PMID- 36055933 OWN - NLM STAT- MEDLINE DCOM- 20221026 LR - 20221108 IS - 2213-2945 (Print) IS - 2213-2953 (Linking) VI - 11 IP - 6 DP - 2022 Nov-Dec TI - Utility of TRPS-1 immunohistochemistry in diagnosis of metastatic breast carcinoma in cytology specimens. PG - 345-351 LID - S2213-2945(22)00064-3 [pii] LID - 10.1016/j.jasc.2022.06.007 [doi] AB - INTRODUCTION: At present, GATA binding protein 3 (GATA-3) is the most frequently used diagnostic immunohistochemical (IHC) marker for breast carcinoma (BC). However, it is not specific and has very low sensitivity for triple-negative BC (TNBC). SRY-box transcription factor 10 (SOX-10) and trichorhinophalangeal syndrome type 1 (TRPS-1) have been suggested for inclusion in the diagnostic workup of TNBC. TRPS-1 has not been established in cytology specimens as a diagnostic IHC marker for metastatic BC (MBC). Hence, in the present study we evaluated the utility of TRPS-1 in diagnosing MBC in cytology specimens. MATERIALS AND METHODS: MBC cases diagnosed on cytology specimens from January to October 2020 were included in the present study. Only cases with hormonal status available and >/=20 tumor cells on cell blocks were included in the study. The cell blocks were assessed for TRPS-1, GATA-3, and SOX-10 IHC marker positivity (intensity and percentage of tumor cells). The results were correlated with the specimen type (fine needle aspiration [FNA] versus body fluid) and various BC prognostic subgroups. RESULTS: We analyzed 61 cases, including 33 body fluid and 28 FNA (13 lymph node, 10 bone, 2 liver, 2 soft tissue, and 1 lung) specimens. TRPS-1 had 97.2% positivity in ER/PR+ (estrogen receptor/progesterone receptor-positive) MBC compared with GATA-3, which had 100% positivity in the same group. TRPS-1 showed high positivity in 35 of 37 cases (94.6%) and intermediate positivity in 1 (2.6%) and was negative/low positive in 1 case (2.7%). In contrast, GATA-3 showed high positivity for all 37 cases (100%). SOX-10 showed positivity in only 1 of 37 cases (2.7%), with intermediate positivity. In the HER2+ (human epidermal growth factor receptor 2-positive) group, TRPS-1 showed high positivity in 5 of 7 cases (71.4%), intermediate positivity in 1 case (14.3%), and negativity in 1 case (14.3%). However, GATA-3 showed high positivity in 6 of 7 cases (85.7%) and negative/low positivity in 1 case (14.3%). SOX-10 was negative in all 7 cases. In TNBC, TRPS-1 showed high positivity in 16 of 17 cases (94%) and intermediate positivity in 1 (5.9%), and GATA-3 showed high positivity in 9 (53%), intermediate positivity in 2 (11.8%), and low positive/negative in 6 of the 17 cases (35.3%). TRPS-1 expression was significantly higher than GATA-3 expression for the number of positive cases (P = 0.07), mean percentage of positive tumor cells (P = 0.005), and intensity of reactivity (P = 0.005). SOX-10 expression was present in only 5 of 17 cases (29%), with a mean percentage of positivity in the tumor cells of 26.5% and intensity of 0.8. No differences were found in the IHC results between the different specimen types (FNA versus fluid) in any group. CONCLUSIONS: TRPS-1 is a highly sensitive new diagnostic IHC marker for breast carcinoma, with a similar positivity rate in ER/PR+ and HER2+ BC compared with GATA-3 and a higher positivity rate than GATA-3 and SOX-10 in TNBC in cytology specimens. In particular, when only a few clusters of tumor cells are present on the cell block, TRPS-1 can be highly useful, because its mean percentage of positive tumor cells and intensity are higher than those of other IHC markers. CI - Copyright (c) 2022 American Society of Cytopathology. Published by Elsevier Inc. All rights reserved. FAU - Abdelwahed, Mohammed AU - Abdelwahed M AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. Electronic address: mabdelwahed@northwell.edu. FAU - Yurtsever, Nalan AU - Yurtsever N AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. FAU - Savant, Deepika AU - Savant D AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. FAU - Karam, Priyanka AU - Karam P AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. FAU - Gimenez, Cecilia AU - Gimenez C AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. FAU - Das, Kasturi AU - Das K AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. FAU - Sheikh-Fayyaz, Silvat AU - Sheikh-Fayyaz S AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. FAU - Khutti, Seema AU - Khutti S AD - Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, New York. LA - eng PT - Journal Article DEP - 20220714 PL - United States TA - J Am Soc Cytopathol JT - Journal of the American Society of Cytopathology JID - 101613234 RN - 0 (Biomarkers, Tumor) RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) RN - 0 (TRPS1 protein, human) SB - IM MH - Humans MH - Biomarkers, Tumor/metabolism MH - Immunohistochemistry MH - Receptors, Estrogen/metabolism MH - *Receptors, Progesterone/metabolism MH - *Triple Negative Breast Neoplasms OTO - NOTNLM OT - Breast cancer OT - GATA-3 OT - Immunohistochemistry OT - Nongynecologic cytopathology OT - SOX-10 OT - TRPS-1 EDAT- 2022/09/03 06:00 MHDA- 2022/10/26 06:00 CRDT- 2022/09/02 22:07 PHST- 2022/03/22 00:00 [received] PHST- 2022/06/15 00:00 [revised] PHST- 2022/06/24 00:00 [accepted] PHST- 2022/09/03 06:00 [pubmed] PHST- 2022/10/26 06:00 [medline] PHST- 2022/09/02 22:07 [entrez] AID - S2213-2945(22)00064-3 [pii] AID - 10.1016/j.jasc.2022.06.007 [doi] PST - ppublish SO - J Am Soc Cytopathol. 2022 Nov-Dec;11(6):345-351. doi: 10.1016/j.jasc.2022.06.007. Epub 2022 Jul 14.