A six marker panel for differential diagnostics of female cancers

• Aim: To present a new immunohistochemistry-based panel for clinical differential diagnostics of breast, ovarian, endometrial and cervical cancer. Background: Diagnostics of metastatic ER-positive tumors can present a clinical challenge. Breast and gynecological cancers are to a varying degree ER+, and can have similar growth patterns. The close proximity of the ovaries, endometrium and cervix also renders difficulties to distinguish between primary gynecological cancer in advanced stages. Material and Methods: As a discovery set for the selection of antibodies, tissue microarray (TMA) blocks containing 60 breast, 60 ovarian, 60 endometrial and 60 cervical tumor samples of predominantly metastatic sources were sectioned and immunohistochemically stained using 43 different primary antibodies, including both well accepted diagnostic markers and novel candidate markers. The results were analyzed for best possible differential diagnostic power to discriminate between these forms of female cancer. Results: By the implementation of a decision tree we were able to define a six-marker panel including antibodies detecting the WT1, ZAG, VIM, CK5, GATA3 and PAX8 proteins. This antibody panel enabled differentiation between breast, ovarian, endometrial and cervical cancer with an accuracy of 80%. The selected markers were then examined in a second cohort of 452 cancer samples comprising 60 breast, 48 ovary, 233 endometrium and 111 cervix patients. A decision tree classifier was used to evaluate the performance of various combinations of these markers in differential diagnosis of the female cancers.  The results suggest that this panel could be used in a clinical setting to achieve a more accurate diagnosis and thus provide a basis for further prospective clinical studies.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Keyword

Differential diagnostics

immunohistochemistry

Patologi

Pathology

Publication and Content Type

vet (subject category)

ovr (subject category)