Diagnostic utility of the combined use of HNF4A and GATA3 in distinction between primary and metastatic breast and gastric carcinomas

Abstract

his retrospective study was conducted on (81) cases divided into four groups of cohorts: primary BC (cohort I, n=25), primary GC (cohort II, n=23), and metastases derived from both types of tumors designated as metastasis derived from BC (cohort III-A, n=17) and metastasis derived from GC (cohort III-B, n=16). All cases were retrieved from the archival files of the pathology labs of Ain Shams University Hospitals (El Demerdash and specialized) (from 2012-2019). The specimens were obtained by radical mastectomy/gastrectomy or Tru cut/endoscopic biopsy. Sections were prepared from paraffin blocks and slides were stained with hematoxylin and eosin and immunohistochemically stained with both HNF4A and GATA3 antibodies. Ten cases of non-neoplastic breast and gastric tissue were included as control. In our study, GATA-3 exhibited the strongest qualities to differentiate between the groups with high sensitivity varying from 88%-92% and specificity varying from 95.8%-100%. As regards breast carcinomas, eighty-eight percent (88%) of mBCs cases stained positive for GATA3 with 60% of them showing diffuse staining while the remaining 40% expressed GATA3 focally. Two cases (2/17) of mBCs showed negative GATA3 expression.