title: P-cadherin and vimentin are useful basal markers in breast cancers.
abstract: Basal-like breast cancer (BLBC) is the breast cancer subtype defined by gene profiling and generates keen clinical interest. Immunohistochemical panels using basal cytokeratins and epidermal growth factor receptor are widely adopted for its identification. Nonetheless, there are concerns about the risk for missing some true BLBCs. Both P-cadherin and vimentin have been proposed as BLBC markers, but their usefulness for BLBC classification has not been well documented. In this study, we evaluated by immunohistochemistry their expression in a large cohort of breast carcinoma. Cancers expressing vimentin or P-cadherin showed BLBC-related morphological features (high grade, presence of necrosis, and lymphocytic infiltration; P < .001 for all except P = .006 for vimentin with lymphocytic infiltration) and immunohistochemical profile (P < .001 for all markers tested except P = .007 for vimentin with human epidermal growth factor receptor 2). Concordantly, they were significantly associated with BLBC (P < .001 for both). Nonetheless, they did not appear to be good stand-alone BLBC markers. Compared with the commonly used reference panel, the specificity (95.9%) and sensitivity (43.1%) of coexpression of vimentin and P-cadherin were better than most single markers or their combinations tested. Moreover, their coexpression was significantly associated with basal features in non-BLBCs and worse disease-free survival in triple-negative breast cancers (hazard ratio, 2.232; P = .027). This raised the possibility that the vimentin and P-cadherin combination can be used to identify BLBC especially those that were missed by the commonly used basal cytokeratins and epidermal growth factor receptor panel. Together, P-cadherin and vimentin could be adjunctive to the commonly used immunohistochemical surrogates for BLBC identification.
authors.affiliation: Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Julia Y S
authors.initials: JY
authors.lastname: Tsang
authors.forename: Sze-Kit
authors.initials: SK
authors.lastname: Au
authors.forename: Yun-Bi
authors.initials: YB
authors.lastname: Ni
authors.forename: Mu-Min
authors.initials: MM
authors.lastname: Shao
authors.forename: Wing-Man
authors.initials: WM
authors.lastname: Siu
authors.forename: Suen-Wah
authors.initials: SW
authors.lastname: Hui
authors.forename: Siu-Ki
authors.initials: SK
authors.lastname: Chan
authors.forename: Kit-Wing
authors.initials: KW
authors.lastname: Chan
authors.forename: Ying-Kin
authors.initials: YK
authors.lastname: Kwok
authors.forename: Kui-Fat
authors.initials: KF
authors.lastname: Chan
authors.forename: Gary M
authors.initials: GM
authors.lastname: Tse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D015820:Cadherins / Q000378:metabolism*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D064726:Triple Negative Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D014746:Vimentin / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D015820:Cadherins; D014746:Vimentin; D066246:ErbB Receptors
keywords: Basal-like breast cancers; Immunohistochemistry; P-cadherin; Vimentin