Tags

Type your tag names separated by a space and hit enter

The predictive ability of a CK5/p63/CK8/18 antibody cocktail in stratifying breast papillary lesions on needle biopsy: an algorithmic approach works best.
Am J Clin Pathol. 2013 Dec; 140(6):767-79.AJ

Abstract

OBJECTIVES

Immunohistochemical markers have been shown to assist in the stratification of breast papillary lesions. We evaluated the ability of different cytokeratin (CK) and p63 expression profiles on needle biopsy specimens to predict excision diagnoses.

METHODS

A CK5/p63/CK8/18 antibody cocktail was applied to 58 needle biopsy specimens (32 papillomas, 7 atypical papillomas, 19 papillary carcinomas on excision).

RESULTS

p63 expression was greater in papillomas than in atypical papillomas (P = .044) and papillary carcinomas (P< .0001). Papillary carcinomas and atypical papillomas showed greater CK8/18 expression (and conversely less CK5 expression) than did papillomas (P < .0001). Negative or focal p63 expression was 96% sensitive for diagnosing any atypical lesion (atypical papilloma or papillary carcinoma) on excision, whereas CK8/18 predominant expression (≥80% cells) was 100% sensitive. In contrast, the sensitivity of the original diagnosis was only 81%. The greatest accuracy for the diagnosis of atypical papillary lesions (95%) was achieved when both p63 and cytokeratins were used in combination in an algorithmic fashion. This method also correctly identified all cases that had papillary carcinoma (100% sensitivity) on excision.

CONCLUSIONS

Although a single stain or combination cannot independently stratify papillary lesions, a CK5/p63/CK8/18 antibody cocktail is a useful adjunct to morphology for evaluating breast papillary lesions in needle biopsy specimens.

Authors+Show Affiliations

Department of Pathology, Microbiology and Immunology, Vanderbilt University, 1161 21st Ave S, MCN C-3321, Nashville, TN 37232-2561; emily.s.reisenbichler@vanderbilt.edu.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24225742

Citation

Reisenbichler, Emily S., et al. "The Predictive Ability of a CK5/p63/CK8/18 Antibody Cocktail in Stratifying Breast Papillary Lesions On Needle Biopsy: an Algorithmic Approach Works Best." American Journal of Clinical Pathology, vol. 140, no. 6, 2013, pp. 767-79.
Reisenbichler ES, Adams AL, Hameed O. The predictive ability of a CK5/p63/CK8/18 antibody cocktail in stratifying breast papillary lesions on needle biopsy: an algorithmic approach works best. Am J Clin Pathol. 2013;140(6):767-79.
Reisenbichler, E. S., Adams, A. L., & Hameed, O. (2013). The predictive ability of a CK5/p63/CK8/18 antibody cocktail in stratifying breast papillary lesions on needle biopsy: an algorithmic approach works best. American Journal of Clinical Pathology, 140(6), 767-79. https://doi.org/10.1309/AJCPXV64GXLZCIGA
Reisenbichler ES, Adams AL, Hameed O. The Predictive Ability of a CK5/p63/CK8/18 Antibody Cocktail in Stratifying Breast Papillary Lesions On Needle Biopsy: an Algorithmic Approach Works Best. Am J Clin Pathol. 2013;140(6):767-79. PubMed PMID: 24225742.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The predictive ability of a CK5/p63/CK8/18 antibody cocktail in stratifying breast papillary lesions on needle biopsy: an algorithmic approach works best. AU - Reisenbichler,Emily S, AU - Adams,Amy L, AU - Hameed,Omar, PY - 2013/11/15/entrez PY - 2013/11/15/pubmed PY - 2014/1/1/medline KW - Breast KW - Cytokeratin 5 KW - Cytokeratin 8/18 KW - Needle core biopsy KW - Papillary lesions KW - p63 SP - 767 EP - 79 JF - American journal of clinical pathology JO - Am J Clin Pathol VL - 140 IS - 6 N2 - OBJECTIVES: Immunohistochemical markers have been shown to assist in the stratification of breast papillary lesions. We evaluated the ability of different cytokeratin (CK) and p63 expression profiles on needle biopsy specimens to predict excision diagnoses. METHODS: A CK5/p63/CK8/18 antibody cocktail was applied to 58 needle biopsy specimens (32 papillomas, 7 atypical papillomas, 19 papillary carcinomas on excision). RESULTS: p63 expression was greater in papillomas than in atypical papillomas (P = .044) and papillary carcinomas (P< .0001). Papillary carcinomas and atypical papillomas showed greater CK8/18 expression (and conversely less CK5 expression) than did papillomas (P < .0001). Negative or focal p63 expression was 96% sensitive for diagnosing any atypical lesion (atypical papilloma or papillary carcinoma) on excision, whereas CK8/18 predominant expression (≥80% cells) was 100% sensitive. In contrast, the sensitivity of the original diagnosis was only 81%. The greatest accuracy for the diagnosis of atypical papillary lesions (95%) was achieved when both p63 and cytokeratins were used in combination in an algorithmic fashion. This method also correctly identified all cases that had papillary carcinoma (100% sensitivity) on excision. CONCLUSIONS: Although a single stain or combination cannot independently stratify papillary lesions, a CK5/p63/CK8/18 antibody cocktail is a useful adjunct to morphology for evaluating breast papillary lesions in needle biopsy specimens. SN - 1943-7722 UR - https://www.unboundmedicine.com/medline/citation/24225742/The_predictive_ability_of_a_CK5/p63/CK8/18_antibody_cocktail_in_stratifying_breast_papillary_lesions_on_needle_biopsy:_an_algorithmic_approach_works_best_ L2 - https://academic.oup.com/ajcp/article-lookup/doi/10.1309/AJCPXV64GXLZCIGA DB - PRIME DP - Unbound Medicine ER -