Comparison of P-53, Ki-67 and Cd-10 Expression Between Fibroadenoma, Benign Phyllodes Tumor and Malignant Phyllodes Tumor
DOI:
https://doi.org/10.21276/apalm.2937Keywords:
Fibroepithelial tumors, fibroadenoma, phyllodes tumorAbstract
Background: Fibroepithelial tumors of the breast are a heterogeneous group of biphasic lesions comprising of an epithelial component and a quantitatively predominant mesenchymal component. These are classified into two major categories: Fibroadenoma and phyllodes tumor (PT). Phyllodes tumors are classified into benign, borderline and malignant grade categories based on histological parameters.
Methods: An analytical-cross sectional study was conducted in the Department of Pathology, Hindu Rao Hospital, Delhi-110007 from November 2016 to December 2018. Total 50 cases were included in the study comprising of 30 cases of fibroadenoma, 15 cases of benign phyllodes tumor and 5 cases of malignant phyllodes tumor. All specimens were fixed in 10% buffered formalin. Tissue were processed and embedded in paraffin. The sections were stained with hematoxylin and eosin (H&E) to study the histopathological section. Immunostaining using CD-10, Ki-67 and p53 antibodies was done in all cases.
Result: Among fibroadenoma cases only 3.33% showed positive CD-10 expression and 96.66% were negative. CD-10 expression was positive in 26.67% cases of benign phyllodes while 73.33 showed negative expression. 40% malignant phyllodes cases showed positive CD-10 expression and 60% showed negative CD-10 expression. CD-10 expression was significantly higher in benign phyllodes (p value = 0.019) and malignant phyllodes (p value 0.007) group as compared to fibroadenoma. P-53 expression in epithelium was seen in 56% of fibroadenoma and 26% of benign phyllodes cases, while all cases of malignant phyllodes tumor show negative P-53 expression. The stromal expression of P-53 was significantly higher in malignant phyllodes as compared to fibroadenoma and benign phyllodes tumor. Stromal expression of Ki-67 was significantly higher in malignant phyllodes as compared to benign phyllodes and fibroadenoma. Epithelial expression of Ki-67 was negative in all malignant phyllodes cases while positive epithelial Ki-67 expression was seen in 56% of fibroadenoma and 33% of benign phyllodes tumor.
Conclusion: Both Ki-67 and P-53 showed a significantly increasing expression from fibroadenoma to benign phyllodes to malignant phyllodes tumor. The difference in expression of CD-10 was insignificant among fibroadenoma, benign phyllodes and malignant phyllodes tumor.
References
World Health Organization. Histological typing of breast tumours.International. Histological Classification of Tumors. 2nd ed. Geneva, Switzerland: WHO; 1981.
Tan P, Tse G, Lee A. Fibroepithelial Tumours. In: Lakhani S, Ellis I, Schnitt S, Tan P, van de Vijver M, ed. by. WHO Classification of Tumours of the Breast. 4th ed. Lyon: IARC; 2012. p. 142-143.
Cole P, Elwood JM, Kaplan SD. Incidence rates and risk factors of benign breast neoplasms. American journal of epidemiology. 1978 Aug 1;108(2):112-20.
Fiks A. Cystosarcoma phyllodes of the mammary gland—müller's tumor. Virchows Archiv A. 1981 May 1;392(1):1-6.
Tan BY, Acs G, Apple SK, Badve S et al. "Phyllodes tumours of the breast: a consensus review.". Histopathology. 68 (1): 5–21.
Velazquez EF, Yancovitz M, Pavlick A, Berman R et al. Clinical relevance of neutral endopeptidase (NEP/CD10) in melanoma. Journal of translational medicine. 2007 Dec;5(1):2.
Cohen AJ, Bunn PA, Franklin W, Magill-Solc C et al. Neutral endopeptidase: variable expression in human lung, inactivation in lung cancer, and modulation of peptide-induced calcium flux. Cancer research. 1996 Feb 15;56(4):831-9.
Iwaya K, Ogawa H, Izumi M, et al. Stromal expression of CD10 in invasive breast carcinoma: a new predictor of clinical outcome. Virchows Arch 2002;440:589–93.
Lane DP. Cancer. p53, guardian of the genome. Nature. 1992 Jul 2;358(6381):15-6.
BatinacT, Gruber F, Lipozencic J, Zamolo-Koncar G, Stasic A, Brajac I. Protein p53—structure, function, and possible therapeutic implications. Acta Dermatovenerol Croat. 2003 Dec;11(4):225-30.
Scholzen T, Gerdes J (March 2000). "The Ki-67 protein: from the known and the unknown". J. Cell. Physiol. 182 (3): 311–22.
Rahmanzadeh R, Hüttmann G, Gerdes J, Scholzen T. Chromophoreâ€assisted light inactivation of pKiâ€67 leads to inhibition of ribosomal RNA synthesis. Cell proliferation. 2007 Jun;40(3):422-30.
Puri V, Jain M, Mahajan G, Pujani M. Critical appraisal of stromal CD10 staining in fibroepithelial lesions of breast with a special emphasis on expression patterns and correlation with WHO grading. J Cancer Res Ther. 2016 Apr-Jun;12(2):667-70.
Tse GM, Tsang AK, Putti TC, Scolyer RA et al. Stromal CD10 expression in mammary fibroadenomas and phyllodes tumours. J Clin Pathol. 2005 Feb;58(2):185-9.
Ibrahim WS. Comparison of stromal CD10 expression in benign, borderline, and malignant phyllodes tumors among Egyptian female patients. Indian J Pathol Microbiol. 2011 Oct-Dec;54(4):741-4.
Surender K, Faraz A, Akshay A, SonkarAA et al. Diagnostic and prognostic role of stromal CD 10 and Ki 67 in benign and malignant Phylloides tumor of breast. International Journal of Medical and Health Sciences. 2017;6(2):85-9.
Kim CJ, Kim WH. Patterns of p53 expression in phyllodes tumors of the breast--an immunohistochemical study. J Korean Med Sci. 1993 Oct;8(5):325-8.
Chan YJ, Chen BF, Chang CL, Yang TL, Fan CC. Expression of p53 protein and Ki-67 antigen in phyllodes tumor of the breast. Journal-Chinese Medical Association. 2004 Jan;67(1):3-8.
Al-Masri M, Darwazeh G, Sawalhi S, Mughrabi A et al. Phyllodes tumor of the breast: role of CD10 in predicting metastasis. Annals of surgical oncology. 2012 Apr 1;19(4):1181-4.
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 Apr-Jun;56(2):129-34.
Feakins RM, Mulcahy HE, Nickols CD, Wells CA. p53 expression in phyllodes tumours is asso-ciated with histological features of malignancy but does not predict outcome. Histopathology. 1999 Aug;35(2):162-9.
Bernstein L, Deapen D, Ross RK. The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast. Cancer. 1993 May 15;71(10):3020-4.
Cohnâ€Cedermark G, Rutqvist LE, Rosendahl I, Silfverswärd C. Prognostic factors in cystosarcoma phyllodes. A clinicopathologic study of 77 patients. Cancer. 1991 Nov 1;68(9):2017-22.
KoÄová L, Skálová A, Fakan F, RouÅ¡arová M. Phyllodes tumour of the breast: immunohistochemical study of 37 tumours using MIB1 antibody. Pathology-Research and Practice. 1998 Jan 1;194(2):97-104.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Challa Sukumar, Shakti Kumar Yadav, Garima Singh, Sompal Singh, Namrata Sarin
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
