The correlation between the immunohistochemical expression of DF3 antigen and serum CA15-3 in breast cancer patients

The value of serum tumour markers in the prediction of aetiology and follow up of patients with pericardial effusion

BACKGROUND

The aim of this study was to evaluate the value of tumour markers in the differential diagnosis of pericardial effusions and to assess their changing levels during follow up.

METHODS

Sixty-nine patients who were admitted to hospital with a diagnosis of pericardial effusion were included in the study. Serum tumour markers were measured on admission and after a mean of 18 ± 7 months' follow up. An aetiological diagnosis was made on clinical evaluation, imaging techniques and biochemical, microbiological and pathological analysis. The patients were divided into five groups according to the aetiology of their pericardial effusions.

RESULTS

Carbohydrate antigen (CA) 12-5 and CA 15-3, and carcinoembryonic antigen (CEA) levels were significantly higher in patients with malignancies than in those with viral/idiopathic pericarditis. With multivariate analysis, CA 15-3 levels were found to be the most significant determinant (p = 0.027). In the ROC curve analysis, CA 15-3 values above 25 U/ml predicted a malignancy with 71% sensitivity and 78% specificity.

CONCLUSION

Tumour markers, particularly CA 15-3, may be useful in the differential diagnosis and prediction of malignancies in patients with pericardial effusion. In patients with viral/idiopathic aetiology, these serum tumour markers were slightly elevated in the acute phase, but after a mean of one year of follow up, their levels returned to normal, contrary to those with malignancies.

A case of breast cancer metastatic to the tail of the pancreas

Breast cancer metastasis to pancreas is rarely seen. There have been only 6 cases described in the literature. We present the seventh case of a 54-year-old woman with breast cancer that metastasized to the tail of the pancreas 4 years and 4 months after radical mastectomy. Although the serum levels of CA15-3 and TPA had gradually increased without symptoms, it was difficult to establish the diagnosis before contrast-enhanced abdominal CT scan was performed. Immunohistochemical staining using E-cadherin was positive, proving that the breast cancer was ductal rather than lobular in origin. CA15-3 immunohistochemically stained positive in the resected pancreas lesion. Positive monoclonal staining by GCDFP-15 (gross cystic disease fluid protein-15) in the pancreas tumor also confirmed it breast cancer origin. Investigation of chemokine/chemokine receptors may clarify a new mechanism of metastasis to the pancreas from breast cancer.

A case of breast cancer metastasizing to cervix after resection of pancreatic metastasis

A case of breast cancer that metastasized to the cervix 10 years and 8 months after mastectomy is reported. The patient had undergone pancreaticoduodenectomy due to solitary metastasis to the head of the pancreas 4 years previously. The cervical metastasis was associated with abnormal genital bleeding. After pancreaticoduodenectomy the serum levels of CEA, CA15-3 and NCC-ST-439, which are markers of breast cancer, were within normal limits, but the serum level of CA15-3 had increased month by month. The patient had abnormal genital bleeding and presented to the department of gynecology at our hospital. The tumor was in the cervix, bled easily and 2.5x2.0 cm in size on ultrasonography. It was thought to be carcinoma of the cervix, but biopsy revealed the tumor to be an adenocarcinoma pathologically and CA15-3 was immunohistochemically demonstrated in the resected specimen, similar to lobular carcinoma of the breast. Abdominal CT scan revealed involvement of the ovaries and uterus, prompting hysterectomy with bilateral oophorectomy. After discharge, she received chemoendocrine therapy. However, she subsequently died due to peritoneal carcinomatosis.

Immunohistochemical study of p185 HER2 and DF3 in primary breast cancer and correlation with CA-15-3 serum tumor marker

Human epidermal growth factor receptor 2 (p185 HER2) oncoprotein immunohistochemical expression and DF3 antigen distribution were evaluated in 129 patients with primary breast cancer. p185 HER2 overexpession was positively correlated with the degree of differentiation, metastatic disease, progesterone receptors, and cytoplasmic distribution of DF3 antigen. p185 HER2 overexpression had prognostic significance for the disease-free interval.

Diagnostic value of a second generation CA 15-3 antibody to detect adenocarcinoma in body cavity effusions

BACKGROUND

Detecting malignant cells in body cavity effusions can be diagnostically challenging. Several monoclonal antibodies have been studied to improve the diagnostic yield of effusion cytology but without widespread acceptance. The CA 15-3 antibody has demonstrated high sensitivity but limited specificity for breast carcinoma in surgical pathology. A second generation CA 15-3 antibody has been developed that has not been studied in serous effusions to the authors' knowledge. The authors examined this second generation CA 15-3 antibody for its diagnostic utility in detecting adenocarcinomas in this cytologic setting.

