Immunostaining Patterns of CD10 in Fibroadenomas and Phyllodes Tumours of Breast

Farah Muhammad  Ali; Saba Hassan  Shamim; Farheen Danish; Lubna Avesi; Uzma Bukhari; Sana Tahir

doi:10.36283/ziun-pjmd13-4/004

Authors

Farah Muhammad Ali Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan https://orcid.org/0009-0009-0358-6266
Saba Hassan Shamim Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan https://orcid.org/0000-0002-5349-4812
Farheen Danish Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan https://orcid.org/0000-0003-1187-2640
Lubna Avesi Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan https://orcid.org/0009-0008-2906-7379
Uzma Bukhari Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan https://orcid.org/0000-0001-5950-2994
Sana Tahir Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan https://orcid.org/0009-0002-6450-5537

DOI:

https://doi.org/10.36283/ziun-pjmd13-4/004

Abstract

Background: Accurate differentiation between fibroadenomas and phyllodes tumours (PTs) is challenging due to overlapping morphological features. CD10, an immunohistochemistry (IHC) marker, has shown promise in distinguishing these breast lesions. This study aimed to evaluate CD10 expression patterns in fibroepithelial lesions (FELs) of the breast.

Methodology: This cross-sectional study was conducted in the Histopathology Department, at Dow University of Health Sciences over 1 year (01st Jan 2023 to 15th Dec 2023). Through the purposive sampling technique, the female patients having FELs were diagnosed by Consultant Pathologists as fibroadenomas or PT and were included in the study by employing specific histological parameters on H & E slides. Immunohistochemistry with CD10 antibody was conducted on a total of 120 samples with an equal split of fibroadenomas, benign PT, borderline PT, and malignant PT (30 cases each), assessing stromal cell staining and categorizing expression as negative (<10% positivity), weak (10–30% positivity), or strong (>30% positivity). Data was statistically analyzed by using SPSS version 26 including reporting mean ± S.D for continuous data and utilizing the Chi-square test to assess associations, with significance set at p<0.05.

Results: Negative CD10 expression was observed in fibroadenomas and benign PT, while borderline and malignant PT exhibited weak and strong positive CD10 expression. The analysis revealed a highly significant association (p-value < 0.001) between CD10 expression levels and the various forms of breast lesions. This strong statistical correlation indicates that CD10 could be an important biomarker for assessing the nature of breast lesions. A low p-value reinforces the reliability of the findings, suggesting that the observed differences in CD10 expression are unlikely to be due to random chance.

Conclusion: The findings of the study suggest that CD10 expression could assist as a valuable marker for differentiating between FELs of the breast. Moreover, it may serve as an indicator of the aggressiveness and metastatic potential of PT.

Author Biographies

Farah Muhammad Ali, Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan

Registrar in Histopathology Department
Saba Hassan Shamim, Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan

Associate Professor in Histopathology Department
Farheen Danish, Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan

Assistant Professor in Histopathology Department
Lubna Avesi, Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan

Associate Professor
Uzma Bukhari, Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan

Professor, Head of department Histopathology
Sana Tahir, Dow International Medical College, Dow University of Health & Sciences, Karachi. Pakistan

Registrar in Histopathology Department

References

Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, Ashoor AA, Veronesi P, Pantanowitz L, Hornick JL, Rossi ED. Malignant phyllodes tumour of the breast: a systematic review. Pathologica. 2022 Apr;114(2):111-120. Doi: 10.32074/1591-951X-754.

Tan PH. Fibroepithelial lesions revisited: implications for diagnosis and management. Modern Pathology. 2021;34:15-37. https://doi.org/10.1038/s41379-020-0583-3. Doi:10.1038/s41379-020-0583-3

Tan BY, Tan PH. A diagnostic approach to fibroepithelial breast lesions. Surgical Pathology Clinics. 2018;11(1):17-42.https://doi.org/10.1016/j.path.2017.09.003. Doi:10.1016/j.path.2017.09.0

Memon SS, ValiRam P, Memon MS. Clinico-pathological profile of breast lesions at a tertiary care center in Karachi, Pakistan. Pak J Surg. 2020;36(1):25-8.

Aslam HM, Saleem S, Shaikh HA, Shahid N, Mughal A, Umah R. Clinico- pathological profile of patients with breast diseases. Diagn Pathol. 2013 May 9;8:77. Doi: 10.1186/1746-1596-8-77.

Sikandar B, Qureshi MA, Avesi L, Sheraz N, Mirza T. Histopathological spectrum of breast diseases in a multi-ethnic population of Karachi, Pakistan. Rawal Medical Journal. 2015;40(1):52-8.

Rockbrand Campos LP, Koutsowris Sáenz S, García Carranza MA, Castro González M, Sibaja Matamorros DA. Phyllodes tumour: literature review. Medicina Legal de Costa Rica. 2020;37(1):146-53.Doi:10.31434/rms.v4i9.273.

Wang S, Xiao Y, An X, Luo L, Gong K, Yu D. A comprehensive review of the literature on CD10: its function, clinical application, and prospects. Front Pharmacol. 2024 Feb 8;15:1336310. Doi: 10.3389/fphar.2024.1336310.

Louhichi T, Saad H, Dhiab MB, Ziadi S, Trimeche M. Stromal CD10 expression in breast cancer correlates with tumor invasion and cancer stem cell phenotype. BMC Cancer. 2018 Jan 6;18(1):49. Doi: 10.1186/s12885-017-3951-8.

Skibinski A, Kuperwasser C. The origin of breast tumour heterogeneity. Oncogene. 2015 Oct 16;34(42):5309-16. Doi: 10.1038/onc.2014.475.

