Evaluation of androgen receptor and GATA binding protein 3 as immunohistochemical markers in the diagnosis of metastatic breast carcinoma to the lung

Our plain-English summary of Evaluation of androgen receptor and GATA binding protein 3 as immunohistochemical markers in the diagnosis of metastatic breast carcinoma to the lung, by Y. Hattori, A. Yoshida, M. Yoshida, et al (Pathology International, 2015).

The study

• Authors: Y. Hattori, A. Yoshida, M. Yoshida, M. Takahashi, K. Tsuta
• Journal: Pathology International
• Published: 2015;65(6):286-92
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Differentiating metastatic breast carcinoma in the lungs from primary lung tumors and mesotheliomas is important for determining prognosis and treatment. We evaluated novel breast specific markers, androgen receptor (AR) and GATA binding protein 3 (GATA3) immunohistostaining, for this differential, and compare to other traditional markers. The specimens comprised 33 metastatic breast carcinomas to the lung, 566 primary lung tumors (170 adenocarcinomas, 157 squamous cell carcinomas, 31 pleomorphic carcinomas, 115 large cell neuroendocrine carcinomas, 43 small cell carcinomas, and 49 typical carcinoids) and 42 malignant mesotheliomas. They were analyzed by immunohistochemistry using antibodies to AR, GATA3, estrogen receptor (ER), progesterone receptor (PgR), mammaglobin, gross cystic disease fluid protein-15 (GCDFP-15). Of the metastatic breast carcinomas, immunohistostaining of AR, GATA3, ER, PgR, mammaglobin, GCDFP-15 were positive in 27 cases (81.8%), 24 cases (72.7%), 26 cases (78.8%), 13 cases (39.4%), 12 cases (36.4%), 9 cases (27.3%), respectively. Of primary lung tumors and mesotheliomas, staining of AR, GATA3, ER, PgR, mammaglobin, GCDFP-15 were positive in 18 cases (3%), 3 cases (0.5%), 4 cases (0.7%), 2 cases (0.3%), 0 case (0%), 2 cases (0.3%), respectively. Immunohistochemistry of AR and GATA3 are reliable for differentiating metastatic breast carcinoma from primary lung tumors and mesotheliomas.

© 2015 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

In plain English

This laboratory study tested whether two tissue stains, androgen receptor (AR) and GATA3, can tell breast cancer that has spread to the lung apart from cancers that start in the lung or pleura, including malignant mesothelioma. The study did not look at asbestos exposure. The authors stained tumor samples from 33 metastatic breast carcinomas removed from the lung and from 607 lung or pleural tumors, 42 of them malignant mesotheliomas. They compared AR and GATA3 with four traditional breast markers. AR was positive in 27 of the 33 breast metastases (81.8%) and GATA3 in 24 (72.7%). Among the lung and pleural tumors, AR was positive in 18 (3.0%), none of them mesotheliomas, and GATA3 in three (0.49%), one of which was a mesothelioma. Specificity was 97.0% for AR and 99.5% for GATA3. Using both markers together did not improve sensitivity. The authors concluded that both stains appear to be reliable markers for this purpose. They noted that some non-breast tumors also express these markers, and that few cases were available for comparing primary breast tumors with their metastases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Diagnostic immunohistochemistry study of archived tumor specimens using tissue microarrays, with sensitivity, specificity and ROC curve analysis
• Who was studied: 33 metastatic breast carcinomas resected from the lung and 607 lung or pleural tumors: 170 adenocarcinomas, 157 squamous cell carcinomas, 31 pleomorphic carcinomas, 115 large cell neuroendocrine carcinomas, 43 small cell carcinomas, 49 typical carcinoids and 42 malignant mesotheliomas. Corresponding primary breast tumors were available for 11 of the 33 metastatic cases. Specimens came from the National Cancer Center Hospital, Tokyo, Japan; dates are not given.
• Main results:
  • In the 33 metastatic breast carcinomas, AR was positive in 27 cases (81.8%).
  • In the 33 metastatic breast carcinomas, GATA3 was positive in 24 cases (72.7%).
  • Using AR and GATA3 together did not improve sensitivity for detecting metastatic breast carcinoma.
  • Among the 607 lung and pleural tumors, AR was positive in 18 cases (3.0%): 8 squamous cell carcinomas, 1 pleomorphic carcinoma, 2 large cell neuroendocrine carcinomas, 5 small cell carcinomas and 2 typical carcinoids. No mesothelioma and no lung adenocarcinoma was AR-positive.
  • Among the lung and pleural tumors, GATA3 was positive in three cases (0.49%): one squamous cell carcinoma, one typical carcinoid and one malignant mesothelioma.
  • Specificity for detecting metastatic breast carcinoma was 97.0% for AR and 99.5% for GATA3.
  • Area under the ROC curve was 0.894 for AR and 0.861 for GATA3. Among the four traditional markers, ER had the highest value (0.888).
  • Of the six breast markers, only ER stained any primary lung adenocarcinomas, in three cases (1.8%).
  • In 11 cases with matched primary breast tumors, AR and GATA3 status was unchanged between the primary tumor and the lung metastasis in 8 of 11.
• The authors' conclusion: The authors concluded that AR and GATA3 stains appear to be reliable markers for differentiating metastatic breast carcinomas from primary lung and pleural tumors, and recommended adding them to the routine diagnostic panel.
• Limitations the authors state:
  • The comparison of marker status between primary breast tumors and their lung metastases involved a limited number of cases.
  • Some non-breast tumors also express these markers, such as AR in salivary gland tumors and GATA3 in urothelial carcinomas, so other organ-specific markers may be needed.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: GATA3, Carcinoma, Mesothelioma, Prognosis, Adenocarcinoma, Squamous Cell Carcinoma, Pleomorphic, Malignant Mesothelioma.

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