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Marabi M, Aphivatanasiri C, Jamidi SK, Wang C, Li JJ, Hung EH, Poon IK, Tsang JY, Tse GM. The International Academy of Cytology Yokohama System for Reporting Breast Cytopathology showed improved diagnostic accuracy. Cancer Cytopathol 2021; 129:852-864. [PMID: 34029453 DOI: 10.1002/cncy.22451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/21/2021] [Accepted: 02/24/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The aim of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology is to improve cytology practice. This study assessed cytologic diagnoses made with the system and its efficacy when it was applied by pathologists with different levels of experience. METHODS In all, 1080 cases of breast fine-needle aspiration biopsy (FNAB) over a period of 16 years were reviewed and reclassified with the system. The category distribution and the diagnostic performance were compared with the original diagnoses. The concordance rates for diagnoses from pathologists with different levels of experience were also determined. RESULTS The distribution of cytologic diagnoses made with the system was as follows: 11.7% were insufficient, 56.6% were benign, 20.1% were atypical, 6.1% were suspicious for malignancy, and 5.6% were malignant. The rates for the insufficient and atypical categories were lower than the original diagnosis rates (13.1% and 23.8%, respectively). Overall, 120 cases (11.1%) were recategorized. Among those recategorized as benign, suspicious, or malignant with follow-up data, 96.7% were correctly reclassified. A significant improvement in diagnostic performance was found with the system (P < .001). Such improvement was also seen in problematic breast lesions, including fibroepithelial lesions, papillary lesions, and low-grade carcinomas. Pathologists with intermediate experience showed a higher concordance with an expert pathologist in the diagnoses than those with short experience (κ, 0.838 vs 0.634). CONCLUSIONS The system effectively categorized the diagnoses, and the diagnostic performance of FNAB reporting was improved. The structured reporting also enhanced the reproducibility of reporting by pathologists with intermediate experience and, to some extent, those with short experience.
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Affiliation(s)
- Monalyn Marabi
- Department of Pathology, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | | | | | - Chao Wang
- Department of Pathology, Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Joshua J Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Esther H Hung
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Ivan K Poon
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Julia Y Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Gary M Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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Jamidi SK, Hu J, Aphivatanasiri C, Tsang JY, Poon IK, Li JJ, Chan SK, Cheung SY, Tse GM. Sry-related high-mobility-group/HMG box 10 (SOX10) as a sensitive marker for triple-negative breast cancer. Histopathology 2020; 77:936-948. [PMID: 32304249 DOI: 10.1111/his.14118] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/20/2020] [Accepted: 04/14/2020] [Indexed: 12/13/2022]
Abstract
AIMS Confirmation of a breast origin for triple-negative breast cancer (TNBC) is sometimes problematic. The traditional breast markers GATA-binding protein 3 (GATA3), mammaglobin (MGB) and gross cystic disease fluid protein 15 (GCDFP15) have shown limitations in identifying TNBC. Here, we aimed to examine the diagnostic potential of the newly proposed TNBC marker, Sry-related high-mobility-group/HMG box 10 (SOX10). METHODS AND RESULTS We analysed and compared SOX10 expression with GATA3, MGB and GCDFP15 expression in a test cohort of 1838 invasive breast cancers (IBCs) by using tissue microarrays. The findings from the test cohort were further examined with a validation cohort of 42 TNBCs in whole sections. The overall expression rates of SOX10, GATA3, MGB and GCDFP15 were 6.9%, 83.1%, 47.0%, and 34.8%, respectively. Among the TNBCs within this cohort, the expression rates of SOX10, GATA3, MGB and GCDFP15 were 31.3%, 34.5%, 27.9%, and 25.2%, respectively. SOX10 was strongly associated with TNBC (P < 0.001), whereas all other traditional markers were associated with non-TNBC (P < 0.001 for all). In addition, SOX10 was more correlated to basal-like breast cancer (BLBC) (P = 0.001) than five-marker-negative subtype among the TNBCs. A high expression rate of SOX10 (81%) was confirmed in the validation cohort. Additionally, SOX10 expression was inversely correlated with GATA3 and GCDFP15 expression, so they may complement each other in TNBC detection. The SOX10-GATA3 combination yielded a sensitivity of 60.3% for TNBC detection in the test cohort. CONCLUSION SOX10 is a reliable marker for identifying TNBC, and complements GATA3. The SOX10-GATA3 combination may be used as a sensitive TNBC marker.
