Diagnostic Role of p63 Immunostaining in Fine Needle Aspiration Cytology of Different Breast Lesions

Abstract

Objective: To evaluate the potential diagnostic role of the myoepithelial marker p63 in fine needle aspiration cytology (FNAC) of breast in comparison to other diagnostic tools. Study Design: A total of 49 FNAC of breast were assessed according to clinical, mammographic, cytological findings, and p63 immunostaining on FNAC. The strength of agreement with final histological diagnosis (FHD) was measured by kappa test. Results: p63 was positive in myoepithelial cells of 75% (9/12) of benign cases and negative in 89% (33/37) of the malignant cases with strong agreement with the FHD (p < 0.0001, ĸ = 0.63). All the malignant positive cases showed variable degrees of in situ component. Only one malignant case (1/37, 0.03%) showed few p63 positive neoplastic cells in FNAC. Combined FNAC and p63 staining (with <25% cutoff point) to diagnose malignancy showed 100% sensitivity, 75% specificity, 92% positive predictive value, 100% negative predictive value, and 94% diagnostic accuracy. Most of the cytologically suspicious cases (7/9, 78%) showed negative p63 staining results, and all these suspicious cases (100%) proved to be malignant by the FHD. There was poor agreement between diagnosis according to positive background naked nuclei (NN) and the FHD (ĸ = 0.24 and p < 0.0001); however, presence of more than 74% positive NN is strongly suggestive of fibroadenoma. Conclusion: p63 immunostaining with a cutoff value of <25% to diagnose malignancy is a highly sensitive and specific myoepithelial marker which is recommended as an adjuvant tool to FNAC of breast in suspicious cases.

Expression of p63 immunostaining in liquid‐based cytology (BD SurePath) of breast fine‐needle aspiration

“…Aiad et al reported that p63 immunostaining with a cutoff value of <25% to diagnose malignancy was a highly sensitive and specific myoepithelial marker, and when it was combined with cytological diagnosis, the diagnostic sensitivity, specificity, PPV, and NPV were 100%, 75%, 92%, and 100%, respectively . The reason why the sensitivity was not 100% in our present study is that there were 2 false‐negative lesions.…”

<p>The Expressions of Keratins and P63 in Primary Squamous Cell Carcinoma of the Thyroid Gland: An Application of Raman Spectroscopy</p>

“…22,23 The p63 gene is located on chromosome 3q27~3q29, expresses in the basement membrane of the epithelium of different organs, and has high specificity and sensitivity to diagnose malignancies. 24,25 and P63 are homogenous genes that play a key role not only in the damage response of DNA, but also in the differentiation, proliferation, and apoptosis of tumour cells. It has been reported that the expression of P63 in LECos may indirectly reflect the role of P63 in the proliferation and differentiation of squamous epithelial cells.…”

Expression of glucose transporter protein 1 and p63 in serous ovarian tumor

“…There have been several reports that p63 plays a regulatory role in the normal differentiation of cells, whereas its role in tumor biology must be elucidated . Recently, studies revealed that p63 is highly expressed in proliferating basal cells of epithelial layers, including epidermis, cervix and prostate, and the major p63 isoforms in the basal cells lack the transactivating domain …”