Background: Casitas B-lineage
lymphoma proto-oncogene-b (Cbl-b) is an E3
ubiquitin-protein ligase and a signal-transducing adaptor
protein involved in the development and progression of
cancer. Despite the known functions of Cbl-b, its role in
breast cancer remains unclear. The aim of this study is to explore the prognostic value of Cbl-b in
breast cancer. Methods: Cbl-b expression was analyzed by immunohistochemistry in 292
breast cancer patients from the First Hospital of China Medical University between 1999 and 2008. Kaplan-Meier curve and Cox proportional hazards regression were used to analyze the independent prognostic factors for overall survival (OS) and disease-free survival (DFS). Nomogram was constructed based on these prognostic factors. Results: Cbl-b expression was detected in 54.1% (158/292)
breast cancer tissue samples. Cbl-b expression was correlated with DFS (p = 0.033), but was not significantly associated with the known clinic-pathological factors in this study. Log-rank analysis indicated that Cbl-b expression was correlated with better OS (p = 0.013) and DFS (p = 0.016). Multivariate analysis showed that Cbl-b expression was an independent prognostic factor in
breast cancer. The nomogram we built for predicting OS was integrated with Cbl-b expression, age,
tumor size,
lymph node metastasis and histological grade. Except
tumor size, all the above factors and date of diagnosis were used to construct the DFS nomogram. The C-indexes of the nomograms were 0.735 and 0.678, respectively. Our new clinical model was superior to the TNM staging for prediction of OS. Conclusion: Cbl-b expression independently predicts favorable prognosis in
breast cancer. Cbl-b expression, combined with other variables could be more precise clinical predictive models for predicting OS and DFS in patients with
breast cancer.