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Affiliation(s)
- Shirley K Jamidi
- Department of Pathology, Eka Hospital, Bumi Serpong Damai, Tangerang, Indonesia
| | - Jintao Hu
- Department of Pathology, the Second Affiliated Hospital of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | | | - Julia Y Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Ivan K Poon
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Joshua J Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Siu-Ki Chan
- Department of Pathology, Kwong Wah Hospital, Hong Kong, China
| | - Sai-Yin Cheung
- Department of Pathology, Tuen Mun Hospital, Hong Kong, China
| | - Gary M Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Aphivatanasiri C, Li J, Chan R, Jamidi SK, Tsang JY, Poon IK, Shao Y, Tong J, To KF, Chan SK, Tam F, Cheung SY, Shea KH, Tse GM. Combined SOX10 GATA3 is most sensitive in detecting primary and metastatic breast cancers: a comparative study of breast markers in multiple tumors. Breast Cancer Res Treat 2020; 184:11-21. [PMID: 32737715 DOI: 10.1007/s10549-020-05818-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/17/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE For invasive breast cancer (IBC), high SOX10 expression was reported particularly in TNBC. This raised the possibility that SOX10 may complement other breast markers for determining cancers of breast origin. METHODS Here, we compared the expression of SOX10 with other breast markers (GATA3, mammaglobin and GCDFP15) and their combined expression in a large cohort of IBC together with nodal metastases. We have also evaluated the expression of GATA3 and SOX10 in a wide spectrum of non-breast carcinomas to assess their value as breast specific markers. RESULTS Compared with other markers, SOX10 showed lower overall sensitivity (6.5%), but higher sensitivity in TNBC (31.4%) than other breast markers including GATA3 (29.7% for TNBC). Its expression demonstrated the highest concordance between the paired IBC and nodal metastases (96.4%, κ = 0.663) among all the breast markers. More importantly, SOX10 identified many GATA3-negative TNBC, thus the SOX10/GATA3 combination was the most sensitive marker combination for IBC (86.6%). For non-breast carcinoma, a high SOX10/GATA3 expression rate was found in melanoma (77.9%, predominately expressed SOX10), urothelial carcinoma (82.0%, predominately expressed GATA3) and salivary gland tumors (69.4%). Other carcinomas, including cancers from lungs, showed very low expression for the marker combination. CONCLUSIONS The data suggested that SOX10/GATA3 combination can be used for differentiating metastases of breast and multiple non-breast origins. However, the differentiation with melanoma and urothelial tumors required more careful histologic examination, thorough clinical information and additional site-specific IHC markers. For salivary gland tumors, the overlapping tumor types with IBC renders the differentiation difficult.
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Affiliation(s)
| | - Joshua Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Ronald Chan
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Shirley K Jamidi
- Department of Pathology, Eka Hospital, Bumi Serpong Damai, Tangerang, Indonesia
| | - Julia Y Tsang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Ivan K Poon
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Yan Shao
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Joanna Tong
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Ka-Fai To
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong
| | - Siu-Ki Chan
- Department of Pathology, Kwong Wah Hospital, Hong Kong, Hong Kong
| | - Fiona Tam
- Department of Pathology, Kwong Wah Hospital, Hong Kong, Hong Kong
| | - Sai-Yin Cheung
- Department of Pathology, Tuen Mun Hospital, Hong Kong, Hong Kong
| | - Ka-Ho Shea
- Department of Pathology, Tuen Mun Hospital, Hong Kong, Hong Kong
| | - Gary M Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong.
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