Glucose Transporter Glut-1 Is of Limited Value for Detecting Breast Carcinoma in Serous Effusions

Abstract

Diagnosing breast carcinoma that has metastasized to body cavity fluids can be difficult. Recently, immunostaining for the facultative glucose transporter Glut-1 has been described as a sensitive and specific means of detecting carcinomas in effusions. However, only five cases of breast carcinoma were studied. We examined Glut-1 specifically as a means of detecting breast carcinoma in effusion cytology. Using avidin-biotin immunocytochemistry, cell block material from 31 cases of breast carcinoma metastatic to body cavity effusions and 33 cases of benign effusions were studied. All cases were immunostained with the Glut-1 antibody. An additional set of slides from these same cases was stained for mucin using the Mayer's mucicarmine technique. Slides were graded for percentage of cells exhibiting immunoreactivity for Glut-1 or for the presence of mucin. Results of staining for both Glut-1 alone and in combination with mucicarmine were compared between the benign and malignant groups. Of the breast cancer cases, 19 of 31 (61%) were immunoreactive for Glut-1, and 25 of 31 (81%) were positive for either Glut-1 or mucicarmine. One of the 33 (3%) benign cases was immunoreactive for Glut-1, and none were positive for mucin. These data suggest that using Glut-1 as a single immunostain or in conjunction with mucicarmine is a specific but modestly sensitive means of detecting breast carcinoma in this cytologic setting.

Glucose Transporters in Sex Steroid Hormone Related Cancer

“…However, many studies have shown a higher association between GLUT1 presence and breast cancer. GLUT1 staining was present in 12 of 12 primary human breast cancers [22], in 53 of 66 breast cancers [105], in 30 of 33 invasive ductal carcinomas [19] and in 19 of 31 serous breast cancer effusions [26]. To further confound the controversy, GLUT1 has been paradoxically associated with disease free survival [106] and the invasive potential [107] of breast cancer cells.…”

“…GLUT8 may transport glucose (removed from glycoproteins) out of the rough endoplasmic reticulum into the cytosol, thereby playing a key role in maintaining neuronal glucose homeostasis in this organelle. However, when the gene was inactivated in embryonic stem cells, Membrez et al [56] showed Target Normal Tissue Expression Sex Steroid Hormone Target Tumor Tissue Expression GLUT1 492 3-7 Glucose (galactose, DHA) Testis germinal cells [18,19] Prostate basal cells [19] Endometrium [20,21] Breast carcinoma [22][23][24] Testis, seminoma [19] Prostate carcinoma [19,25] Endometrium carcinoma [19,20,26] Uterus leiomyoma [19] Ovarian carcinoma [19,27,28] GLUT2 524 10-20 Glucose, (fructose and galactose)…”

Diagnostic Utility of GLUT-1 Expression in the Cytologic Evaluation of Serous Fluids

“…2,32,33 Zimmerman et al concluded that GLUT-1 is of limited value in detecting breast carcinoma in serous effusions. 33 Unlike other markers used routinely in clinical practice, GLUT-1 provides biologic insight into metabolic changes in tumor cells. All mammalian cell membranes contain proteins involved in glucose transport.…”

The β subunit of human chorionic gonadotropin lacks specificity for malignant cells in serous effusions

“…Some of these cases have been reported previously. [10][11][12] In all, 47 cases were diagnosed as benign reactive mesothelium; the remaining cases were malignant. The malignant cases were primarily adenocarcinomas with a small number of other carcinomas and mesotheliomas.…”