Diagnostic utility of the combined use of HNF4A and GATA3 in distinction between primary and metastatic breast and gastric carcinomas

Abstract Context.—Breast carcinoma often metastasizes to the gastrointestinal tract, especially the stomach, where it is frequently difficult to distinguish from a primary gastric carcinoma. Objective.—To evaluate the utility of immunohistochemical stains in differentiating primary gastric carcinomas from metastatic breast carcinomas. Design.—Mucosal biopsy specimens from 47 adenocarcinomas involving the gastrointestinal tract (28 primary gastric carcinomas and 19 metastatic breast carcinomas) and 16 control cases of primary breast carcinomas without metastasis were immunohistochemically stained for estrogen receptor protein (ER), progesterone receptor protein (PR), gross cystic disease fluid protein (GCDFP), human epidermal growth factor receptor 2 protein, cytokeratin (CK) 5/6, CK/7, CK/20, a panel of mucin glycoprotein antigens (MUC2, MUC3, MUC5AC, and MUC6), monoclonal antibody DAS-1, and caudal-type homeobox transcription factor CDX2 and compared between primary and metastatic adenocarcinomas. Results.—Highly significant proportions of metastatic breast carcinomas were positive for ER (72%), PR (33%), GCDFP (78%), and CK5/6 (61%) compared with primary gastric carcinomas (ER, 0%; PR, 0%; GCDFP, 0%; and CK5/6, 14%) (P < .001, P = .002, P < .001, and P = .004, respectively). Of these immunostains, ER, PR, and GCDFP were 100% specific. Primary breast tumors and their metastases showed a similar phenotypic profile. In contrast, primary gastric carcinomas showed significantly higher proportions of cases that stained with CK20 (50%), MUC2 (54%), MUC5AC (71%), MUC6 (39%), DAS-1 (43%), and CDX2 (67%) compared with metastatic breast carcinomas (CK20, 0%; MUC2, 24%; MUC5AC, 6%; MUC6, 0%; DAS-1, 0%; and CDX2, 0%) (P = .001, P = .01, P < .001, P = .02, P = .009, and P < .001, respectively). No significant differences were observed with regard to any of the other immunostains (human epidermal growth factor receptor 2 protein, CK7, and MUC3) between the patient groups. Conclusions.—Estrogen receptor protein, PR, GCDFP, CK5/6, CK20, MUC5AC, MUC6, DAS-1, and CDX2 are helpful in distinguishing primary gastric carcinomas from metastatic breast carcinomas. Of these, ER, PR, and GCDFP are highly specific for metastatic breast carcinomas, whereas CK20, DAS-1, MUC2, MUC5AC, MUC6, and CDX2 are highly specific for primary gastric carcinomas.

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Adverse Interaction between Capecitabine and Warfarin Resulting in Altered Coagulation Parameters: A Review of the Literature Starting from a Case Report

Case Reports in Medicine ◽

10.1155/2010/426804 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Giovanni Giunta

Keyword(s):

Cytochrome P450 ◽

Antineoplastic Agent ◽

Liver Microsomes ◽

Metastatic Breast ◽

Concomitant Administration ◽

Current Data ◽

Tumor Tissues ◽

Combined Use ◽

Orally Active

Capecitabine is an orally active prodrug of fluorouracil and is extensively used as an antineoplastic agent. It is converted to 5-Fluorouracil in the liver and tumor tissues. Warfarin is an anticoagulant agent for preventing and treating venous and arterial thrombosis and embolism and is metabolized by cytochrome P450 isoenzymes in the liver. Preclinical in vitro studies using human liver microsomes report no inhibitory effects between capecitabine and substrates of cytochrome P. However, the concomitant administration of capecitabine and warfarin resulted in INR elevation in the cases previously reported in the literature. The exact mechanism of this interaction is unknown but may be related to downregulation of cytochrome P450 2C9 by capecitabine or its metabolites. We report on the possible adverse interaction between capecitabine and warfarin in a patient with metastatic breast cancer and critically review the existing literature on this topic. Physicians should be aware of adverse reactions arising from the combined use of capecitabine and warfarin. In the light of the current data, INR levels should be closely monitored in patients using these drugs together.

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Combined Use of Auto-Grafting and Non-Myeloablative Allografting for the Treatment of Hematologic Malignancies and Metastatic Breast Cancer

Non-Myeloablative Allogeneic Transplantation - Cancer Treatment and Research ◽

10.1007/978-1-4615-0919-6_5 ◽

2002 ◽

pp. 101-112 ◽

Cited By ~ 13

Author(s):

Angelo M. Carella ◽

Germana Beltrami ◽

Enrica Lerma ◽

Marina Cavaliere ◽

Maria T. Corsetti

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Metastatic Breast ◽

Hematologic Malignancies ◽

Combined Use

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Diagnostic utility of mammaglobin and GCDFP-15 in the identification of metastatic breast carcinoma in fluid specimens

Diagnostic Cytopathology ◽

10.1002/dc.21039 ◽

2009 ◽

Vol 37 (7) ◽

pp. 475-478 ◽

Cited By ~ 22

Author(s):

Z. Yan ◽

J. Gidley ◽

D. Horton ◽

J. Roberson ◽

I. E. Eltoum ◽

...

