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. 2017 Jun 5;12(1):43.
doi: 10.1186/s13000-017-0635-2.

HNF4A expression as a potential diagnostic tool to discriminate primary gastric cancer from breast cancer metastasis in a Brazilian cohort

Patrícia Chaves de Freitas Campos Jucá  1   2 , Stephany Corrêa  3 , Giselle Maria Vignal  4   5 , Maria Theresa de Souza Accioly  5 , Suzana Angélica Silva Lustosa  6 , Eliana Abdelhay  3 , Delcio Matos  6
Affiliations

HNF4A expression as a potential diagnostic tool to discriminate primary gastric cancer from breast cancer metastasis in a Brazilian cohort

Patrícia Chaves de Freitas Campos Jucá et al. Diagn Pathol. .

Abstract

Background: Among the many challenges in cancer diagnosis is the early distinction between metastatic cancer and a secondary tumor. This difficulty stems from the lack of markers that offer high sensitivity and specificity and can be easily applied in routine laboratory work. An example of this challenge is distinguishing gastric metastases originating from breast cancer from a gastric primary tumor. Hepatocyte nuclear factor 4 alpha (HNF4A) has been suggested as a potential marker in these cases. The aim of this study was to analyze the expression of HNF4A, estrogen receptor (ER), progesterone receptor (PR) and gross cystic disease fluid protein 15 (GCDFP-15) in a Brazilian cohort.

Methods: We performed immunohistochemistry analysis of HNF4A, ER, PR and GCDFP-15 in 126 patients divided into three cohorts: primary breast cancer, primary gastric cancer and both types of tumors.

Results: Our data confirmed the sensitivity and specificity of the HNF4A marker compared to other currently used clinical markers.

Conclusion: HNF4A alone could be a gold standard marker for distinguishing primary gastric cancer from breast metastasis, thus validating its potential clinical use, especially in populations with high genetic diversity.

Keywords: Biomarker; Breast cancer; Gastric cancer; HNF4A; Metastasis.

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Figures

Fig. 1
Fig. 1
Representative immunohistochemistry results from the patient cohorts. a Invasive ductal carcinoma (IDC) (left) with mucin differentiation area (right). b Invasive lobular carcinoma (ILC) (left) associated with “in situ” lobular carcinoma (right). c Poorly differentiated primary gastric adenocarcinoma with signet ring cells (stomach). d Details at 20X magnification. e HNF4A staining in primary gastric adenocarcinoma. Nuclear staining in a non-neoplastic gland (left): internal control and nuclear staining in poorly differentiated gastric carcinoma cells with signet ring cells. f Metastasis from ILC to gastric mucosa. HNF4A nuclear staining in gastric cells from mucosa and non-staining from ILC cells
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