1
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Erdem O, Dursun A, Coşkun U, Günel N. The Prognostic Value of p53 and c-erbB-2 Expression, Proliferative Activity and Angiogenesis in Node-Negative Breast Carcinoma. TUMORI JOURNAL 2019; 91:46-52. [PMID: 15850004 DOI: 10.1177/030089160509100109] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background p53, c-erbB-2 and Ki-67 protein expression and microvessel density (MVD) determined by CD34 antibody were evaluated by immunohistochemistry and their correlation with clinicopathological parameters including estrogen (ER) and progesterone (PR) receptor status and survival were investigated in patients with axillary lymph node-negative infiltrating ductal breast carcinoma. Methods The study population consisted of 47 patients with axillary lymph node-negative infiltrating ductal breast carcinoma. Results p53 and c-erbB-2 expression was detected in 36.2% and 31.9% of patients, respectively. Median Ki-67 expression was 10%. There were no statistically significant differences in the distribution of p53, Ki-67 and c-erbB-2 protein expression in relation to the age of the patients or to the size, histological grade or ER and PR status of the tumors. p53 protein expression correlated positively with c-erbB-2 and Ki-67 protein expression (P <0.05). The mean MVD was 63.65 ± 29.1 and it correlated positively with histological grade and Ki-67 expression (P <0.05). Survival analysis revealed that age, tumor size, p53 and c-erbB-2 expression and PR status had no significant prognostic impact, whereas histological grade, proliferative activity and angiogenic activity were significant prognostic factors. Although ER-positive patients had a statistically significant overall survival advantage, the difference in disease-free survival was not significant. Conclusion In axillary lymph node-negative breast carcinoma the histological grade and the proliferative and angiogenic activity of the tumor could be useful prognostic indicators.
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MESH Headings
- Adult
- Biomarkers, Tumor/analysis
- Breast Neoplasms/blood supply
- Breast Neoplasms/chemistry
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/blood supply
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Cell Proliferation
- Disease-Free Survival
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Ki-67 Antigen/analysis
- Lymphatic Metastasis
- Middle Aged
- Neovascularization, Pathologic
- Predictive Value of Tests
- Progesterone/analysis
- Prognosis
- Receptor, ErbB-2/analysis
- Receptors, Estrogen/analysis
- Survival Analysis
- Tumor Suppressor Protein p53/analysis
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Affiliation(s)
- Ozlem Erdem
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey.
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2
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Affiliation(s)
- Emanuela Guerra
- Laboratory of Experimental Oncology, Department of Cell Biology and Oncology, Institute Mario Negri – Consorzio Mario Negri Sud, Santa Maria Imbaro (Chieti), Italy
| | - Saverio Alberti
- Laboratory of Experimental Oncology, Department of Cell Biology and Oncology, Institute Mario Negri – Consorzio Mario Negri Sud, Santa Maria Imbaro (Chieti), Italy
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3
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Guerra E, Vacca G, Palombo B, Alberti S. Prognostic Value of Mutations in TP53 and RAS Genes in Breast Cancer. Int J Biol Markers 2018. [DOI: 10.1177/172460080301800108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The identification of molecular indicators of higher risk for specific subgroups of cancer patients may allow to develop more aggressive therapeutic strategies aimed at cases with the highest likelihood of response. This would avoid unnecessary toxicity to patients and alleviate the burden of cancer care for healthcare systems. Activated oncogenes and mutated tumor suppressor genes are causal determinants of the appearance and progression of tumors in man. They therefore represent potential indicators of prognosis and/or response to therapy. However, even in cases of well-studied oncogenes and tumor suppressor genes such as TP53 and RAS, their attributed prognostic and predictive value is often based on studies of insufficient statistical power that often lead to conflicting conclusions. Findings in favor or against the use of TP53 and RAS as prognostic and predictive indicators in breast cancer are reviewed and discussed here.
