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Annals of Clinical & Laboratory Science 37:127-134 (2007)
© 2007 Association of Clinical Scientists

Expression of Cytokeratin Markers, ER-alpha, PR, HER-2/neu, and EGFR in Pure Ductal Carcinoma In Situ (DCIS) and DCIS with Co-existing Invasive Ductal Carcinoma (IDC) of the Breast

Sharon Steinman1, Jianmin Wang2, Patricia Bourne1, Qi Yang1 and Ping Tang1
1 Department of Pathology and Laboratory Medicine, University of Rochester Medical School, Rochester, New York, and 2 RTI Health Solution, Research Triangle Park, North Carolina

Address correspondence to Ping Tang, M.D., Ph.D., Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Ave, Box 626, Rochester, New York 14642, USA; tel 585 275 6640; fax 585 273 3637; e-mail: ping_tang{at}urmc.rochester.edu.

Previously, we showed that pure ductal carcinoma in situ (DCIS) of the breast can be divided into 3 subtypes (luminal, basal/stem, and null) based on the expression of 5 cytokeratin (CK) markers: CK5/6, CK14, CK17 (stem/basal), and CK8, CK18 (luminal). The distributions of CK subtypes were associated with nuclear grade and differential expression of estrogen receptor-alpha (ER-{alpha}), progesterone receptor (PR), HER-2/neu, and epidermal growth factor receptor (EGFR). In this study, we further explore the expression patterns of CK markers, ER-{alpha}, PR, HER-2/neu, and EGFR by immunohistochemical (IHC) analysis of 99 cases of pure DCIS and 96 cases of DCIS with co-existing invasive ductal carcinoma (DCIS/IDC). We show that between high-grade DCIS and DCIS/IDC, there are differential expression patterns for ER-{alpha}, PR, and EGFR in corresponding CK subtypes, suggesting that at least some pure DCIS is molecularly distinct from DCIS/IDC. In most cases there is a high degree of co-expression of these markers between DCIS and the co-existing IDC, suggesting that DCIS is frequently a precursor lesion for co-existing IDC. The rate of discordant expression of these markers is low and is more frequently associated with high-grade carcinoma, suggesting that other molecular pathways also may also be present. There are significant differences in the expression of these molecular markers between high-grade and non-high-grade carcinomas, supporting the view that high-grade and non-high-grade carcinomas of the breast are molecularly distinct entities.

Keywords: breast carcinoma, IDC, DCIS, cytokeratin, ER-{alpha}, PR, HER-2/neu, EGFR




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 INT J SURG PATHOLHome page
N. Khilko, P. Bourne, Qi Yang, and Ping Tang
Mismatch Repair Genes hMLH1 and hMSH2 May Not Play an Essential Role in Breast Carcinogenesis
International Journal of Surgical Pathology, July 1, 2007; 15(3): 233 - 241.
[Abstract] [PDF]


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