AJCY2501 - CME/CMLE - TRPS1 Is a Useful Marker in Differentiating Metastatic Breast Carcinoma from Pancreatic Adenocarcinoma in Fine- Needle Aspiration Specimens-TRPS1 Is a Useful Marker in Differentiating Metastatic Breast Carcinoma from Pancreatic Adenocarcinoma in Fine- Needle Aspiration Specimens

TRPS1 Is a Useful Marker in Differentiating Metastatic Breast Carcinoma from Pancreatic Adenocarcinoma in Fine- Needle Aspiration Specimens

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In a study by Yildiz et al., published in the American Journal of Clinical Pathology, the authors investigated the use of trichorhinophalangeal syndrome type 1 (TRPS1) as an immunohistochemical marker to distinguish metastatic breast carcinoma (BC) from primary pancreatic adenocarcinoma (PAC) in fine-needle aspiration (FNA) specimens. Differentiating these cancers is crucial due to their similar morphology and overlapping immunohistochemistry (IHC) profiles.<br /><br />The study analyzed 49 PAC cases and 26 metastatic BC cases gathered from various locations, such as lymph nodes, lungs, bones, or soft tissues. TRPS1 expression was examined through IHC analysis. Results revealed that 95.9% of PAC cases showed negative TRPS1 expression, while 88.0% of metastatic BC cases exhibited high positive expression for TRPS1, including 83.3% of triple-negative BC (TNBC) and 92.9% of non-TNBC cases.<br /><br />The study concluded that TRPS1 is a highly accurate and reliable marker to differentiate metastatic BC from PAC, particularly in TNBC cases. This is significant as BC and PAC share similar clinical presentations and radiologic findings, making differentiation challenging.<br /><br />Furthermore, TRPS1 demonstrated robust immunostaining, with strong nuclear positivity in BC, contrasting with the often low or absent expression in PAC. GATA binding protein 3 (GATA3), while commonly used, has limitations due to cross-reactivity with other carcinomas, including PAC. <br /><br />Thus, TRPS1 IHC provides a more specific and sensitive method for distinguishing these malignancies, especially in FNA samples. However, the authors note the study's limitation due to the small number of cases of metastatic BC to the pancreas and suggest further research with larger patient cohorts.

Keywords

TRPS1

immunohistochemical marker

metastatic breast carcinoma

primary pancreatic adenocarcinoma

fine-needle aspiration

differentiation

TNBC

GATA3

IHC analysis

nuclear positivity