Objective: To investigate the expression of TRPS1 in salivary gland-type breast carcinoma and its clinical application. Methods: A total of 30 cases of salivary gland-type breast carcinoma diagnosed from May 2015 to November 2022 at the Department of Pathology of the First Affiliated Hospital of Nanjing Medical University were collected. The expression of TRPS1 was detected by immunohistochemistry and compared with that of GATA3. TRPS1 and GATA3 expression in 24 cases of primary salivary gland carcinoma. Results: There were 10 cases of breast secretory carcinoma, aged 21-61 years (median 53.5 years), with the size ranging from 0.9-2.2 cm (median 1.6 cm), 2 of which were accompanied by axillary nodal macrometastasis. All patients were alive after 2-55 months of follow-up (median 29.5 months, mean 29.7 months). There were 20 cases of breast adenoid cystic carcinoma, aged 36-77 years (median 53.5 years), with the size ranging from 1.2-5.5 cm (median 2.5 cm), 3 of which were accompanied by axillary nodal macrometastasis. All patients were alive after 3-92 months of follow-up (median 22.5 months, mean 31.7 months), and 1 patient had lung metastasis 15 months after surgery. The medium/high expression ratio of TRPS1 in breast secretory carcinoma was 10/10, which was higher than that of GATA3 (7/10). TRPS1 was also positive in the 2 cases with lymph node metastases. The medium/high expression rate of TRPS1 in breast adenoid cystic carcinoma was 20/20, which was significantly higher than that of GATA3 (2/20). TRPS1 was highly expressed in both classic and solid subtypes, while GATA3 was only expressed in a few cases of the classic subtype. TRPS1 was also positive in 3 cases with lymph node metastases and 1 case of the pulmonary metastases. The expression level of TRPS1 was the same in 1 case before and after neoadjuvant chemotherapy. In addition, TRPS1 was positive in parotid secretory carcinoma and adenoid cystic carcinoma. The medium/high expression rate of TRPS1 in parotid secretory carcinoma (6/6) was higher than that of GATA3 (2/6), and the medium/high expression rate of TRPS1 in parotid adenoid cystic carcinoma (17/18) was higher than that of GATA3 (2/18). Conclusions: The expression of TRPS1 is highly sensitive to salivary gland-type breast carcinoma, especially in GATA3-negative solid subtype of adenoid cystic carcinoma, which plays an important role in clinical practice.
目的： 探讨TRPS1在涎腺型乳腺癌中的表达及实践应用。 方法： 收集南京医科大学第一附属医院病理科2015年5月至2022年11月诊断的涎腺型乳腺癌30例，利用免疫组织化学方法检测肿瘤细胞TRPS1的表达，并与GATA3比较；同时对同期诊断的24例腮腺原发对应癌（分泌性癌6例，腺样囊性癌18例）行TRPS1、GATA3检测。 结果： 乳腺分泌性癌10例，年龄21~61岁（中位53.5岁），肿瘤最大径0.9~2.2 cm（中位1.6 cm），其中2例伴腋窝淋巴结宏转移，术后随访2~55个月（中位29.5个月，平均29.7个月），所有患者均存活。乳腺腺样囊性癌20例，年龄36~77岁（中位53.5岁），肿瘤最大径1.2~5.5 cm（中位2.5 cm），其中3例伴腋窝淋巴结宏转移，术后随访3~92个月（中位22.5个月，平均31.7个月），所有患者均存活，1例术后15个月出现肺转移。乳腺分泌性癌中TRPS1的中/高表达占比为10/10，高于GATA3的7/10；其中2例腋窝淋巴结转移灶中TRPS1也呈阳性表达。乳腺腺样囊性癌中TRPS1的中/高表达占比为20/20，显著高于GATA3的2/20，经典型及实体型中TRPS1均呈无差异性高表达，而GATA3仅在少数经典型中表达；其中3例对应淋巴结转移灶、1例对应肺转移灶中TRPS1也呈阳性表达；1例新辅助化疗前后标本中TRPS1表达水平相同。TRPS1在腮腺分泌性癌、腺样囊性癌中也呈阳性表达，且TRPS1表达（分泌性癌6/6，腺样囊性癌17/18）均显著高于GATA3（分泌性癌2/6，腺样囊性癌2/18）。 结论： TRPS1在涎腺型乳腺癌中的表达具有高灵敏度，尤其在GATA3阴性的实体亚型腺样囊性癌中具有重要临床应用价值。.