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Affiliation(s)
- E. Guerra
- Laboratory of Experimental Oncology, Department of Cell Biology and Oncology, Mario Negri Institute - Consorzio Mario Negri Sud, Santa Maria Imbaro (CH)
| | - G. Vacca
- Department of Oncology, School of Medicine, University “G. D'Annunzio”, Chieti - Italy
| | - B. Palombo
- Laboratory of Experimental Oncology, Department of Cell Biology and Oncology, Mario Negri Institute - Consorzio Mario Negri Sud, Santa Maria Imbaro (CH)
| | - S. Alberti
- Laboratory of Experimental Oncology, Department of Cell Biology and Oncology, Mario Negri Institute - Consorzio Mario Negri Sud, Santa Maria Imbaro (CH)
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4
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Tumor Size and Pathologic Characteristics of Breast Cancer Analysis of 639 Early Breast Cancers. POLISH JOURNAL OF SURGERY 2007. [DOI: 10.2478/v10035-007-0013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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5
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Lai H, Ma F, Trapido E, Meng L, Lai S. Spectrum of p53 tumor suppressor gene mutations and breast cancer survival. Breast Cancer Res Treat 2004; 83:57-66. [PMID: 14997055 DOI: 10.1023/b:brea.0000010699.53742.60] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
CONTEXT p53 mutation is associated with poor prognosis in breast cancer patients. Mutations in different structural and functional domains of p53 have different effects on its biological activities. Nevertheless, few studies have examined the full spectrum of p53 gene mutations in relation to breast cancer survival. OBJECTIVE To evaluate the prognostic significance of the types, localizations, and multiplicity of p53 gene mutations in breast cancer patients. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of a consecutive series of 271 women with histologically confirmed primary breast cancer who underwent breast resection at the Jackson Memorial Hospital, Miami, FL, between 1984 and 1986. Main outcome measures. Ten year overall and breast-cancer-specific deaths. RESULTS After adjustment for tumor stage, treatment regimen, and the number of mutations, patients with p53 mutations had significantly greater breast-cancer-specific mortality than did patients without p53 mutations (hazard ratio = 2.86; 95% confidence interval: 1.15-7.11). Further analysis of mutation characteristics showed that patients with the following mutations had significantly poorer breast cancer disease-free survival: silent/missense mixed mutations (7.95; 1.28-49.62), nonsense mutations (9.43; 1.29-69.12), transitions (3.79; 1.46-9.88), mutations in which guanine changed (3.32; 1.01-10.35), and mutations on exon 7 (6.46; 1.78-23.45). CONCLUSIONS Breast-cancer-specific and all-cause mortality are increased in female breast cancer patients with the following p53 mutation characteristics: silent and missense mixed mutations, transitional mutations, mutations in which guanine changed, mutations on exon 7, or multiple mutations occurring within 60 codons. These findings indicate that not just p53 mutation per se but the full spectrum (i.e., different types, locations, and numbers) of p53 mutation needs to be examined when it is used as a prognostic marker of survival in breast cancer patients.
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Affiliation(s)
- Hong Lai
- Department of Ophthalmology, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.
