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Tumor histology and stage but not p53, Her2-neu or cathepsin-D expression are independent prognostic factors in breast cancer patients.

AbstractBACKGROUND:
Several factors are currently employed for prognosis assessment and treatment determination in breast cancer. An array of molecular parameters, such as p53, Her2-neu (c-erbB 2) and Cathepsin-D, are also examined to improve clinical patient management. We have conducted a statistically powerful study of the prognostic value of conventional factors and of the investigational factors p53, Her2-neu and Cathepsin-D in patients with invasive breast carcinoma, in order to compare their significance. Our analysis was extended to determine the associations of p53 and Her2-neu with risk of death and relapse among patients with and without lymph node metastases.
MATERIALS AND METHODS:
In a set of 125 primary breast tumors, p53 and Her2-neu expression were immunohistochemically evaluated. Cathepsin-D, estrogen and progesterone receptor concentrations were determined in cytosols by a standard immunoradiometric assay.
RESULTS:
Over a mean of 62 months, 49 patients (39%) had a relapse and 29 patients (23%) died. Overexpression of p53, Her2-neu and Cathepsin-D was observed in 31%, 46% and 88% of cases, respectively. Overall survival was associated with histology (hazard ratio 0.04, 95% confidence interval: 0.01, 0.49 for lobular tumors) and stage (hazard ratio 5.94, 95% confidence interval: 1.30, 27.15 for stage III samples). Disease-free survival was also related to histology (hazard ratio 0.23, 95% confidence interval: 0.08, 0.73 for lobular tumors) and stage (hazard ratio 4.27, 95% confidence interval: 1.36, 13.36 for stage III tumors). Patients with both negative nodal status and Her2-neu overexpression tended to display an elevated risk of death.
CONCLUSION:
Our results support the prognostic power of tumor histology and stage and emphasize the need for further studies on the prognostic impact of p53. Her2-neu and Cathepsin-D in breast cancer. Additionally, our analysis indicates that deregulation of Her2-neu might characterize a subgroup of node-negative patients with poor prognosis who could benefit from an aggressive adjuvant therapy.
AuthorsD P Korkolis, E Tsoli, D Fouskakis, J Yiotis, G J Koullias, D Giannopoulos, E Papalambros, N I Nikiteas, C A Spiliopoulou, E Patsouris, P Asimacopoulos, V G Gorgoulis
JournalAnticancer research (Anticancer Res) 2004 May-Jun Vol. 24 Issue 3b Pg. 2061-8 ISSN: 0250-7005 [Print] Greece
PMID15274401 (Publication Type: Journal Article)
Chemical References
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Tumor Suppressor Protein p53
  • Receptor, ErbB-2
  • Cathepsin D
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms (metabolism, pathology, surgery)
  • Cathepsin D (biosynthesis)
  • Disease-Free Survival
  • Female
  • Humans
  • Immunohistochemistry
  • Lymph Nodes (pathology)
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Proportional Hazards Models
  • Receptor, ErbB-2 (biosynthesis)
  • Receptors, Estrogen (biosynthesis)
  • Receptors, Progesterone (biosynthesis)
  • Survival Analysis
  • Tumor Suppressor Protein p53 (biosynthesis)

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