CD-10: An Emerging biomarker in Prognostication of Infiltrating Duct Carcinoma Breast

Abstract

BACKGROUND: All carcinomas of the breast can be classified based on the hormone receptors on cells and also by cell of origin. Generally most of health setup in developing countries carries out assessment of tumour behavior for breast cancer based on three parameters: tumour size, lymph node status, and histological grade. A few better established medical institutes have added immunohistochemistry to forecast the tumour outcome and guide the clinicians for better management of such patients. In carcinoma breast prognostic panel consisting of Estrogen Receptor (ER), Progesterone Receptor (PR) & Her2neu is being commonly used for prognostication of the Infiltrating duct carcinomas (IDC).  With new breakthrough in the field it has become clear that stroma also plays a significant role in the spread of carcinoma breast and the proliferation rate of tumors has been shown to be a good predictor of aggressiveness of the tumor, hence new markers such as Ki67gene over expression and CD 10 have been added to the armament for prognostication . The aims of this study are to estimate the frequency of expression of stromal CD10 in invasive breast carcinomas and also to assess prognostic significance of stromal CD10 marker.

METHODS: In this study, we examined 20 cases of invasive breast carcinoma.  Apart from routine H&E stain, the selected cases were stained with concurrent immunohistochemical prognostic panel (ER, PR, Her2neu) and CD10 stromal marker, to characterize and to identify prognostic markers that can identify tumors with more aggressive behavior.

RESULT: We found 06 cases were of the triple-negative phenotype (ER, PR, Her2neu) and all exhibited strong CD10 stromal positivity. The majority of these tumors were grade III, IDC. There were positive associations with larger size, pushing margins, poorer Nottingham Prognostic Index (NPI). In all tumors, we considered tumor size, lymph node stage, and hormone receptors as the most useful prognostic markers and found that the traditional markers indicating poor outcome correlated well with CD 10 stromal positivity in 80% cases.

 

CONCLUSION: In the present study all triple-negative cases with positive nodal status , larger tumor size and higher grade, the hormonal  expression revealed a strong correlation with CD 10 marker which appears to be a very strong potential and the most useful emerging prognostic marker.