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6
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Linjawi A, Kontogiannea M, Halwani F, Edwardes M, Meterissian S. Prognostic significance of p53, bcl-2, and Bax expression in early breast cancer. J Am Coll Surg 2004; 198:83-90. [PMID: 14698315 DOI: 10.1016/j.jamcollsurg.2003.08.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The use of adjuvant chemotherapy in early breast carcinoma is controversial, with most advocating its use in high-risk patients as defined by specific clinicopathologic parameters. Both bcl-2 and p53, which play a role in determining tumor growth by their effects on apoptosis and cell proliferation respectively, may serve to delineate this subset more accurately. The purpose of this study was to determine the prognostic value of bcl-2, Bax, and mutant p53 in stage I breast cancer. STUDY DESIGN A total of 75 patients with stage Ic breast carcinoma diagnosed from 1989 to 1992 were identified retrospectively and clinicopathologic parameters such as age, tumor size, estrogen receptor (ER) and progesterone receptor (PR) status, disease-free survival and overall survival obtained. Paraffin-embedded formalin-fixed tissues were immunostained with bcl-2, Bax and p53 monoclonal antibodies using a standard avidin biotin peroxidase reaction. Stained slides were evaluated by two independent pathologists for staining intensity and percentage of cells staining positively. Cox regression was used for multivariate survival analysis using the clinicopathologic parameters and molecular markers. Chi-square tests were used for frequency tables. RESULTS Mean patient age was 58 years (range 29 to 79 years) with a median followup of 80 months from time of diagnosis. The most common histopathology was infiltrating ductal carcinoma. Neither bcl-2 nor Bax expression was associated statistically with disease-free or overall survival. Expression of mutant p53 was associated with a significant decrease in both 5-year disease-free survival (70% versus 98%, p </= 0.01 in multivariate analysis) and 5-year overall survival (74% versus 100%, p = 0.03). Expression of bcl-2 was associated with hormone receptor expression and tumor diploid status. Of tumors expressing bcl-2, 36 of 49 (73%) were ER+ (p = 0.017, versus tumors not expressing bcl-2, 6 of 15 [40%]), 22 of 49 (45%) PR+ (p = 0.027 versus tumors not expressing bcl-2, 2 of 15 [13%]) and 28 of 44 (64%) diploid (p = 0.004 versus tumors not expressing bcl-2, 1 of 9 [11%]). CONCLUSIONS These results indicate that bcl-2 expression is significantly associated with hormonal receptor status and that p53 is a significant prognostic marker for survival in early breast cancer.
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Affiliation(s)
- Ayman Linjawi
- Division of General Surgery, Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
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7
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Vagunda V, Smardová J, Vagundová M, Jandáková E, Zaloudík J, Koukalová H. Correlations of Breast Carcinoma Biomarkers and p53 Tested by FASAY and Immunohistochemistry. Pathol Res Pract 2003; 199:795-801. [PMID: 14989491 DOI: 10.1078/0344-0338-00498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
p53 status is an important predictive factor in breast cancer, but the results of many studies are ambiguous. We tested p53 by functional analysis of separated alleles in yeast (FASAY) as well as by immunohistochemistry (IHC) and evaluated correlations with main prognostic factors, proliferation, and Bcl-2. Thirty-two tumors were tested with antibodies BP53-12, DO1, DO11, DO12, and by FASAY. Spearman rank correlations were tested separately with age, tumor type, pT, grade, pN, NPI, Ki-67, S-phase, proliferation index, Bcl-2, and steroid receptor status determined by ER, PR, and pS2. FASAY showed significant correlations with ductal type, grade and proliferation, and an inverse correlation with functional estrogen receptor and Bcl-2. FASAY provided better correlations compared to p53 IHC. We conclude that FASAY shows significant correlations with main prognostic/predictive factors and provides more reliable biological information compared to p53 IHC. Apoptosis is positively linked to proliferation and is not under the control of p53, which is frequently mutated in highly proliferating carcinomas. FASAY seems to be very important in assessing the predictive significance of p53 for a specific therapy of breast cancer.
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MESH Headings
- Adult
- Aged
- Alleles
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- DNA Mutational Analysis/methods
- DNA, Neoplasm/analysis
- Female
- Genes, bcl-2
- Genes, p53
- Humans
- Immunohistochemistry
- Middle Aged
- Mutation
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
- Yeasts/genetics
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Affiliation(s)
- Václav Vagunda
- Masaryk Memorial Cancer Institute, Dept. Pathology, Brno, Czech Republic.
