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Zhang SL, Yu HJ, Lian ZQ, Wan J, Xie SM, Lei W, Chen QP, Zhang L, Wang Q. Septin9 DNA methylation is associated with breast cancer recurrence or metastasis. J Int Med Res 2024; 52:3000605231220827. [PMID: 38180895 PMCID: PMC10771060 DOI: 10.1177/03000605231220827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/23/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE We aimed to explore the prognostic value of Septin9 DNA methylation in breast cancer. METHODS Breast cancer patients with and without recurrence or metastasis and matched non-breast cancer patients were screened retrospectively from 2014 to 2016. Bisulfite conversion and fluorescence quantitative methylation-specific polymerase chain reaction were used to detect the Septin9 methylation status and distribution levels in patient breast tissues. RESULTS Septin9 DNA methylation was more frequent in breast cancer tissues than in non-breast cancer tissues, but was not significantly correlated with any relevant breast cancer patient clinicopathological characteristic. Septin9 methylation rates were higher in patients with recurrence or metastasis. Septin9 methylation, tumor size, lymph node status, and progesterone receptor (PR) expression could influence prognosis. Septin9 methylation was significantly associated with worse disease-free survival in breast cancer patients, with receiver operating characteristic curve analysis indicating that it had good prognostic ability, with an area under the curve (AUC) value of 0.719. The AUC values increased when Septin9 methylation was combined with tumor size, lymph node status, and PR to predict prognosis. CONCLUSIONS Septin9 DNA methylation was an independent predictors of breast cancer prognostic risk. This could possibly help improve comprehensive prognosis prediction methods when combined with other risk factors.
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Affiliation(s)
- Shao-Ling Zhang
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
| | - Hai-Jing Yu
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
| | - Zhen-Qiang Lian
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jian Wan
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
| | - Si-Mei Xie
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wen Lei
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
| | - Qiu-Ping Chen
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Liang Zhang
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Qi Wang
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou, China
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Ma L, Lian ZQ, Zhao YX, Di JL, Song B, Ren WH, Miao HZ, Wu JL, Wang Q. [Breast ultrasound optimization process analysis based on breast cancer screening for 1 501 753 rural women in China]. Zhonghua Zhong Liu Za Zhi 2021; 43:497-503. [PMID: 33902214 DOI: 10.3760/cma.j.cn112152-20190828-00549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effectiveness and quality of ultrasound-based (BUS) process optimization in breast cancer screening. Methods: The program collected the first to fourth quarterly breast cancer screening statistic data and case report data from 30 provinces, autonomous regions and municipalities in 2015 by the online report system of national key service program of women and children's public health. The call rate, mammography (MG) subsequent screen rate, biopsy rate, detection rate, early diagnosis rate, carcinoma in situ rate, missing detection rate, false positive rate and positive predictive value (PPV) of breast cancer were calculated. Results: A total of 1 501 753 rural women attended the BUS process optimization screening. The nationwide recall rate was 3.01%(45 156/1 501 753), and in the eastern and central area were 3.41%(17 173/503 130) and 3.56%(14 499/407 739), respectively, higher than 2.28% (13 484/590 884) of western area (P<0.05). The nationwide MG subsequent screen rate was 2.78%(41 694/1 501 753), and in the eastern and central area were 3.19%(16 036/503 130) and 3.29% (13 421/407 739), respectively, higher than 2.07%(12 237/590 884) of western area (P<0.05). The nationwide biopsy rate was 0.23%(3 462/1 501 753), and in the central area were 0.26%(1 078/407 739), respectively, higher than 0.21%(1 247/590 884) of western area and 0.23% (1 137/503 130) of eastern area (P<0.05). The nationwide biopsy PPV was 37.00%(1 281/3 462). The biopsy PPV of eastern area was (34.30%, 390/1 137), lower than 39.33% (424/1 078) of central area (P<0.05). A total of 1 281 cases of breast cancer were detected, the detection rate was 0.85‰(1 281/1 501 753), and the detection rates of central area was 1.04‰ (424/407 739), higher than 0.79‰(467/590 884) of western area and 0.78‰(390/503 130) of eastern area (P<0.05). The BUS initiate screening positive rate from detected breast cancer cases was 96.96%(1 242/1 281), the MG subsequent screening positive rate was 2.42%(31/1 281). The nationwide early diagnosis rate was 85.25%(1 092/1 281), and in the eastern and central areas were 87.95%(343/390) and 88.21%(374/424), higher than 80.30%(375/467) of western area (P<0.05). The screening rate of on or above stage Ⅱ breast cancer in eastern area was 55.64%(217/390), lower than 64.62%(374/424) of central area and 62.31%(291/467) of western area. The missing detection rate was 0.62%(8/1 281) and false positive rate was 1.20%(17 528/1 464 149). Conclusions: The BUS process optimization of breast cancer screening scheme is reasonable and applicable to China rural women. The effectiveness and quality of eastern area are superior to those of central and western area.
