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Relationship of flow cytometry with other clinical and histopathological parameters in patients with neuroendocrine ductal carcinoma of the breast

Aims. The aim of the study was to determine cellular ploidy of invasive ductal breast carcinoma with neuroendocrine (NE) differentiation and its share in certain phases of the cell cycle. It was also aimed at assessing the relationship of the cell cycle profile with other clinical and histopathological features. Methods. The study was carried out in 80 patients with invasive ductal breast cancer, and classified as breast carcinoma with NE differentiation according to their histopathological parameters. The patients underwent treatment at the University Hospital for Tumors, Zagreb, Croatia during the period January 1 to December 31, 1992. Data about patients' age, estrogen and progesterone receptor concentration, cancer size, and treatment modality were retrospectively collected from their case histories. Paraffin blocks were used for immunohistochemical and histochemical analysis and flow cytometric analysis of the tumor cell cycle. Neuroendocrine tumor diagnosis was made using Grimelius and immunohistochemical staining including neuron-specific enolase (NSE), chromogranin A and synaptophysin. Results. Analysis by flow cytometry detected 27 tumors (33.8%) with DNA diploidy showing proliferative activity lower than 20%, and 53 tumors (66.2%) with DNA aneuploidy, tetraploidy and/or DNA diploidy with proliferative activity over 20%. Progesterone receptor concentration in DNA-diploid tumors was significantly higher that in DNA- aneuploid, tetraploid tumors and tumors with proliferative activity of ≥20% (p<0.001). Concentration of estrogen receptors, age, histological grade, tumor size, Grimelius staining and immnohistochemical markers did not significantly differ between the groups. Conclusion. Data collected in our study show a higher mean concentration of progesterone receptors in the group of diploid tumors and tumors with low proliferative activity. In consideration with the above criterium, other pathological and clinical parameters did not show any significant difference relative to both tumor ploidy and its proliferative activity. For final conclusion on the clinical significance of neuroendocrine differentiation in breast cancer further studies that would include monitoring of the course and outcome of the disease are required.

flow cytometry, histopathology, neuroendocine carcinoma, breast cancer

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