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8
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Tissue microarrays for rapid linking of molecular changes to clinical endpoints. THE AMERICAN JOURNAL OF PATHOLOGY 2001; 159:2249-56. [PMID: 11733374 PMCID: PMC1850582 DOI: 10.1016/s0002-9440(10)63075-1] [Citation(s) in RCA: 421] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Advances in genomics and proteomics are dramatically increasing the need to evaluate large numbers of molecular targets for their diagnostic, predictive or prognostic value in clinical oncology. Conventional molecular pathology techniques are often tedious, time-consuming, and require a lot of tissue, thereby limiting both the number of tissues and the number of targets that can be evaluated. Here, we demonstrate the power of our recently described tissue microarray (TMA) technology in analyzing prognostic markers in a series of 553 breast carcinomas. Four independent TMAs were constructed by acquiring 0.6 mm biopsies from one central and from three peripheral regions of each of the formalin-fixed paraffin embedded tumors. Immunostaining of TMA sections and conventional "large" sections were performed for two well- established prognostic markers, estrogen receptor (ER) and progesterone receptor (PR), as well as for p53, another frequently examined protein for which the data on prognostic utility in breast cancer are less unequivocal. Compared with conventional large section analysis, a single sample from each tumor identified about 95% of the information for ER, 75 to 81% for PR, and 70 to 74% for p53. However, all 12 TMA analyses (three antibodies on four different arrays) yielded as significant or more significant associations with tumor-specific survival than large section analyses (p < 0.0015 for each of the 12 comparisons). A single sample from each tumor was sufficient to identify associations between molecular alterations and clinical outcome. It is concluded that, contrary to expectations, tissue heterogeneity did not negatively influence the predictive power of the TMA results. TMA technology will be of substantial value in rapidly translating genomic and proteomics information to clinical applications.
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9
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Pezeshki AM, Farjadian S, Talei A, Vasei M, Gharesi-Fard B, Doroudchi M, Ghaderi A. p53 gene alteration and protein expression in Iranian women with infiltrative ductal breast carcinoma. Cancer Lett 2001; 169:69-75. [PMID: 11410327 DOI: 10.1016/s0304-3835(01)00557-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Genetic alterations in the p53 tumor suppressor gene with or without protein overexpression have been reported to be associated with sporadic breast cancer. To assess the role of p53 in infiltrative ductal breast carcinoma among Iranian patients, p53 protein expression and p53 gene mutations were studied by immunohistochemical analysis and single-strand conformation polymorphism, respectively. The p53 protein was expressed in 25 out of 51 (49%) tumors and p53 gene mutations were detected in 17 out of 37 (46%) tested tumors. No significant correlation was observed between p53 gene mutations and p53 protein expression. There was no significant correlation between p53 abnormalities (mutation and expression) and tumor size, histological grade, nodal status, and progesterone receptor expression. However, a non-statistically significant trend of association (P=0.07) was observed between p53 gene mutations and lack of estrogen receptor. The high percentage of alterations both in p53 gene and protein among southern Iranian breast cancer patients suggests that p53 is probably one of the genes involved in sporadic breast cancer in this area.
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MESH Headings
- Adult
- Aged
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Female
- Gene Expression
- Genes, p53/genetics
- Humans
- Immunohistochemistry
- Middle Aged
- Mutation
- Polymerase Chain Reaction
- Polymorphism, Single-Stranded Conformational
- Receptors, Estrogen/biosynthesis
- Receptors, Progesterone/biosynthesis
- Tumor Suppressor Protein p53/biosynthesis
- Tumor Suppressor Protein p53/genetics
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Affiliation(s)
- A M Pezeshki
- Department of Immunology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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10
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González-Cámpora R, Galera Ruiz MR, Vázquez Ramírez F, Ríos Martín JJ, Fernández Santos JM, Ramos Martos MM, Gómez Pascual A. Apoptosis in breast carcinoma. Pathol Res Pract 2000; 196:167-74. [PMID: 10729921 DOI: 10.1016/s0344-0338(00)80097-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Apoptosis may play a major role in determining tumor growth and aggressiveness. The aim of this study was to examine the relationship between apoptosis, expression of bcl-2 and p53 proteins, proliferation index, and other clinicopathological features of breast carcinoma. Sixty-five formalin-fixed paraffin-embedded tissue sections from invasive ductal breast carcinomas were studied for the presence of apoptosis by the terminaldeoxynucleotidyl-transferase-mediated dUTP-FITC nick end-labeling (TUNEL) method. Immunohistochemical methods were also used to determine the expression of estrogen receptor, Ki67, bcl-2 and p53 proteins. The number of apoptotic cells ranged from 2.0 to 236.0/10HPF (mean 36.26, median 28.0). The observation of 30 apoptotic cells/10HPF was more common in tumors > 3 cm, of histological grade III, with a high mitotic index, Ki67 index > or = 300, and p53 positivity; however, statistical significance was found only for the histological grade. Grade I and III tumors displayed an inverse association between the apoptotic index and bcl-2 and p53 protein expressions; grade I tumors frequently expressed bcl-2 (19/28), lacked p53 (20/28), and presented a low number of apoptotic cells (18/28), whereas grade III tumors tended to express p53 (12/17), lacked bcl-2 (13/17), and displayed a high number of apoptotic cells/10HPF (12/17). Multivariate analysis for survival revealed that estrogen receptors and apoptosis were independent variables. These data suggest that apoptosis, rather than proliferation index or expression of bcl-2 or p53 proteins, is an independent factor for the prognosis of survival.
