Subscribe to RSS
Immunohistochemical expression of Ki-67, p53, and CD10 in phyllodes tumor and their correlation with its histological gradeFinancial support and sponsorship Nil
CONTEXT: Phyllodes tumors (PTs) are the fibroepithelial neoplasms of the breast. Histologically, PTs are divided into three subgroups according to their clinicopathological behavior: benign, borderline, and malignant. It is at times difficult to ascertain the grade of PT on morphological criteria alone, especially borderline PT may be at times difficult to distinguish from its benign or malignant counterparts.
AIMS: This study was undertaken to evaluate an immunohistochemical panel of Ki-67, p53, and CD10 in PT and to determine their expression in PT in correlation with its grade.
SETTINGS AND DESIGN: This was a retrospective study.
SUBJECTS AND METHODS: The study included six malignant, six borderline, and twelve benign PT. Expressions of Ki-67, p53, and CD10 were evaluated on all the 12 cases and compared in these three categories.
STATISTICAL ANALYSIS USED: Chi-square test was applied, and P < 0.05 was taken as statistically significant.
RESULTS: Stromal expression of Ki-67 and p53 between the benign and borderline/malignant group showed a statistically significant difference. Neither CD10 expression nor epithelial expressions of Ki-67 and p53 were found significant. Periepithelial accentuation of Ki-67 and p53 immunostaining was noted in all positive cases.
CONCLUSIONS: Ki-67 labeling index and p53 immunostaining can be a useful adjunct to determine the grade in difficult cases. However, no single immunomarker can reliably distinguish between benign and borderline phyllodes in all cases.
Received: 20 June 2019
Accepted: 07 November 2019
Article published online:
07 April 2020
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 Tan PH, Jayabaskar T, Chuah KL, Lee HY, Tan Y, Hilmy M, et al. Phyllodes tumors of the breast: The role of pathologic parameters. Am J Clin Pathol 2005;123:529-40.
- 2 Kleer CG, Giordano TJ, Braun T, Oberman HA. Pathologic, immunohistochemical, and molecular features of benign and malignant phyllodes tumors of the breast. Mod Pathol 2001;14:185-90.
- 3 Dacic S, Kounelis S, Kouri E, Jones MW. Immunohistochemical profile of cystosarcoma phyllodes of the breast: A study of 23 cases. Breast J 2002;8:376-81.
- 4 Niezabitowski A, Lackowska B, Rys J, Kruczak A, Kowalska T, Mitus J, et al. Prognostic evaluation of proliferative activity and DNA content in the phyllodes tumor of the breast: Immunohistochemical and flow cytometric study of 118 cases. Breast Cancer Res Treat 2001;65:77-85.
- 5 Kaya R, Pestereli HE, Erdogan G, Gülkesen KH, Karaveli S. Proliferating activity in differential diagnosis of benign phyllodes tumor and cellular fibroadenomas: Is it helpful? Pathol Oncol Res 2001;7:213-6.
- 6 Moffat CJ, Pinder SE, Dixon AR, Elston CW, Blamey RW, Ellis IO. Phyllodes tumours of the breast: A clinicopathological review of thirty-two cases. Histopathology 1995;27:205-18.
- 7 Ang MK, Ooi AS, Thike AA, Tan P, Zhang Z, Dykema K, et al. Molecular classification of breast phyllodes tumors: Validation of the histologic grading scheme and insights into malignant progression. Breast Cancer Res Treat 2011;129:319-29.
- 8 Tan PH, Thike AA, Tan WJ, Thu MM, Busmanis I, Li H, et al. Predicting clinical behaviour of breast phyllodes tumours: A nomogram based on histological criteria and surgical margins. J Clin Pathol 2012;65:69-76.
- 9 Tan PH, Jayabaskar T, Yip G, Tan Y, Hilmy M, Selvarajan S, et al. P53 and c-kit (CD117) protein expression as prognostic indicators in breast phyllodes tumors: A tissue microarray study. Mod Pathol 2005;18:1527-34.
- 10 Karim RZ, Scolyer RA, Tse GM, Tan PH, Putti TC, Lee CS. Pathogenic mechanisms in the initiation and progression of mammary phyllodes tumours. Pathology 2009;41:105-17.
- 11 Rosen PP. Rosen's breast pathology. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2001. p. 176-94.
- 12 Tse GM, Tsang AK, Putti TC, Scolyer RA, Lui PC, Law BK, et al. Stromal CD10 expression in mammary fibroadenomas and phyllodes tumours. J Clin Pathol 2005;58:185-9.
- 13 Kucuk U, Bayol U, Pala EE, Cumurcu S. Importance of P53, ki-67 expression in the differential diagnosis of benign/malignant phyllodes tumors of the breast. Indian J Pathol Microbiol 2013;56:129-34.
- 14 Song JY, Yoon HK. Immunohistochemical phenotypes of phyllodes tumor of the breast. Korean J Pathol 2008 1;42:151-6.
- 15 Hussin H, Pailoor J, Cheng PS. The Role of CD10 Immunohistochemistry in the Grading Of Phyllodes Tumor of the Breast. J Interdiscipl Histopathol 2013;1:195-203
- 16 Esposito NN, Mohan D, Brufsky A, Lin Y, Kapali M, Dabbs DJ. Phyllodes tumor: A clinicopathologic and immunohistochemical study of 30 cases. Arch Pathol Lab Med 2006;130:1516-21.
- 17 Tse GM, Niu Y, Shi HJ. Phyllodes tumor of the breast: An update. Breast Cancer 2010;17:29-34.
- 18 Witte F, Hönig A, Mirecka J, Schauer A. Cystosarcoma phyllodes of the breast: Prognostic significance of proliferation and apoptosis associated genes. Anticancer Res 1999;19:3355-9.