الفهرس 
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Abstract
Fibroepithelial breast lesions are group of heterogenous biphasic neoplasms which were classified by the World Health Organization (WHO) into hamartoma, fibroadenoma NOS, phyllodes tumor NOS and periductal stromal tumor.
Phyllodes tumor’s international incidence ranges from 0.3% to 1% of all tumors of the breast. While the isolated national incidence of malignant phyllodes tumor, reported by the National Cancer Institute (2000-2011), comprised 0.4% of total primary malignant breast tumors.
The WHO classified phyllodes tumor into benign, borderline and malignant grades depending on several histomorphological characters. Distinguishing between cellular fibroadenomas and phyllodes tumor is mandatory owing to different clinical behavior and therefore the management is different.
The current study focused on assessing the immunohistochemical expression of IMP3 and CD10 in cellular fibroadenomas and different grades of phyllodes tumor, focusing on borderline and malignant phyllodes tumor categories.
The current study comprised tumor blocks of 50 cases retrieved from archive of the Pathology Department, Medical Research Institute, Alexandria University retrospectively over a period from January 2016 to December 2018 and were divided into:15 cases of cellular fibroadenoma as well as 15 benign, 10 borderline and 10 malignant phyllodes tumor.
Statistical analysis revealed that IMP3 performance was of significance in differentiating borderline from benign phyllodes tumor (AUC = 0.893 and P=0.001), as well as borderline from malignant phyllodes tumor (AUC = 0.800 and P=0.023). On the other hand it was of no significance in diagnosing benign phyllodes tumor from cellular fibroadenoma (AUC = 0.700 and P=0.062).
As for CD10, its performance was of significance in differentiating benign phyllodes tumor from cellular fibroadenoma (AUC = 0.767and P=0.013) as well as from borderline phyllodes tumor (AUC = 0.910 and P=0.001). However, it failed to show significance in differentiating malignant from borderline phyllodes tumor (AUC = 0.690 and P=0.151).
The correlation of both markers with the clinicopathological parameters revealed high IMP3 expression with higher stromal cellularity (score3, p<0.001), higher nuclear atypia (score 3, p<0.001) as well as mitotic activity ≥ 10 /HPF (p<0.002). As for CD10 strong correlation was noted between strong expression and high stromal cellularity (score3, p=0.001), high nuclear atypia (score 3, p<0.001) as well as mitosis ≥10 /HPF (p=0.007).
The combined correlation of IMP3 and CD10 in the 4 studied groups revealed significant negative to weak expression in benign phyllodes tumor (P = 0.001) while both were significantly strongly expressed in malignant phyllodes tumor (P = 0.032).