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Affiliation(s)
- R González-Cámpora
- Department of Pathology, Hospital Universitario Virgen Macarena, Faculty of Medicine, Seville, Spain
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11
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Ferrero JM, Ramaioli A, Formento JL, Francoual M, Etienne MC, Peyrottes I, Ettore F, Leblanc-Talent P, Namer M, Milano G. P53 determination alongside classical prognostic factors in node-negative breast cancer: an evaluation at more than 10-year follow-up. Ann Oncol 2000; 11:393-7. [PMID: 10847456 DOI: 10.1023/a:1008359722254] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is heterogeneity of methods and conflicting results concerning the prognostic value of p53 in node-negative breast cancer. The clinical value of a quantitative method for measuring tumoralp53 content still needs to be evaluated. PATIENTS AND METHODS A long-term retrospective study was conducted on 297 node-negative patients with a median follow-up greater than 10 years (11 years, 101-172 months). Classic prognostic factors were considered including age, tumor size, histoprognostic grade and estradiol (ER) and progesterone receptors (PR). In addition, the value of p53 determination (immunoluminometric assay in tumor cytosol) was assessed for this long follow-up period. RESULTS p53 concentrations were significantly linked to the histological grade (P = 0.001), to tumor size (P = 0.02) and ER status (P = 0.01). Higher p53 tumoral concentrations were found in tumors with large size, pejorative histological grade and negative ER status. In contrast, p53 tumoral concentrations were not influenced by menopausal or PR status. Multivariate Cox analysis demonstrates that tumor size was the only significant predictor of disease-free survival (P = 0.049) with a risk factor at 1.38. As regards specific survival, univariate Cox analysis indicates that p53 taken as a continuous variable is a significant predictor (P = 0.024) together with histological grade, tumor size and ER status. In a multivariate Cox analysis there were two significant and independent variables for predicting overall survival: tumor size (P = 0.031) and, ER status (P = 0.015) with the highest risk factor (RR = 2.14). CONCLUSIONS The present investigation points out that the prognostic power of p53 tumor determination evaluated at more than 10 years median survival is not higher than the well-recognized classic prognostic factors in node-negative breast cancer. The present data highlight the need to assess the prognostic value of potentially new biological factors in node-negative breast cancer on cohorts of patients followed over periods in excess of 10 years.
