Napsin-A Expression, a Reliable Immunohistochemical Marker for Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas

Nili, Fatemeh; Tavakoli, Mansoureh; Mood, Narges Izadi; Saffar, Hiva; Sarmadi, Soheila

doi:10.30699/ijp.2020.106598.2222

Cited by 4 publications

(3 citation statements)

References 22 publications

(25 reference statements)

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“…Napsin A is a well-established marker for clear cell carcinomas in female genital tract cancers of both the ovary and endometrium (10,28,34). In the current study, we found a total of 5% of cases (3/60) expressing Napsin A.…”

Section: Discussionsupporting

confidence: 48%

Utility of ER, p53, CEA and Napsin A in Histological Subtyping of Endometrial Carcinoma and Their Correlation with Clinicopathological Prognostic Parameters: Experience from a Referral Institute

Shivakumar,

Sahu,

Rao

et al. 2024

Iran J Pathol

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Background & Objective: Endometrial Carcinoma (EC) is the most common gynecological cancer with a global incidence of 23.2 per 1 lakh population. Histological subclassification of EC is extremely crucial for the diagnosis, proper management strategies, and prognosis. This study was conducted in a tertiary care institute to analyze the expression pattern of a minimum panel of 4 markers (ER, p53, CEA, Napsin A) with emphasis on their utility in the routine histological subtyping, aberrant expression, and correlation with various clinicopathological parameters. Methods: A time-bound cross-sectional observational and analytical study was conducted, which includes cases diagnosed in our laboratory from January 2016 to April 2021. Results: Sixty cases diagnosed as EC during the study period formed the sample cases. The ER was expressed in 85% (53/60) of cases in the current study. Among them, 94% (50/53) were endometrioid endometrial carcinomas (EECs). A negative correlation was found between ER intensity and age (r= -1.48). Of 60 EC cases, 10 (16%) cases expressed p53. The tumors positive for p53 with higher intensity were negative for ER and vice versa. The expression pattern of ER and p53 was statistically significant ( P =-0.021). On IHC, 84.6% (11/13) of CEA-positive cases expressed both ER and CEA, suggesting mucinous differentiation. Napsin A was expressed in two cases of EEC, FIGO grade I, and one case of serous carcinoma. Conclusion: An inverse association was found between ER and p53 expression. The CEA is valuable in identifying EEC with mucinous differentiation.

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Section: Discussionsupporting

confidence: 48%

Utility of ER, p53, CEA and Napsin A in Histological Subtyping of Endometrial Carcinoma and Their Correlation with Clinicopathological Prognostic Parameters: Experience from a Referral Institute

Shivakumar,

Sahu,

Rao

et al. 2024

Iran J Pathol

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“…It is a marker with high sensitivity and high specificity for CCC. Sensitivity, specificity, PPV, and NPV are 88%, 98%, 98%, and 91% have been reported (28)(29)(30)(31).…”

Section: Resultsmentioning

confidence: 89%

Diagnostic Accuracy of Alpha-Methylacyl-CoA Racemase Immunohistochemical Expression for the Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas

et al. 2023

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Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial. Methods: In this study, 31 cases of ovarian clear cell carcinoma (OCCC), 28 endometrial clear cell carcinoma (ECCC), and 80 non-CCC subtypes (33 high-grade serous carcinomas of the ovary, 2 low-grade serous carcinomas, 10 ovarian endometrioid, 3 serous carcinomas and 29 endometrioid carcinomas of the endometrium) were investigated for immunohistochemical expression of AMACR. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the distinction of OCCC and ECCC from other histopathologic subtypes were calculated. Results: Positive AMACR staining was seen in 18 OCCCs (58%) and 10 ECCCs (35.7%). In the non-clear cell group, 44 cases of ovarian (98%) and 25 cases of endometrial carcinoma (78%) showed negative results. Only one case of ovarian endometrioid carcinoma and 7 cases (22%) of endometrial endometrioid carcinomas revealed a positive reaction ( P <0.05). Collectively, sensitivity, specificity, PPV, and NPV of AMACR expression, for the diagnosis of OCCC were calculated as 58%, 98%, 94.7%, and 77.2%, respectively. The sensitivity, specificity, PPV, and NPV were shown to be as 35.7%, 78.1%, 58.8%, and 58.1%, respectively in the endometrium. Conclusion: AMACR may be a highly specific immunohistochemical marker for the distinction of serous and clear cell carcinoma. A small percentage of endometrioid carcinoma may show positive staining. The sensitivity of this marker may not be higher than the other well-known Napsin-A IHC marker.

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“…Triple-negative breast cancers, however, may not express GCDFP-15, GATA 3, or mammaglobin, and in such cases, SOX-10 may be helpful ( 16 ). On the other hand, PAX8 expression is a sensitive marker for endometrial carcinoma ( 17 ) and napsin A supports the clear cell subtype ( 18 ). Nonetheless, it must be recognized that some overlap exists between the immunohistochemical markers seen in breast and endometrial cancers.…”

Section: Discussionmentioning

confidence: 99%

Breast metastasis from endometrial clear cell carcinoma: A case report and review of the literature

et al. 2023

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Metastasis to the breast from extra-mammary malignancies are rare, accounting for less than 1% of all breast cancers. Endometrial cancer, a common gynecological malignancy, often spreads to the pelvis, abdominal lymph nodes, peritoneum or the lungs. Endometrial metastasis to the breast is extremely rare, and while there have been isolated case reports of endometrial serous carcinoma with breast metastasis, it has not been reported in the case of clear cell carcinoma. We present a rare case of a 70 year old Chinese lady who had a metastatic endometrial clear cell carcinoma with metastasis to the breast, mimicking an inflammatory breast cancer clinically. We reviewed the current literature and describe the challenges in differentiating primary from metastatic breast lesions, as well as clinical, radiological and histopathological features that may help to differentiate the two. Tumour metastasis to the breast via lymphatic or hematogenous route can affect their radiological features: the former mimicking inflammatory breast cancer and the latter with features similar to benign breast lesions. Regardless, histological features with immunohistochemical staining is still the gold standard in diagnosing metastatic breast lesions and determining their tissue of origin. Breast metastases from extra-mammary malignancies are uncommon and it is even rarer for endometrial clear cell carcinoma to spread to the breast. Nonetheless, this case highlights the importance of keeping an open mind and engaging a multidisciplinary team for the care of complex patients.

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Napsin-A Expression, a Reliable Immunohistochemical Marker for Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas

Cited by 4 publications

References 22 publications

Utility of ER, p53, CEA and Napsin A in Histological Subtyping of Endometrial Carcinoma and Their Correlation with Clinicopathological Prognostic Parameters: Experience from a Referral Institute

Utility of ER, p53, CEA and Napsin A in Histological Subtyping of Endometrial Carcinoma and Their Correlation with Clinicopathological Prognostic Parameters: Experience from a Referral Institute

Diagnostic Accuracy of Alpha-Methylacyl-CoA Racemase Immunohistochemical Expression for the Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas

Breast metastasis from endometrial clear cell carcinoma: A case report and review of the literature

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