Background: Among the many challenges in cancer diagnosis is the early distinction between metastatic cancer\nand a secondary tumor. This difficulty stems from the lack of markers that offer high sensitivity and specificity and\ncan be easily applied in routine laboratory work. An example of this challenge is distinguishing gastric metastases\noriginating from breast cancer from a gastric primary tumor. Hepatocyte nuclear factor 4 alpha (HNF4A) has been\nsuggested as a potential marker in these cases.\nThe aim of this study was to analyze the expression of HNF4A, estrogen receptor (ER), progesterone receptor (PR)\nand gross cystic disease fluid protein 15 (GCDFP-15) in a Brazilian cohort.\nMethods: We performed immunohistochemistry analysis of HNF4A, ER, PR and GCDFP-15 in 126 patients divided\ninto three cohorts: primary breast cancer, primary gastric cancer and both types of tumors.\nResults: Our data confirmed the sensitivity and specificity of the HNF4A marker compared to other currently used\nclinical markers.\nConclusion: HNF4A alone could be a gold standard marker for distinguishing primary gastric cancer from breast\nmetastasis, thus validating its potential clinical use, especially in populations with high genetic diversity.
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