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12
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Werenskiold AK, Prechtel D, Harbeck N, Höfler H. Tumor-associated overexpression of the soluble T1-S receptor in lymph node-negative breast cancer. DIAGNOSTIC MOLECULAR PATHOLOGY : THE AMERICAN JOURNAL OF SURGICAL PATHOLOGY, PART B 2000; 9:26-34. [PMID: 10718210 DOI: 10.1097/00019606-200003000-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The oncogene-inducible secreted T1-S glycoprotein is overexpressed in invasive breast carcinomas in mice. As yet, nothing is known about the expression of T1-S in spontaneously occurring human cancers. A report follows on the overexpression of T1-S mRNA in 67% of primary invasive lymph node-negative breast carcinomas (31 of 46 patients) as determined by quantitative reverse transcriptase polymerase chain reaction. Overexpression of T1-S mRNA was independent of the tumor size, the histologic tumor type, and the estrogen-and progesterone-receptor status but was associated with high to moderate differentiation of the tumors (G , G2). T1-S mRNA levels were low to nondetectable in resting normal mammary tissue and benign fibrocystic disease of the breast. Immunohistochemistry confirmed a low to moderate T1 immunoreactivity in epithelial cells of resting mammary tissue and benign fibrocystic disease and highly variable levels of T1 immunoreactivity in breast carcinoma cells. Kaplan-Meier analysis of disease-free survival during a median observation period of 61 months revealed a trend toward a reduced relapse rate and an extended relapse-free survival period for T1-S mRNA--overexpressing breast carcinomas. It is concluded that overexpression of T1-S receptor in lymph node-negative breast cancer may be a potential indicator for tumors with a low metastatic potential.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast/metabolism
- Breast/pathology
- Breast Neoplasms/genetics
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- DNA Primers/chemistry
- Female
- Fibroadenoma/genetics
- Fibroadenoma/metabolism
- Fibroadenoma/pathology
- Fibrocystic Breast Disease/genetics
- Fibrocystic Breast Disease/metabolism
- Fibrocystic Breast Disease/pathology
- Humans
- Immunoenzyme Techniques
- In Situ Hybridization
- Interleukin-1 Receptor-Like 1 Protein
- Lymph Nodes/metabolism
- Lymphatic Metastasis
- Membrane Proteins
- Middle Aged
- Neoplasm Recurrence, Local/pathology
- Protein Biosynthesis
- Proteins/genetics
- RNA, Messenger/metabolism
- Receptors, Cell Surface
- Receptors, Interleukin-1/biosynthesis
- Receptors, Interleukin-1/genetics
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- A K Werenskiold
- Institut für Allgemeine Pathologie und Pathologische Anatomie der Technischen Universität München, Germany
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13
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Pharoah PD, Day NE, Caldas C. Somatic mutations in the p53 gene and prognosis in breast cancer: a meta-analysis. Br J Cancer 1999; 80:1968-73. [PMID: 10471047 PMCID: PMC2363143 DOI: 10.1038/sj.bjc.6690628] [Citation(s) in RCA: 221] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Many studies have investigated the association between alterations in the p53 gene and clinical outcome of breast cancer, and most investigators have reported poorer overall and disease-free survival (as indicated by a relative hazard (RH) greater than one) in breast cancer cases with somatic mutations in p53. However, different studies have produced widely differing RH estimates, ranging from no risk (RH = 1) to a relative hazard of 23, and not all of these results have been statistically significant. We have therefore reviewed all the published studies that have investigated the association between somatic mutations in the p53 gene and breast cancer prognosis and used standard techniques of meta-analysis to combine the results of these studies to produce a more precise estimate of the prognostic significance of p53 mutations. Eleven studies investigated overall survival in a total of 2319 unselected cases. The RH estimates from these ranged from 1 to 23.4 with a combined RH estimate of 2.0 (confidence interval 1.7-2.5). Three studies investigated the role of p53 in node-negative patients and in these, the combined estimate of RH was 1.7 (1.2-2.3). For three studies of node-positive breast cancer the combined risk estimate was 2.6 (1.7-3.9). The inclusion of p53 mutation screening in large breast cancer clinical trials seems warranted in the light of these results. Analysis of large numbers of cases matched for stage and therapy will allow definitive clarification of the value of p53 mutational status in prognostication, and possibly choice of therapy.
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Affiliation(s)
- P D Pharoah
- CRC Human Cancer Genetics Group and Department of Oncology, University of Cambridge, UK
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14
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Ravaioli A, Bagli L, Zucchini A, Monti F. Prognosis and prediction of response in breast cancer: the current role of the main biological markers. Cell Prolif 1998. [DOI: 10.1111/j.1365-2184.1998.tb01190.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - L. Bagli
- *Istituto Oncologico Romagnolo Sede di Rimini, Italy
| | - A. Zucchini
- *Istituto Oncologico Romagnolo Sede di Rimini, Italy
| | - F. Monti
- Department of Oncology, Azienda USL Rimini
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