Diagnostic Value of Cytokeratin 5 and Cytokeratin 6 in Benign and Malignant Lesions of Breast
Keywords:
Breast Carcinoma, Histopathology, Immunohistochemistry, CK5, CK6, Cytokeratin
Abstract
Background: Correlation of Cytokeratin 5 and Cytokeratin 6 expression in benign and malignant lesions of the female breast-ducts and to find out the utility of Cytokeratin 5/6 in the prognosis of carcinoma breast.Methods: The present study was carried out on 78 benign and malignant lesions of breast. Tissues were fixed in formal saline, processed for paraffin sections and stained with Haematoxylin and Eosin (H&E) stain. Immunohistochemical staining was performed using mouse antihuman polyclonal D5/16B4 antibody for cytokeratin 5/6 and visualization obtained with DAB and the slides were examined for staining pattern (cytoplasmic or membrane), proportion and intensity of staining of tumour cells.Results: Amongst the 78 cases of breast lesions, 38 (48.7%) cases were benign breast disease, 18 (23.1%) were ductal carcinoma in situ and 22 (28.2%) cases were of malignant breast carcinoma. Out of 22 cases of malignant breast disease, 16 (72.7%) cases showed negative cytokeratin reaction with staining score of <2 and 6 (27.3%) cases of triple negative breast carcinoma (TNBC) showed positive cytokeratin expression with staining score of 5-8.Conclusions:Immunohistochemistry is efficiently used for differentiating the UDH (usual-ductal-hyperplasia) from the DCIS (ductal carcinoma in situ), ruling out micro-invasion, distinguishing invasive carcinoma from pseudo-invasive lesions, identifying breast cancer histological sub-type and molecular phenotype.References
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2. Yeh I-Tien and Carolyn M. Application of Immunohistochemistry to Breast Lesions. Archives of Pathol Lab Med 2008; 132: 349-358.
3. Abdel-Fatah, Tarek MA, Desmond GH, Zsolt RF, Jorge SL, Andrew H, et al. Morphologic and molecular evolutionary pathways of low nuclear grade invasive breast cancers and their putative precursor lesions: further evidence to support the concept of low nuclear grade breast neoplasia family. Am J Surg Pathol 2008; 32:513-523.
4. Tan M, Puayhoon AW, Meng Yuan BS, Bay B, Huat S, Lang H et al. Cytokeratins in Papillary Lesions of the Breast: Is There a Role in Distinguishing Intraductal Papilloma From Papillary Ductal Carcinoma In Situ. Am J Surg Pathol 2005; 29 (5): 625-632.
5. Magali Lacroix-Triki, Eliane M, Jean-Jacques V, Luc I, Philippe R. Value of cytokeratin 5/6 immunostaining using D5/16 B4 antibody in the spectrum of proliferative intraepithelial lesions of the breast. A comparative study with 34beta E12 antibody. Virchows Archiv 2003; 442(6):548-554.
6. Rabban JT, Frederick C, Koerner M, Melinda FL. Solid papillary ductal carcinoma in situ versus usual ductal hyperplasia in the breast: a potentially difficult distinction resolved by cytokeratin 5/6. Hum Pathol 2006; 37(7): 787-793.
7. Raju U, Crissman JD, Zarbo RJ. Epitheliosis of the Breast- An Immunohistochemical Characterization and Comparison to Malignant Intraductal Proliferations of the Breast. Am J Surg Pathol 1990; 14(10): 939-947.
8. Bφcker W, Moll R, Poremba C, Holland R, Van Diest PJ, Dervan P et al. Common adult stem cells in the human breast gives rise to glandular and myoepithelial cell lineages: A new cell biological concept. Lab Invest 2002; 82:737-745.
9. Tot T. The cytokeratin profile of medullary carcinoma of the breast. Histopathol 2006; 37: 175-181.
10. Otterbach F, Bànkfalvi A, Bergner S, Decker T, Krech R, Boecker W. Cytokeratin 5/6 immunohistochemistry assists the differential diagnosis of atypical proliferations of the breast. Histopathol 2000; 37(3):232-240.
11. Rehim DM, Pinder SE, Paish CE, Bell J, Blamey RW, Robertson JF et al. Expression of luminal and basal cytokeratins in human breast carcinoma. J Pathol 2004; 203(2):661-671.
12. Lakhani SR, Reis-Filho JS, Fulford L, Penault-Llorca F, Van der Vijver M, Parry S et al. Breast cancer linkage consortium: Prediction of BRCA 1 status in patients with breast cancer using estrogen receptor and basal phenotype. Clin Cancer Res 2005; 11:5175-5180.
13. Naim M, Soni M, Khan A. Modified Naim Murad classification of female breast cancer in Breast cancer classification, serum adiponectin and SNP rs 2241766. Lap Lambert academic publications, Germany, 2014; pp 19-59.
14. Dent R, Trudeau M, Pritchard KI, Hanna WM. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 2007; 13(15): 4429-4434.
15. Van de Rijn M, Perou CM, Tibshirani R, Haas P, Kallioniemi O, Kononen J et al. Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. Am J Pathol 2002; 161:1991-1996.
16. Takei H, Iino Y, Horiguchi J, Maemura M, Oyama T, Yokoe et al. Low and high molecular weight cytokeratins in invasive breast carcinoma. Oncol Rep 1997; 4: 33-38.
Published
2015-10-26
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