METHODS

Cell block material from 114 cases of unequivocally benign or malignant body cavity effusions were studied. Slides were stained for CA 15-3 by using the avidin-biotin complex method. The percentage of cells exhibiting strong staining was estimated both for breast carcinoma and for all adenocarcinomas as a group. These results were compared with CA 15-3 staining exhibited by benign mesothelium.

RESULTS

CA 15-3 was expressed in at least 10% of tumor cells in 97% of breast carcinoma cases and in 90% of adenocarcinomas overall. The highest sensitivity was observed in carcinomas of the breast, ovary, and lung. Of 40 cases of benign mesothelium, only 4 (10%) were positive (P < 0.001). The sensitivity of CA 15-3 was 97% for breast carcinoma and 91% for adenocarcinomas overall. Specificity was 95% for breast carcinoma and 91% for adenocarcinomas.

CONCLUSIONS

CA 15-3 is an immunostain with high specificity and sensitivity for adenocarcinomas in cell block material from effusions. The antibody holds particular promise for detecting breast carcinoma. Cancer (Cancer Cytopathol)

A Case of Breast Cancer Metastatic to the Head of the Pancrea

A case of breast cancer that metastasized to the head of the pancreas 6 yearsand 8 months after mastectomy is reported. The pancreas head metastasis was associated with general fatigue and obstructive jaundice. The serum levels of CEA, CA15-3 and NCC-ST-439, tumor markers of breast cancer, were within normal limits, but CA15-3 was immunohistochemically demonstrated in the resected metastatic lesion, in a manner similar to lobular carcinoma of the breast.

A Case of Occult Breast Cancer With Paraneoplastic Polyneuropathy

We encountered a very rarc case of occult breast cancer associated with paraneoplastic sensory polyneuropathy. A 59-year-old woman was admitted to our hospital complaining of numbness in all extremities, ataxia of left extremities and a tumor in the left axilla. From the neurological findings, a malignant tumor was suspected. The immunohistochemical analysis of the axillar swollen lymph node revealed metastasis from breast cancer and confirmed the primary lesion. On a preoperative diagnosis of suspected occult breast cancer, left mastectomy and resection of left axillar lymph nodes were performed. Furthermore, immunohistochemical staining of sural nerves and Western blot analysis of the serum of this patient showed the loss of axons and the presence of antineural antibody in the seurm. Immunological response was considered to be the remote effector system between the breast cancer and sensory polyneuropathy in this disorder.

A Case of Breast Cancer Metastatic to the Pituitary Gland

A case of breast cancer that developed pituitary metastasis 22 years after mastectomy is reported. The pituitary metastasis was associated with hypopituitarism, impairment of the visual field and later diabetes insipidus. The serum levels of CA15-3 and NCC-ST-439, tumor markers of breast cancer, were increased, and CA15-3 (DF3) and NCC-ST-439 were demonstrated in the resected pituitary metastatic lesion immunohistochemically.

Characterization of cell surface antigens expressed in the HMA-1 breast cancer cell line

This report describes the characterization of an estrogen receptor-positive breast cancer cell line, HMA-1, established from a breast cancer patient, based on the expression of tumor-associated antigens (TAAs), the HLA-DR antigen, and the c-erbB-2 proto-oncogene product. In flow cytometric and immunohistochemical analyses, HMA-1 was found to express increased levels of several TAAs including MUC1, TAG-72 (sialyl Tn), Tn, T, sialyl Le(a), Le(x), and Le(y). HMA-1 also expressed enhanced levels of the HLA-DR antigen and c-erbB-2 protein. These results indicate that HMA-1 is a unique cell line with abundant TAAs which may serve as an appropriate breast cancer cell line for application in the multidisciplinary research of breast cancer.

Association of expression of blood group-related carbohydrate antigens with prognosis in breast cancer

BACKGROUND

It has been thought that carbohydrate antigens, especially Lewis (Le) blood group antigens, are cancer-related antigens.

METHODS

The authors conducted immunohistochemical studies to investigate the expression of seven different types of Le carbohydrate antigens in breast cancer tissue and their usefulness as an indicator of the degree of malignancy and as a prognostic factor.

RESULTS

When this expression was compared in the cancerous portion of 300 breast cancers and noncancerous mammary ductal epithelium in each of the patients, reduced expression of type 1 carbohydrate antigens and increased expression of type 2 carbohydrate antigens were found in the cancerous portions. No correlation was detected between the antigen expression and clinicopathologic factors. The prognosis of patients in whom type 2 carbohydrate antigens were increased in the cancerous portion, especially Lex (19.7% of patients) and sialyl Lex-i (20.3% of patients), was poorer than in patients in whom they were not increased (P < 0.01).

CONCLUSIONS

The relative expression of type 2 carbohydrate antigens in breast cancer tissue seems capable of serving as a prognostic factor.