/cytokeratin_8/18_antibody_cocktail_in_their_distinction_ L2 - https://doi.org/10.1038/modpathol.2010.197 DB - PRIME DP - Unbound Medicine ER -