Sometimes the distinction between gastric adenocarcinomas and breast carcinomas can be challenging. Hepatocyte nuclear factor 4-alpha (HNF4A) has been suggested as a potential marker in these cases. The aim of the present work was to evaluate the role of the combined use of HNF4A and GATA3 as immunohistochemical markers in distinction between primary and metastatic breast and gastric carcinomas. This 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). We performed immunohistochemistry analysis of HNF4A and GATA3 in all (81) cases. HNF4A expression was seen in 22 of 23 primary gastric adenocarcinomas and was absent in all 25 primary breast carcinomas (sensitivity 95.7%, specificity 100%). HNF4A was seen in 15 of 16 metastatic gastric adenocarcinomas and was absent in all 17 metastatic breast carcinomas (sensitivity 93.8%, specificity 100%). GATA3 showed 92 and 88% sensitivity, and 95.7 and 100% specificity for primary breast carcinomas and metastatic breast carcinomas, respectively. Our data confirmed the potential utility of HNF4A as a diagnostic marker and can be used as an adjunct to GATA3 as an immunohistochemical panel to differentiate between breast and gastric carcinomas.

中文翻译：

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HNF4A 和 GATA3 联合使用在区分原发性和转移性乳腺癌和胃癌中的诊断效用


有时胃腺癌和乳腺癌之间的区别可能具有挑战性。肝细胞核因子 4-α (HNF4A) 被建议作为这些病例的潜在标志物。本工作的目的是评估联合使用 HNF4A 和 GATA3 作为免疫组织化学标记物在区分原发性和转移性乳腺癌和胃癌中的作用。这项回顾性研究对 (81) 例病例进行，分为四组：原发性 BC（队列 I，n = 25）、原发性 GC（队列 II，n = 23）以及源自两种类型肿瘤的转移瘤（指定为转移瘤）源自 BC（队列 III-A，n = 17）和源自 GC 的转移（队列 III-B，n = 16）。我们对所有 (81) 例病例中的 HNF4A 和 GATA3 进行了免疫组织化学分析。 HNF4A 表达见于 23 例原发性胃腺癌中的 22 例，而在所有 25 例原发性乳腺癌中均不表达（敏感性 95.7%，特异性 100%）。 HNF4A 在 16 例转移性胃腺癌中的 15 例中可见，而在所有 17 例转移性乳腺癌中均不存在（敏感性 93.8%，特异性 100%）。 GATA3 对原发性乳腺癌和转移性乳腺癌的敏感性分别为 92% 和 88%，特异性为 95.7% 和 100%。我们的数据证实了 HNF4A 作为诊断标记物的潜在用途，并且可以用作 GATA3 的辅助免疫组织化学组合来区分乳腺癌和胃癌。