Abstract

GATA-3 is a potential marker for detection of metastatic breast carcinoma, reportedly more sensitive than mammaglobin (MAM) and GCDFP-15. We aim to compare the sensitivity of GATA-3, MAM and GCDFP-15 in determining the breast origin of malignant effusions. Cell blocks from 27 cases of serous effusions positive for metastatic breast cancer were retrieved. Immunohistochemistry for GATA-3, MAM, gross cystic disease fluid protein 15 (GCDFP-15), estrogen receptor (ER) and progesterone receptor (PR) was performed on cell-block micro-array. Statistical analysis using two ways Chi square, one-way ANOVA and multiple regression was performed. The detection rate of breast cancer in serous fluid was significantly higher with GATA-3 (88.8 %, X2=15.9, p=0.00034) than with MAM (51.8 %) and GCDFP-15 (37.0 %). All ER positive cases (19) were GATA-3 positive. Conversely, all GATA-3 negative cases (3) were ER negative. The intensity of stain and percentage of positive cells were significantly higher with GATA-3 (p<0.0001) than with MAM and GCDFP-15. The intensity and percentage of positive cells score of GATA-3 were statistically associated with ER stain intensity and percentage of positive cell scores. GATA3 is a sensitive marker, superior to MAM and GCDFP-15 in determining the breast origin of metastatic adenocarcinoma. It is also strongly associated with ER expression.

Highlights

  • GATA binding protein 3 is one of six members of the GATA family of zinc finger transcription factors that recognize a specific nucleotide sequence in the promoter region of target genes [1]

  • GATA-3 and estrogen receptor (ER) are involved in a cross-regulatory loop that explains initial reports correlating GATA-3 expression to ER expression; recent data support that GATA-3 is expressed in triple negative breast cancer and is more sensitive than the previously described markers gross cystic disease fluid protein 15 (GCDFP-15) and mammaglobin (MAM) [10, 11]

  • Utilizing micro-arrays constructed from cell blocks we attempt to compare the performance of GATA-3 to MAM and GCDFP-15 in the diagnosis of breast carcinoma in serous effusions

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Summary

Introduction

GATA binding protein 3 is one of six members of the GATA family of zinc finger transcription factors that recognize a specific nucleotide sequence in the promoter region of target genes [1]. GATA-3 has recently been identified as a multi-specific but successful immunohistochemical marker for breast and urothelial differentiation [5, 6]. It is expressed in a subset squamous cell carcinomas, salivary gland tumors, mesotheliomas, gynecologic carcinomas and skin adnexal tumors [5, 7, 8]. In spite of its multi-specific nature, GATA-3 was recently reported to have high positive predicitve value (96.2 %) in determining the breast origin in serous malignant effusion [9]. Utilizing micro-arrays constructed from cell blocks we attempt to compare the performance of GATA-3 to MAM and GCDFP-15 in the diagnosis of breast carcinoma in serous effusions. The intensity and percentage of positive cells score of GATA-3 were statistically associated with ER stain intensity and percentage of positive cell scores

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