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首页> 外文期刊>Modern Pathology >Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged Women
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Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged Women

机译：老年妇女神经内分泌乳腺癌中主分泌分化标志物的表达

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Neuroendocrine (NE) breast carcinomas are a rare entity in young women; however, their frequency increases in aged patients. The present work demonstrates that NE breast carcinomas in elderly women can also express an apocrine immunophenotype and analyzes the histological and clinical aspects of such differentiation. A selected series of 50 NE tumors (positive for NE markers in 50% of the cells) was tested for the immunocytochemical expression of gross cystic disease fluid protein-15 (GCDFP-15). The results demonstrated that about 50% of moderately (G2) and well-differentiated (G1) NE breast carcinomas (mucinous, solid papillary, and solid cohesive histotypes) coexpressed the apocrine marker. In these cases, specific mRNA for GCDFP-15 (PIP) and for chromogranin A (ChA) was demonstrated using in situ hybridization (ISH). Carcinomas of the alveolar subtype (G2) and poorly differentiated carcinomas (G3), including one case of atypical carcinoid, were pure NE carcinomas, devoid of apocrine differentiation. The steroid receptor status of these lesions was evaluated to test a possible involvement of androgen receptors in apocrine differentiation. We demonstrated that the level of AR and the mean age of patients at diagnosis were significantly higher in apocrine than in nonapocrine differentiated tumors. The histological grade and the expression of estrogen receptor (ER) significantly influenced the prognosis of these NE carcinomas, either pure or NE-apocrine differentiated. The most original result of our study is therefore the demonstration of a possible divergent apocrine differentiation of NE breast carcinomas that might be regulated by the activation of androgen receptors in elder patients. In addition, the possibility for using Chs or GCDFP-15 serum values in the follow-up of these patients, as demonstrated in two cases of the present series, can justify the immunophenotyping of the tumors.
机译：神经内分泌（NE）乳腺癌是年轻女性中罕见的实体。但是，老年患者的频率会增加。目前的工作表明老年妇女的NE乳腺癌也可以表达载脂蛋白免疫表型，并分析这种分化的组织学和临床方面。测试了所选的一系列50种NE肿瘤（50％的细胞中NE标志阳性）的总囊性疾病液蛋白15（GCDFP-15）的免疫细胞化学表达。结果表明，大约50％的中度（G2）和高分化（G1）NE乳腺癌（粘液性，实体乳头状和实体粘着性组织型）共表达载脂蛋白标记。在这些情况下，使用原位杂交（ISH）证明了GCDFP-15（PIP）和嗜铬粒蛋白A（ChA）的特异性mRNA。肺泡亚型（G2）和低分化癌（G3）（包括一例非典型类癌）是纯净的NE癌，无顶分泌分化。对这些病变的类固醇受体状态进行了评估，以测试雄激素受体可能与顶泌分化有关。我们证明了，在顶泌性中，AR水平和平均年龄在诊断时明显高于非在先性分化的肿瘤中。组织学等级和雌激素受体（ER）的表达显着影响这些NE癌的预后，无论是单纯的还是NE分泌的。因此，我们研究的最原始结果是证明了老年乳腺癌中可能存在的弥散性顶分泌分化可能受老年患者雄激素受体激活的调节。另外，如本系列的两个病例所证明的，在这些患者的随访中使用Chs或GCDFP-15血清值的可能性可以证明肿瘤的免疫表型是合理的。

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