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Histopathology ; 59(2): 247-55, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21884203

ABSTRACT

AIMS: Mammary metaplastic carcinoma is a rare breast carcinoma, and may present diagnostic difficulty. Alpha-B-crystallin has been recently reported to be expressed in basal-like and metaplastic carcinomas. METHODS AND RESULTS: Thirty-three metaplastic carcinomas, 44 conventional high-grade carcinomas and 28 mesenchymal spindle cell neoplasms as controls were assessed for their expression of αB-crystallin and conventional basal-like phenotypic markers CK5/6, CK14, p63, c-kit and epidermal growth factor receptor (EGFR) by immunohistochemistry. Alpha-B-crystallin staining was positive in 68% of the metaplastic carcinomas with cytoplasmic staining in all tumour cell components. CK5/6, CK14, p63, c-kit and EGFR stained 43%, 68%, 45%, 21% and 25% of the metaplastic carcinomas, respectively. Combining these markers, 84% of the metaplastic carcinomas expressed either αB-crystallin or CK14. In comparison, only 14% (six cases) of conventional high-grade carcinoma and 7% (two cases) of mesenchymal spindle cell neoplasm expressed αB-crystallin; all but one of these carcinomas were ER/PR/HER2 triple-negative. CONCLUSIONS: Using αB-crystallin for diagnosis of metaplastic carcinoma gives a 68% sensitivity, 88% specificity, 74% positive predictive value, 85% negative predictive value and 78% accuracy. The sensitivity is enhanced to 84% with combinations of αB-crystallin/CK14. Alpha-B-crystallin may be used as an adjunct marker in the diagnosis of metaplastic carcinoma.


Subject(s)
Breast Neoplasms/diagnosis , Neoplasms, Complex and Mixed/diagnosis , alpha-Crystallin B Chain/metabolism , Adenocarcinoma/diagnosis , Adenocarcinoma/metabolism , Adult , Biomarkers, Tumor/metabolism , Breast Neoplasms/metabolism , Carcinoma, Adenosquamous/diagnosis , Carcinoma, Adenosquamous/metabolism , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/metabolism , Carcinosarcoma/diagnosis , Carcinosarcoma/metabolism , Female , Humans , Metaplasia , Middle Aged , Neoplasms, Complex and Mixed/metabolism , Neoplasms, Complex and Mixed/secondary , Predictive Value of Tests
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