https://doi.org/10.4081/monaldi.2023.2641

A comprehensive analysis of GATA3 expression in carcinomas of various origins with emphasis on lung carcinomas

Vol. 94 No. 2 (2024)
Submitted: May 17, 2023
Accepted: July 27, 2023
Published: August 29, 2023
GATA3, urothelial carcinoma, breast carcinoma, lung carcinoma, sensitivity, specificity
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Supplementary Table 1: 116
Supplementary Table 2: 104
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Authors

Eirini-Chrisovalanto Bota
Department of Pathology and Cytopathology, University Hospital of Patras, Greece.
Dimitra Koumoundourou
Department of Pathology and Cytopathology, University Hospital of Patras, Greece.
Panagiota Ravazoula
Department of Pathology and Cytopathology, University Hospital of Patras, Greece.
Vasiliki Zolota
Department of Pathology and Cytopathology, University Hospital of Patras; Department of Pathology, University of Patras, Greece.
Charalambia Psachoulia
Department of Pathology and Cytopathology, University Hospital of Patras, Greece.
Maria Kardari
Department of Pathology and Cytopathology, University Hospital of Patras, Greece.
Theodoros Karampitsakos
Department of Respiratory Medicine, University of Patras, Greece.
Argyrios Tzouvelekis
Department of Respiratory Medicine, University of Patras, Greece.
Vasiliki Tzelepi
Department of Pathology and Cytopathology, University Hospital of Patras; Department of Pathology, University of Patras, Greece.
Fotios Sampsonas
fsampsonas@upatras.gr
https://orcid.org/0000-0002-7796-2959
Department of Respiratory Medicine, University of Patras, Greece.

GATA3 is a transcription factor involved in the embryogenesis of multiple human tissues and organs and in maintaining cell differentiation and tissue homeostasis in the adult organism. GATA3 is also involved in carcinogenesis and is regarded as a sensitive marker for urothelial and breast carcinomas, although its expression in carcinomas of non-breast/urothelial origin has been frequently reported. In this study, we sought to examine the extent and intensity of GATA3 expression in various carcinomas, mainly lung, urothelial, breast, and various other primary sites. Patients with breast carcinoma (n=40), carcinoma of the urinary bladder/renal pelvis (n=40), lung carcinoma (n=110), and various other origins (n=45) were included in the study. 165 patients had a primary tumor diagnosis, and 70 cases had a metastatic tumor diagnosis. Our results showed that GATA3 expression was significantly more common in carcinomas of the breast, urinary bladder, and renal pelvis compared to all other origins. All primary and 93% of metastatic urinary bladder carcinomas and 94% of primary and 80% of metastatic breast carcinomas expressed GATA3. Expression was lower in the non-urothelial histology of urinary primaries and in triple-negative breast carcinomas (TNBC). Focal staining, mostly faint, was seen in 5.6% of the primary lung adenocarcinomas and 35% of the primary lung squamous cell carcinomas. More extensive and intense staining was seen in 3.7% of the primary lung adenocarcinomas and 12% of the primary lung squamous cell carcinomas. Expression, mostly focal, was also seen in 30% of the metastatic lung carcinomas. Finally, high expression was seen in 12.5% of the other tumors (one metastatic pancreatic carcinoma, one metastatic salivary gland adenocarcinoma not otherwise specified, one metastatic squamous cell carcinoma of the skin, one primary uterine cervix serous carcinoma, and one squamous cell carcinoma of the head and neck), and focal expression was present in another 22% of them. No ideal cut-off for positivity for GATA3 staining could be identified, as increasing the cut-off in either the extent or the intensity of staining increased specificity but decreased sensitivity. In conclusion, our study shows that although GATA3 staining is very helpful in everyday practice in determining the breast/urothelial origin of carcinomas, there are two caveats to its use: the first is that nonclassical histologies of urothelial carcinomas and TNBC may be negative for the marker, and secondly, carcinomas of various origins may show (although rarely) intense positivity.

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Ethics Approval

The study protocol was approved by the University Hospital of Patras Committee for Research, Morality and Ethics (#246/14.05.2021).

How to Cite

Bota, Eirini-Chrisovalanto, Dimitra Koumoundourou, Panagiota Ravazoula, Vasiliki Zolota, Charalambia Psachoulia, Maria Kardari, Theodoros Karampitsakos, Argyrios Tzouvelekis, Vasiliki Tzelepi, and Fotios Sampsonas. 2023. “A Comprehensive Analysis of GATA3 Expression in Carcinomas of Various Origins With Emphasis on Lung Carcinomas”. Monaldi Archives for Chest Disease 94 (2). https://doi.org/10.4081/monaldi.2023.2641.
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