Jana SH, Jha BM, Patel C, Jana D, Agarwal A. CD10-a new prognostic stromal marker in breast carcinoma, its utility, limitations and role in breast cancer pathogenesis. Indian J Pathol Microbiol. 2014 Oct-Dec;57(4):530-6. Doi: 10.4103/0377-4929.142639.

Makretsov NA, Hayes M, Carter BA, Dabiri S, Gilks CB, Huntsman DG. Stromal CD10 expression in invasive breast carcinoma correlates with poor prognosis, estrogen receptor negativity, and high grade. Mod Pathol. 2007 Jan;20(1):84-9. Doi: 10.1038/modpathol.3800713.

WAJPEYI K, VAGHA S, SHUKLA S. " STUDY OF STROMAL EXPRESSION OF CD-10 AND ITS CORRELATION WITH CLINICOPATHOLOGICAL PARAMETERS IN CARCINOMA BREAST". International Journal of Early Childhood Special Education. 2022;14(7). Doi: 10.9734/jpri/2021/v33i63B35288.

Sun H, Ding Q, Sahin AA. Immunohistochemistry in the Diagnosis and Classification of Breast Tumours. Arch Pathol Lab Med. 2023 Oct 1;147(10):1119-1132. Doi: 10.5858/arpa.2022-0464-RA.

Kulkarni MM, Khandeparkar SG, Joshi AR, Kothikar V, Nasare A, Patil S, Niraspatil S, Dhande B. Role of CD10 Immunoexpression in Grading Phyllodes Tumour of the Breast. J Clin Diagn Res. 2017 Jan;11(1):EC14-EC16. Doi: 10.7860/JCDR/2017/25613.9231.

Tsang JY, Tse GM. Fibroepithelial Lesions (Phyllodes Tumour and Fibroadenoma) of the Breast. Practical Breast Pathology: Frequently Asked Questions. 2019:159-71.Doi: 10.1007/978-3-030-16518-5_6.

Zamecnik M, Kinkor Z, Chlumska A. CD10+ stromal cells in fibroadenomas and phyllodes tumours of the breast. Virchows Arch. 2006 Jun;448(6):871-2. Doi: 10.1007/s00428-005-0131-z.

Puri V, Jain M, Mahajan G, Pujani M. Critical appraisal of stromal CD10 staining in fibroepithelial lesions of breast with a special emphasis on expression patterns and correlation with WHO grading. J Cancer Res Ther. 2016 Apr-Jun;12(2):667-70. Doi: 10.4103/0973-1482.177215.

Lakhani S, Ellis I, Schnitt S, Tan P, van de Vijver M. World Health Organization classification of tumours, volume 2: breast tumours. Lyon, France, IARC Press; 2019.DOI: 10.1111/his.14091.

Lokuhetty D, White VA, Watanabe R, Cree IA. Breast Tumours: International Agency for Research on Cancer; 2019. Doi:10.1016/j.pathol.2021.05.080.

Zhang Y, Kleer CG. Phyllodes Tumour of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates. Arch Pathol Lab Med. 2016 Jul;140(7):665-71. Doi: 10.5858/arpa.2016-0042-RA.

Fortuna D, Toll A, Palazzo JP. Fibroepithelial Lesions of the Breast. Practical Atlas of Breast Pathology. 2018:183-203. ????

Shubham S, Ahuja A, Bhardwaj M. Immunohistochemical expression of Ki-67, p53, and CD10 in phyllodes tumour and their correlation with its histological grade. J Lab Physicians. 2019 Oct-Dec;11(4):330-334. Doi: 10.4103/JLP.JLP_106_19.

Kainat P, Khan MR, Sindhu S, Memon RA, Nohri ZA, Anmol M. Histopathological Spectrum of Phyllodes Tumour of Breast in a Tertiary Health Care Center: A 5-Year Retrospective Study. Pakistan Journal of Medical & Health Sciences. 2022;16(12):560-. Doi: 10.53350/pjmhs20221612560.

Sukumar C, Yadav SK, Singh G, Singh S, Sarin N. Comparison of P-53, Ki-67 and Cd-10 Expression Between Fibroadenoma, Benign Phyllodes Tumour and Malignant Phyllodes Tumour.Doi: 10.21276/APALM.2937.

Chaudhary D, Singh M, Kushwaha P, Agarwal R, Singh V, Mandal S, Khurana N, wMishra A. Expression of vascular endothelial growth factor, CD10, and factor 8 in phyllodes tumour: A 5-year study of 38 cases. J Cancer Res Ther. 2020 Oct-Dec;16(6):1408-1411. Doi: 10.4103/jcrt.JCRT_300_18.

Hashmi AA, Mallick BA, Rashid K, Zafar S, Zia S, Malik UA, Sapna F, Anjali F, Vishal F, Irfan M. Clinicopathological Parameters Predicting Malignancy in Phyllodes Tumour of the Breast. Cureus. 2023 Sep 28;15(9):e46168. Doi: 10.7759/cureus.46168.

Efared B, Ebang GA, Tahiri L, Sidibé IS, Erregad F, Hammas N, Melhouf MA, Banani A, Chbani L, Fatemi HE. Phyllodes tumours of the breast: clinicopathological analysis of 106 cases from a single institution. Breast Dis. 2018;37(3):139-145. Doi: 10.3233/BD-170297.

Tian F, Zhao J, Shi QF, Zhang DC, Wang YY, Sun JP, Wang Y, Yang SA, Zhang C. Association between CD10 expression and phyllodes tumour: A retrospective case control study. Medicine (Baltimore). 2023 Nov 3;102(44):e35677. Doi: 10.1097/MD.0000000000035677.