Increased alpha-B-crystallin expression in mammary metaplastic carcinomas

• Published in: Histopathology 2011-08, Vol.59 (2), p.247-255
• Main Authors: Chan, Siu-Ki, Lui, Philip C W, Tan, Puay-Hoon, Yamaguchi, Rin, Moriya, Takuya, Yu, Alex M C, Shao, Mu-Min, Hliang, Thazin, Wong, Sio-In, Tse, Gary M
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - metabolism; Adult; alpha-Crystallin B Chain - metabolism; Biological and medical sciences; Biomarkers, Tumor - metabolism; breast; Breast Neoplasms - diagnosis; Breast Neoplasms - metabolism; Carcinoma, Adenosquamous - diagnosis; Carcinoma, Adenosquamous - metabolism; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - metabolism; Carcinosarcoma - diagnosis; Carcinosarcoma - metabolism; CK14; Female; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Mammary gland diseases; Medical sciences; Metaplasia; metaplastic carcinoma; Middle Aged; Neoplasms, Complex and Mixed - diagnosis; Neoplasms, Complex and Mixed - metabolism; Neoplasms, Complex and Mixed - secondary; p63; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Predictive Value of Tests; Tumors; αB-crystallin
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2011.03882.x

Chan S‐K, Lui P C W, Tan P‐H, Yamaguchi R, Moriya T, Yu A M C, Shao M‐M, Hliang T, Wong S‐I & Tse G M
(2011) Histopathology59, 247–255 Increased alpha‐B‐crystallin expression in mammary metaplastic carcinomas 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.