title: Differential expression of immunohistochemical markers in primary lung and breast cancers enriched for triple-negative tumours.
abstract: OBJECTIVE
  In breast cancer patients presenting with a lung lesion, the distinction between lung and breast origin is clinically important. Lung and breast cancers are both CK7(+) /CK20(-) , so additional immunohistochemical markers are needed.
  
  
  RESULTS
  We examined the expression of oestrogen receptor (ER), progesterone receptor (PR), thyroid transcription factor-1 (TTF-1), gross cystic disease fluid protein-15 (GCDFP-15), p63 and Wilms' tumour 1 (WT1) in a series of tissue microarrays comprising 266 non-small-cell lung cancers and 837 primary breast cancers enriched for triple-negative tumours (TNBC). Staining for ER, PR, TTF-1 and GCDFP-15 was present in 63%, 49%, 0% and 25% of breast and 6%, 9%, 59% and 1% of lung cancers, respectively. Strong staining for p63 was present in 63 (97%) lung squamous cell carcinomas and only eight (9%) TNBC. WT1 nuclear staining was rare; however, cytoplasmic staining was identified in 49 (40%) TNBC and 10 (5%) lung cancers. Cluster analysis segregated TNBC from lung cancers with TTF-1 and/or p63 staining favouring lung origin, and GCDFP-15 or WT1 staining favouring breast origin. Cancers negative for all four markers (17%) were 60% breast and 40% lung origin.
  
  
  CONCLUSIONS
  An immunohistochemical panel incorporating ER, TTF-1, GCDFP-15, p63 and WT1 can help to distinguish lung cancer from metastatic breast cancer, including TNBC.
authors.affiliation: Department of Histopathology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Elena
authors.initials: E
authors.lastname: Provenzano
authors.affiliation: Department of Pathology, Peter MacCallum Cancer Centre, The University of Melbourne, Melbourne, Vic., Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Byrne
authors.affiliation: Department of Anatomical Pathology, St Vincent's Hospital, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Prudence A
authors.initials: PA
authors.lastname: Russell
authors.affiliation: Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Gavin M
authors.initials: GM
authors.lastname: Wright
authors.affiliation: Università Operativa Multidisciplinare di Patologia Mammaria/US Terapia Molecolare e Farmacogenomica, dell'Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.affiliation: Department of Pathology, Peter MacCallum Cancer Centre, The University of Melbourne, Melbourne, Vic., Australia.|Department of Pathology, The University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Fox
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D002352:Carrier Proteins / Q000378:metabolism; D016000:Cluster Analysis; D003937:Diagnosis, Differential; D005260:Female; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology; D008565:Membrane Proteins / Q000378:metabolism; D026901:Membrane Transport Proteins; D009687:Nuclear Proteins / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors / Q000378:metabolism; D064726:Triple Negative Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D025721:WT1 Proteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; C081876:CKAP4 protein, human; D002352:Carrier Proteins; D006023:Glycoproteins; D008565:Membrane Proteins; D026901:Membrane Transport Proteins; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; C488892:PIP protein, human; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors; D025721:WT1 Proteins; C583751:WT1 protein, human
keywords: breast cancer; immunohistochemistry; lung cancer; triple negative breast cancer