A Study Of Clinical Pathological Features And Molecular Markers Of Basal-like Breast Carcinoma And Triple Negative Breast Carcinoma

[Objective] To explore the clinical pathological features and molecular markers in basal-like breast carcinoma and triple negative breast carcinoma in order to provide evidences for the clinical diagnosis and individual treatment. To observe the expression of Caveolin-1, Nestin and investigate the potential roles in the carcinogenesis.[Methods] Tissue microarray techniques and immunohistochemistry Envision two-step method were used to detect the expression of ER,PR,HER2,CK5/6,EGFR,CK14,CK17,Caveolin-1 and Nestin in 215 breast carcinomas, and study the morphologic features of each type of breast carcinomas. All data were analyzed by the SPSS 12.0 software for windows.[Results]1. There were 107 basal-like breast carcinomas ( ER and HER2 negative, Heavy chain CK and/or EGFR positive ) and 100 triple negative breast carcinomas ( ER/PR/HER2 all negative ) in the 215 samples, both of which showed specific morphologic features including broad pushing tumor border, geographic tumor necrosis associated with a ribbonlike tumor architect and central scar/sclerosis. Mesenchymal tissues around the cancer nests were loose and rich in lymphocytes. Tumor cells were at high histological grade with obvious atypia and high mitotic rates. Squamous metaplasia and spindled tumor cells can be detected.2. The positive rates of CK5/6,EGFR,CK14,CK17. Caveolin-1 and Nestin in basal-like breast carcinomas were 92.5%, 65.4%, 38.3%, 33.6%, 8.4% and 28.0% , and in triple negative carcinomas were 85.0%, 63.0%, 35.0%, 29.0%, 10.0% and 27.0%, respectively. The expression rates of CK5/6,EGFR,CK14, and Nestin were much higher in basal-like breast carcinoma and triple negative breast carcinoma than that of the control gourps (p<0.05). The expression of CK17 and Caveolin-1 showed no differences (p>0.05) . There was no statistic significance of all the molecular markers between basal-like breast carcinoma and triple negative breast carcinoma (p >0.05) . The expression of CK5/6 and EGFR were much higher in basal-like breast carcinoma and triple negative breast carcinoma.3. Both of the basal-like breast carcinoma and triple negative breast carcinoma were at high histological grades. The metastasis of axillary nodes was less frequently in basal-like breast carcinoma (p<0.05) . No statistic significance was found in tumor size and age between the two groups and their controls (p>0.05) . There was no statistic significance in pathological characteristics between basal-like breast carcinoma and triple negative breast carcinoma (p>0.05) .[Conclusions]1. CK5/6 and EGFR can be used as important molecular markers for diagnosing basal-like breast carcinoma.2. The expression of Caveolin-1 is very low in all kinds of breast carcinomas , so it is not a useful marker in detecting basal-like breast carcinoma.3. The expression of Nestin in basal-like and triple negative breast carcinomas are higher and it can be used as a marker for diagnosing basal-like breast carcinoma.4. Both of the basal-like breast carcinoma and triple negative breast carcinoma are at high histological grades and the metastasis to axillary nodes in basal-like breast carcinoma is lower, which indicates its prognostic factors may be different from the other type breast carcinomas.5. Both of the basal-like breast carcinoma and triple negative breast carcinoma show specific morphologic features and immunophenotypes, which can be used in clinical pathological diagnosis.6. Although there is a great deal of overlap between basal-like breast carcinoma and triple negative breast carcinoma, they are not synonyms.