Keyword(s):

Breast Carcinoma ◽

Metastatic Breast ◽

Diagnostic Utility ◽

Metastatic Breast Carcinoma

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Assessing cannabis consumption frequency: Is the combined use of free and glucuronidated THCCOOH blood levels of diagnostic utility?

Drug Testing and Analysis ◽

10.1002/dta.2114 ◽

2016 ◽

Vol 9 (7) ◽

pp. 1043-1051 ◽

Cited By ~ 3

Author(s):

Marianne Hädener ◽

Marie Martin Fabritius ◽

Stefan König ◽

Christian Giroud ◽

Wolfgang Weinmann

Keyword(s):

Blood Levels ◽

Diagnostic Utility ◽

Combined Use ◽

Consumption Frequency ◽

Cannabis Consumption

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Diagnostic Utility of BAP1, EZH2 and Survivin in Differentiating Pleural Epithelioid Mesothelioma and Reactive Mesothelial Hyperplasia: Immunohistochemical Study

Pathology & Oncology Research ◽

10.3389/pore.2021.600073 ◽

2021 ◽

Vol 27 ◽

Author(s):

Sarah Adel Hakim ◽

Hoda Hassan Abou Gabal

Keyword(s):

Diagnostic Accuracy ◽

Malignant Mesothelioma ◽

Immunohistochemical Study ◽

Survivin Expression ◽

Study Groups ◽

Diagnostic Utility ◽

University Hospitals ◽

Immunohistochemical Markers ◽

Specialized Hospital ◽

Combined Use

Background: Epithelioid mesothelioma (EM) is the commonest subtype of malignant pleural mesothelioma. Its histopathological discrimination from reactive mesothelial hyperplasia (RMH) could be challenging. Thus, an immunohistochemical panel is mandatory for better discrimination. BAP1 is a newly identified diagnostic marker whose loss is specific to malignant mesothelioma. EZH2 overexpression is reported in different cancers, but its relation to BAP1 in malignant mesothelioma has not been fully understood. Survivin expression is said to be significantly higher in EM than in non-neoplastic pleural tissue, but its diagnostic utility as an immunohistochemical marker has not been thoroughly investigated in this field. To the best of our knowledge, no previous studies have been conducted to assess the diagnostic accuracy of the combined use of these three nuclear markers (BAP1, EZH2 and Survivin) in discriminating pleural EM from RMH.Methods: This retrospective study includes two groups: 81 cases of pleural EM and 67 cases of RMH, retrieved from the archives of Pathology Department of Ain Shams University Hospitals and Ain-Shams University Specialized Hospital during the period from January 2016 to December 2019. An immunohistochemical study was performed using BAP1, EZH2 and Survivin antibodies.Results: There were highly statistically significant relations between study groups as regards the studied markers (p = 0.001 for each). The specificity was 100% for all combinations of immunohistochemical markers. Sensitivity of any combination of the immunohistochemical markers used in this study was found to be higher than the sensitivity of any of these markers used individually. The combination of all three markers showed the highest diagnostic accuracy (95.9%) and the highest sensitivity (92.6%). However, the combination of Survivin and EZH2 yielded the same diagnostic accuracy and sensitivity.Conclusion: Adding EZH2, Survivin and BAP1 to the diagnostic IHC panel for differentiating pleural EM and RMH could enhance diagnostic sensitivity. Moreover, Survivin is a potentially promising marker in this context, especially when combined with EZH2.

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Interleukin-15 as a Biomarker Candidate of Rheumatoid Arthritis Development

Journal of Clinical Medicine ◽

10.3390/jcm9051555 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1555

Author(s):

Weronika Kurowska ◽

Malgorzata Przygodzka ◽

Michal Jakubaszek ◽

Brygida Kwiatkowska ◽

Wlodzimierz Maslinski

Keyword(s):

Rheumatoid Arthritis ◽

Diagnostic Utility ◽

Definite Diagnosis ◽

Undifferentiated Arthritis ◽

Rheumatoid Arthritis Development ◽

Combined Use ◽

Interleukin 15 ◽

Citrullinated Peptide ◽

Higher Sensitivity ◽

Peptide Antibodies

There is a need for definite diagnosis of rheumatoid arthritis (RA) at its earliest stages of development in order to introduce early and effective treatment. Here we assessed whether serum interleukin-15 (IL-15) can serve as a new biomarker of RA development in patients with undifferentiated arthritis (UA). Interleukin-15, IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP Abs) were measured in UA patients at inclusion. Six months later, the diagnosis was re-evaluated, and statistical analysis was performed. We found that at the UA stage, IL-15 was more prevalent in patients who progressed to RA than RF or anti-CCP Abs (83.3% vs. 61.1% and 66.7%, respectively). Interleukin-15 showed higher sensitivity (77.8%) than both autoantibodies and higher specificity (80.9%) than anti-CCP Abs in identification of UA patients who developed RA. The diagnostic utility of IL-15 was comparable to that of RF (AUC: 0.814 vs. 0.750, p > 0.05), but higher than that of anti-CCP Abs (AUC: 0.814 vs. 0.684, p = 0.04). The combined use of IL-15, RF and anti-CCP Abs yielded higher diagnostic accuracy for RA than autoantibodies determination only. Our results indicate that IL-15 can be used as a biomarker of RA development in patients with UA.

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