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Expression and role of fibroblast activation protein-alpha in microinvasive breast carcinoma.doc

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Expression and role of fibroblast activation protein-alpha in microinvasive breast carcinoma

Huaetal.DiagnosticPathology2011,6:111 /content/6/1/111 RESEARCH OpenAccess Expressionandroleoffibroblastactivation protein-alphainmicroinvasivebreastcarcinoma XingHua1,2,LinaYu3,4*,XiaoxiaoHuang1,2,ZexiaoLiao1,2 andQiXian1,2 Abstract Background:Diagnosisofductalcarcinomainsitu(DCIS)inbreastcancercasesischallengingforpathologistdue toavarietyofinsitupatternsandartefacts,whichcouldbemisinterpretedasstromalinvasion.Microinvasionis detectedbythepresenceofcytologicallymalignantcellsoutsidetheconfinesofthebasementmembraneand myoepithelium.Whenmalignantcellsinvadethestroma,thereistissueremodelinginducedbyperturbedstromal- epithelialinteractions.Carcinoma-associatedfibroblasts(CAFs)aremaincellsinthemicroenvironmentofthe remodeledtumor-hostinterface.Theyarecharacterizedbytheexpressionofthespecificfibroblastactivation protein-alpha(FAP-a),anddifferfromthatofnormalfibroblastsexhibitinganimmunophenotypeofCD34.We hypothesizedthatstainingforFAP-amaybehelpfulindeterminingwhetherDCIShasmicroinvasion. Methods:349excisedbreastspecimenswereimmunostainedforsmoothmuscleactinSMA,CD34,FAP-a ,and Calponin.Studymaterialwasdividedinto5groups:group1:normalmammarytissuesofhealthywomenafter plasticsurgery;group2:usualductalhyperplasia(UDH);group3:DCISwithoutmicroinvasiononHEstain;group 4:DCISwithmicroinvasiononHEstain(DCIS-MI),andgroup5:invasiveductalcarcinoma(IDC).Acomparative evaluationofthefourimmunostainswasconducted. Results:OurresultsdemonstratedthatusingFAP-aandCalponinadjunctivelyimprovedthesensitivityof pathologicaldiagnosisofDCIS-MIby11.29%,whereastheadjunctiveuseofFAP-aandCalponinimprovedthe sensitivityofpathologicaldiagnosisofDCISby13.6%. Conclusions:ThisstudyprovidesthefirstevidencethatimmunostainingwithFAP-aandCalponincanserveasa novelmarkerforpathologicallydiagnosingwhetherDCIShasmicroinvasion. Keywords:fibroblastactivationprotein-alpha,microinvasionbreastcarcinoma,diagnosis Background therapy forpatients withpureinsitucarcinoma differs Withwidespreaduseofmammographicscre