Gross cystic disease fluid protein 15, GCDFP-15

The gross cystic disease fluid proteins were first identified in the fluid of breast cysts and in the serum of patients with mammary carcinomas. The members of this family of proteins are named from their molecular weights in kilodaltons, the major constituents in breast cyst fluid being GCDFP-15, GCDFP-24 (also known as apolipoprotien-D) and GCDFP-44 (also known as zinc alpha2-glycoprotein)7. GCDFP-15 is the most reproducibly present in breast carcinomas: this protein is induced by prolactin.

Immunohistochemical expression

Non-neoplastic serous salivary gland acini, bronchial serous glands, seminal vesicles and apocrine skin adnexa are immunoreactive4. Renal tubules, ovarian surface epithelium and urothelium are negative4. Staining is cytoplasmic, often with paranuclear enhancement in mammary carcinomas4. There is concordance between the immunoreactivity of primary breast carcinomas and their metastases4.

 

Breast carcinoma

62-77% of cases1, 10/143, 4/295, 80/1076

 

  ductal carcinoma

71/1192, 62/824

  lobular carcinoma

9/102, 8/154

  ductal carcinoma in situ

5/64

  mucinous carcinoma

1/24

Salivary gland tumours

 

  acinic cell tumour

5/124

  mucoepidermoid carcinoma

1/64

  adenoid cystic carcinoma

0/54

  adenocarcinoma, NOS

5/334

Skin adnexal tumours

positive1

  eccrine carcinoma

1/164

Vulval Paget's disease

9/94

Prostatic carcinomas

4/404

Pulmonary carcinomas

2/352

Gastric carcinomas

1/392

Colonic carcinoma

0/252, 0/946

Pancreatic carcinoma

0/292

Ovarian carcinoma

0/292, 0/323, 0/866, 1/264

Renal carcinomas

0/452, 1/294

Bladder carcinomas

1/674

Other carcinomas

usually negative1

Various non-mammary carcinomas

5%4

   
   
   

Positivity for GCDFP-15 occurs in breast carcinomas that are negative for ER or PR4:

 

ER

PR

 

positive

negative

positive

negative

GCDFP-15

positive

12

11

8

8

negative

4

10

2

7

 

One study compared the expresion of the three major gross cystic disease fluid proteins in DCIS7:

 

 

GCDFP-15

GCDFP-24

GCDFP-44

 

well-differentiated

5/13

3/13

5/13

moderately differentiated

11/19

9/19

11/19

poorly differentiated

8/25

8/25

6/25

total

24/57

20/57

22/57

with apocrine differentiation

7/9

5/9

6/9

 

 

Malignant pleural epithelioid mesothelioma

0/218

 

Malignant peritoneal epithelioid mesothelioma

0/208

Peripheral pulmonary adenocarcinoma involving pleura

0/238

Serous surface papillary adenocarcinoma of peritoneum

0/108

Breast carcinoma metastatic to pleura

7/108

   

 

Diagnostic utility

References

1Lerwill, M. F. (2004). "Current practical applications of diagnostic immunohistochemistry in breast pathology." Am J Surg Pathol 28(8): 1076-91.

2Kaufmann, O., T. Deidesheimer, et al. (1996). "Immunohistochemical differentiation of metastatic breast carcinomas from metastatic adenocarcinomas of other common primary sites." Histopathology 29(3): 233-40.

3Monteagudo, C., M. J. Merino, et al. (1991). "Value of gross cystic disease fluid protein-15 in distinguishing metastatic breast carcinomas among poorly differentiated neoplasms involving the ovary." Hum Pathol 22(4): 368-72.

4Wick, M. R., T. J. Lillemoe, et al. (1989). "Gross cystic disease fluid protein-15 as a marker for breast cancer: immunohistochemical analysis of 690 human neoplasms and comparison with alpha-lactalbumin." Hum Pathol 20(3): 281-7.

5Lee, B. H., J. L. Hecht, et al. (2002). "WT1, estrogen receptor, and progesterone receptor as markers for breast or ovarian primary sites in metastatic adenocarcinoma to body fluids." Am J Clin Pathol 117(5): 745-50.

6Lagendijk, J. H., H. Mullink, et al. (1999). "Immunohistochemical differentiation between primary adenocarcinomas of the ovary and ovarian metastases of colonic and breast origin. Comparison between a statistical and an intuitive approach." J Clin Pathol 52(4): 283-90.

7 Selim AA, El-Ayat G,Wells CA Immunohistochemical localization of gross cystic disease fluid protein-15, -24 and -44 in ductal carcinoma in situ of the breast: relationship to the degree of differentiation. Histopathology 2001; 39:198-202

8 Wick MR, Mills SE,Swanson PE Expression of "myelomonocytic" antigens in mesotheliomas and adenocarcinomas involving the serosal surfaces. Am J Clin Pathol 1990; 94:18-26

This page last revised 19.8.2005.

©SMUHT/PW Bishop