Immunoexpression of hormonal receptors in phyllodes tumors
DOI:
https://doi.org/10.22437/proca.v1i2.50323Keywords:
immunoexpression, horomonal receptors, pyhllodes tumorsAbstract
Background: Phyllodes tumor (PT) is a rare fibroepithelial neoplasm of the breast characterized by biphasic proliferation of epithelial and stromal components. The role of hormonal receptors such as estrogen receptor (ER) and progesterone receptor (PR) in PT remains unclear, particularly in relation to tumor grade and stromal behavior. Objective: This study aimed to evaluate the immunoexpression of ER and PR in both stromal and epithelial components of phyllodes tumors and analyze their correlation with histologic grade (benign, borderline, and malignant). Methods: A retrospective cross-sectional study was conducted on 49 archived FFPE samples of phyllodes tumors diagnosed at the Department of Pathology, Universitas Jambi Hospital. Two samples were excluded due to poor tissue quality, leaving 47 cases for immunohistochemical (IHC) evaluation. ER and PR expression were assessed semi-quantitatively in epithelial and stromal cells, and correlations with tumor grade were analyzed using Chi-square and Spearman tests. Results: Among 47 evaluable cases, 28 (59.6%) were benign, 12 (25.5%) borderline, and 7 (14.9%) malignant. ER and PR were expressed predominantly in epithelial cells, with low positivity in stromal cells. No significant correlation was found between ER/PR expression and histologic grade (p > 0.05). Conclusion: Hormonal receptor expression does not correlate significantly with histologic grade of phyllodes tumors, suggesting a limited role of ER and PR in tumor progression.
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[1] Tan PH, Ellis I, Allison K, Brogi E, Fox SB, Lakhani S, et al. The 2019 WHO classification of tumours of the breast. Histopathology. 2020;77(2):181–185
[2] Zhou X, Wang C, Chen Y. Hormonal receptor expression in phyllodes tumor and its correlation with histologic grade. Pathol Res Pract. 2020;216(7):153007.
[3] Wang Z, Li Y, Kong X, Tang J. The role of stromal proliferation markers in predicting recurrence of borderline and malignant phyllodes tumors. Breast. 2022;62:10–17.
[4] Lee CH, Tan PH. Molecular and immunophenotypic features of phyllodes tumor progression: Insights into stromal-epithelial interactions. Histopathology. 2022;81(4):513–522.
[5] Quzwain F. Comparison of Snail-1 and Estrogen Receptor Immunoexpression between Fibroadenomas and Phyllodes Tumors. J Kedokt Brawijaya 2020;31(2):100–4.
[6] Chen Z, Li J, Tang J. TERT and MED12 mutations in stromal progression of phyllodes tumors: Correlation with immunohistochemical markers. Breast Cancer Res Treat. 2023;190(1):77–88.
[7] Wang Z, Li Y, Kong X, Tang J. The role of stromal proliferation markers in predicting recurrence of borderline and malignant phyllodes tumors. Breast. 2022;62:10–17
[8] Mishra SP, Tiwary SK, Mishra M, Khanna AK. Phyllodes tumor of breast: Cytological, histopathological and immunohistochemical study. J Cancer Res Ther. 2019;15(1):27–33.
[9] Wang H, Liu J, Zhang S. Expression of ER, PR, and Ki-67 in phyllodes tumors: A retrospective analysis. Breast J. 2021;27(3):229–236.
[10] Karim RZ, Scolyer RA, Tse GM. Phyllodes tumours of the breast: Clinicopathologic analysis of 65 cases with immunohistochemical correlation. Pathology. 2021;53(1):65–71.
[11] Wang Z, Li Y, Kong X, Tang J. The role of stromal proliferation markers in predicting recurrence of borderline and malignant phyllodes tumors. Breast. 2022;62:10–17.
[12] Roden AC, Macon WR, Keeney GL, Nascimento AG. Benign, borderline, and malignant phyllodes tumors: A clinicopathologic study with long-term follow-up. Am J Surg Pathol. 2008;32(11):1854–62.
[13] Palma G, Frasson A, Steffan A, Bonorico G, Andreetta C, Bortul M. Surgical management of phyllodes tumors of the breast: Is wide excision really necessary in benign lesions? Breast Care. 2021;16(3):262–268.
[14] Yamaguchi R, Tanaka M, Kishimoto Y, Matsukita S, Tsuda H. Clinicopathological predictors of distant metastasis in malignant phyllodes tumour of the breast. Breast Cancer. 2020;27(6):1162–1170.
[15] Tan WJ, Cordenonsi M, Tan PH. Epithelial–stromal interactions in phyllodes tumour progression: A potential model of EMT-driven stromal activation. Breast Pathol Rev. 2022;14(2):45–58.
[16] Simpson PT, Gale T, Reis-Filho JS, Lakhani SR. Molecular evolution of breast phyllodes tumours. J Clin Pathol. 2021;74(8):481–489.
[17] Loke BN, Md Nasir ND, Thike AA, Lee JY, Tan VKM, Tan PH. Malignant phyllodes tumour of the breast: A proposal for improved risk stratification. Breast J. 2020;26(6):1206–1214.
[18] Lim SH, Tan PH. Current perspectives on the pathogenesis of breast phyllodes tumours: Stromal biology, MED12 mutations and beyond. Arch Pathol Lab Med. 2021;145(6):695–706.
[19] Tan WJ, Thike AA, Yong-Zheng J, Tan PH. Stromal markers (p53, Ki-67, EGFR) in predicting behaviour of phyllodes tumours. Ann Diagn Pathol. 2019;40:170–176.
[20] He L, Fang L, Wang J. Estrogen receptor signalling and mesenchymal transformation in breast fibroepithelial lesions: Is there a link? Int J Surg Pathol. 2022;30(5):461–470.
[21] Chua CL, Tan PH. Phyllodes tumours of the breast: Updates in diagnosis, management, and molecular genetics. Surg Pathol Clin. 2023;16(1):59–77.
[22] Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, Ashoor AA, Veronesi P, Pantanowitz L, Hornick JL, Rossi ED. Malignant phyllodes tumor of the breast: a systematic review. Pathologica. 2022 Apr;114(2):111-120.
[23] Dillon J, Bernik S, Zeizafoun N, Balija T. Benign phyllodes tumour in a transgender woman receiving hormonal therapy. BMJ Case Rep. 2024 Mar 7;17(3):e258616
[24] Thind A, Patel B, Thind K, et al. Surgical margins for borderline and malignant phyllodes tumours. Ann R Coll Surg Engl 2020;102:165–73
[25] Xu W, Ma W, Wang D, Zhou X, Wang K, Mu K. Integrated multi-omics profiling reveals a clinically relevant molecular feature and potential therapeutic target on phyllodes tumors of breast. Transl Oncol. 2024;46:101998
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