A pilot study: Comparison of TRPS1 and GATA3 immunoperoxidase staining using cytologic smears in entities reportedly positive for GATA3

Abstract

BACKGROUND: Metastatic breast carcinoma (mBC) is frequently encountered and may be challenging to diagnose as the tumor cells can morphologically resemble carcinomas of other primary origins. An additional challenge is that direct smears are often the only sample type available for immunostaining studies in cytology. Trichorhinophalangeal syndrome GATAbinding type 1 1 (TRPS1) is a highly sensitive marker for BC compared to the commonly used marker GATA3, especially in triple-negative BC (TNBC), in histologic samples. However, its sensitivity and specificity in mBC and other GATA3-positive tumors have not been studied. METHODS: The authors identified the following cytology cases: 37 GATA3-positive mBC cases and 19 available cases that were deemed mBC but were GATA3-negative during the original case workup and five cases of each of eight epithelioid entities known to have high rates of GATA3 positivity and commonly seen in cytology practice. Immunostainings of TRPS1 and GATA3 were performed on the chosen smears following standard protocols. RESULTS: TRPS1 was positive in all 37 GATA3-positive mBC cases and in 18 of the 19 GATA3-negative mBC cases. TRPS1 was negative in all five of the seven frequently GATA3-positive epithelioid entities, with the exception of salivary duct carcinomas where GATA3 was positive in a rate ranging 60%-100% among them. CONCLUSIONS: TRPS1 is as sensitive as GATA3 in GATA3positive mBC and is more sensitive than GATA3 in TNBC. TRPS1 is negative in most GATA3-positive nonbreast tumors. Thus, the combination of TRPS1 and GATA3 could be used to differentiate breast primary from others in most situations.

The diagnostic utility of trichorhinophalangeal syndrome type 1 immunohistochemistry for metastatic breast carcinoma in effusion cytology specimens

“…Analogous results were also reported using whole tissue sections 20 . Recently, Rohra et al demonstrated TRPS1 as a valuable marker for metastatic breast carcinoma in direct cytology smears, with good sensitivity for both GATA3‐negative and GATA3‐positive breast carcinomas 21 . Wang et al also reported that TRPS1 was positive in 94.4% ( n = 36) of GATA3‐positive and 50% ( n = 2) GATA3‐negative metastatic breast carcinoma in pleural effusion specimens 22 .…”

“…8 Therefore, the status of GATA3 expression in mesothelial cells or mesotheliomas remains controversial. In our breast and salivary duct carcinomas, 14,21 other carcinomas seldom express TRPS1, and those that do are mostly from the lung and gynecologic tract. 14,20 In the current study, TRPS1 expression was significantly lower than in other malignancies.…”

“…study and the study conducted by Rohra et al,21 the 15 selected mesotheliomas were all negative for TRPS1 staining. Because of the limited number of cases, further exploration of TRPS1 expression in mesothelial cells and mesotheliomas is warranted.…”

“…According to Ai et al, TRPS1 is rarely expressed in urothelial carcinoma (2%, 2/115) 14 . Rohra et al also reported 0% positivity in five cases of urothelial carcinoma obtained from touch preparations 21 . In the current study, the positive rate of TRPS1 was significantly higher in breast carcinoma than in urothelial carcinoma (74.5% vs 0%, p < .001), whereas the positive rate of GATA3 showed no difference between these two (85.1% vs 85.7%, p = .956).…”

“…(D) GATA3 expression in BC and UC. BC indicates breast carcinoma; TNBC, triple-negative breast carcinoma; TRPS1, trichorhinophalangeal syndrome type 1; UC, urothelial carcinoma demonstrated TRPS1 as a valuable marker for metastatic breast carcinoma in direct cytology smears, with good sensitivity for both GATA3-negative and GATA3-positive breast carcinomas 21. Wang et al also reported that TRPS1 was positive in 94.4% (n = 36) of GATA3-positive and 50% (n = 2) GATA3-negative metastatic breast carcinoma in pleural effusion specimens 22.…”