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Invasive Micropapillary Carcinoma of the Breast: Immunophenotypic Analysis and Role of Cell Adhesion Molecules (CD44 and E-Cadherin) in Nodal Metastasis

Invasive Micropapillary Carcinoma of the Breast: Immunophenotypic Analysis and Role of Cell... Invasive micropapillary carcinoma is a morphologically distinct subtype of breast carcinoma with high frequency of lymph node metastasis. In this study, we analyzed clinicopathologic features, immunophenotype, and expression of adhesion molecules (CD44 and E-cadherin (E-Cad)) in pure invasive micropapillary carcinoma of the breast. All cases had diffuse micropapillary pattern and were grade II tumors. Lymphovascular emboli were present in 80% and lymph node tumor deposits were seen in 69.2% cases. The cases were classified as; luminal A (11 cases), luminal B (8 cases), Her-2-neu overexpressing (4 cases), and triple negative (2 cases). All cases were positive for luminal cytokeratin (CK)CK8/18, and 2 cases showed <10% positivity for CK5/6. Eighteen cases showed loss of CD44 expression and 7 cases showed only weak positivity. Seven cases with lymph node metastasis showed reexpression of CD44 at metastatic site. Strong to moderate expression of E-Cad was observed in all cases and the corresponding nodal metastasis. To conclude, the loss of the CD44 expression plays role in lymphovascular permeation and metastasis and it can be hypothesized that its reexpression at metastatic site may play a role in homing of tumor cells. However, intact E-Cad expression could be because of the fact that tumour cells travel as clusters and retain their expression of E-Cad. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Applied Immunohistochemistry & Molecular Morphology Wolters Kluwer Health

Invasive Micropapillary Carcinoma of the Breast: Immunophenotypic Analysis and Role of Cell Adhesion Molecules (CD44 and E-Cadherin) in Nodal Metastasis

Invasive Micropapillary Carcinoma of the Breast: Immunophenotypic Analysis and Role of Cell Adhesion Molecules (CD44 and E-Cadherin) in Nodal Metastasis


Pure invasive micropapillary carcinoma (IMPC) is a special histologic subtype that accounts for 0.7% to 3% of all breast cancers. 1 Histologically, IMPC is characterized by “morules-like clusters” of tumor cells with “inverted polarity” floating in clear spaces. 2 This histologic subtype of breast carcinoma is rare and has been reported to show lymphovascular invasion, lymph node metastasis (LNM), local recurrence, and distant metastasis at a relatively high frequency, thereby exhibiting more aggressive behavior than invasive ductal carcinomas of no special type (IDC-NSTs). 3 Metastatic spread requires a series of interactions between the tumor cells and the surrounding extracellular matrix. CD44 and E-cadherin (E-Cad) are 2 adhesion molecules that have been extensively studied in tumor metastasis. CD44 is a large family of cell surface transmembrane glycoproteins and is implicated in tumor pathology, playing a role in tumor cell differentiation, invasion, and metastasis. 4 Although a number of studies have shown that overexpression of the CD44 and its splice variants, especially CD44v6, is associated with poor prognosis and metastasis, others have shown that downregulation of CD44 expression correlated with adverse outcome. 4,5 Thus, the role of CD44 in the biological behavior and prognosis of breast carcinomas is controversial. 5,6 E-Cad is a calcium-dependent transmembrane protein and is involved specifically in epithelial cell-to-cell interactions. 7 In the breast, E-Cad is thought to act as a metastatic or invasion suppressor gene, and the reduced expression of this adhesion molecule in breast carcinomas is associated with the acquisition of increased invasiveness and high metastatic potential. 8,9 A recent study has evaluated the expression of these adhesion molecules in the primary tumor but not in the nodal metatstaic deposits. 10 In this study we examined immunohistochemical expression of cell adhesion molecules, CD44 and E-Cad...
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Copyright
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Subject
Research Articles
ISSN
1541-2016
eISSN
1533-4058
DOI
10.1097/PAI.0000000000000167
pmid
26200840
Publisher site
See Article on Publisher Site

Abstract

Invasive micropapillary carcinoma is a morphologically distinct subtype of breast carcinoma with high frequency of lymph node metastasis. In this study, we analyzed clinicopathologic features, immunophenotype, and expression of adhesion molecules (CD44 and E-cadherin (E-Cad)) in pure invasive micropapillary carcinoma of the breast. All cases had diffuse micropapillary pattern and were grade II tumors. Lymphovascular emboli were present in 80% and lymph node tumor deposits were seen in 69.2% cases. The cases were classified as; luminal A (11 cases), luminal B (8 cases), Her-2-neu overexpressing (4 cases), and triple negative (2 cases). All cases were positive for luminal cytokeratin (CK)CK8/18, and 2 cases showed <10% positivity for CK5/6. Eighteen cases showed loss of CD44 expression and 7 cases showed only weak positivity. Seven cases with lymph node metastasis showed reexpression of CD44 at metastatic site. Strong to moderate expression of E-Cad was observed in all cases and the corresponding nodal metastasis. To conclude, the loss of the CD44 expression plays role in lymphovascular permeation and metastasis and it can be hypothesized that its reexpression at metastatic site may play a role in homing of tumor cells. However, intact E-Cad expression could be because of the fact that tumour cells travel as clusters and retain their expression of E-Cad.

Journal

Applied Immunohistochemistry & Molecular MorphologyWolters Kluwer Health

Published: Mar 1, 2016

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