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Affiliation(s)
- L Ma
- National Center for Women and Children's Health, China Center of Disease Control and Prevention, Beijing 100081, China
| | - Z Q Lian
- Breast Center of Guangdong Women and Children Hospital, Guangzhou 511422, China
| | - Y X Zhao
- National Center for Women and Children's Health, China Center of Disease Control and Prevention, Beijing 100081, China
| | - J L Di
- National Center for Women and Children's Health, China Center of Disease Control and Prevention, Beijing 100081, China
| | - B Song
- National Center for Women and Children's Health, China Center of Disease Control and Prevention, Beijing 100081, China
| | - W H Ren
- National Center for Women and Children's Health, China Center of Disease Control and Prevention, Beijing 100081, China
| | - H Z Miao
- Breast Center of Guangdong Women and Children Hospital, Guangzhou 511422, China
| | - J L Wu
- National Center for Women and Children's Health, China Center of Disease Control and Prevention, Beijing 100081, China
| | - Q Wang
- Breast Center of Guangdong Women and Children Hospital, Guangzhou 511422, China
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Zhang SL, Lian ZQ, Yu HY, Wang YN, Zou SW, Wang Q. [Effect of ultrasound-guided vacuum-assisted excision verus open surgery for benign phyllodes tumors of breast on postoperative local recurrence]. Zhonghua Wai Ke Za Zhi 2020; 58:110-113. [PMID: 32074809 DOI: 10.3760/cma.j.issn.0529-5815.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: To examine the effect of VAE and open surgery on the postoperativelocal recurrence of benign phyllodes tumors of breast and to investigate the clinical efficacy of VAE in the treatment of benign phyllodes tumors. Methods: The clinical data of 128 patients with benign phyllodes tumors of breast admitted to the Guangdong Women and Children Hospital from January 2013 to January 2018 were retrospectively analyzed. All patients were female, aged (37.7±9.1) years (range: 16 to 56 years). Eighty patients underwent ultrasound-guided VAE (minimally invasive group) and 48 patients underwent open surgery (open group). The t-test, χ(2) test or Fisher exact probability method were used to compare the clinical characteristics of the two groups of patients. Logistic regression was used to analyze the prognostic factors of postoperative local recurrence. Results: The maximum diameter of tumor in the minimally invasive group was smaller than that in the open group ((20.6±7.4) mm vs. (42.0±2.0) mm, t=-7.173, P=0.000). The follow-up time was (36.4±1.8) months (range: 12 to 71 months). There were 7 cases of local recurrences during the follow-up period. The local recurrence rates in the minimally invasive and open groups were 5.0% (4/80) and 6.3% (3/48). The results of multivariate analysis showed that the maximum tumor diameter of 25 mm was an independent prognosis factor for postoperativelocal recurrence (OR=0.122, 95%CI: 0.016 to 0.901, P=0.039). While surgical procedure, age, menopausal status and history of fibroadenomas in the ipsilateral breast is not an independent prognostic factor for postoperative local recurrence. In the minimally invasive surgery group, the local recurrence rates were 2.9% (2/69) and 2/11 in patients with tumor maximum diameters<25 mm and ≥25 mm, respectively. Conclusions: Local recurrence of breast benign phyllodes tumors is closely related to the tumor size. For patients with tumor diameter<25 mm, the postoperative local recurrence rate of VAE is low, which can be used in clinical practice. Intraoperative complete resection to achieve a negative surgical margin should be guaranteed to avoid local recurrence.
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Affiliation(s)
- S L Zhang
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510010, China
| | - Z Q Lian
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510010, China
| | - H Y Yu
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510010, China
| | - Y N Wang
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510010, China
| | - S W Zou
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510010, China
| | - Q Wang
- Department of Breast Diseases, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou 510010, China
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Lian ZQ, Yu HY, Zhang AQ, Xie SM, Wang Q. Use of urinary balloon catheter to prevent postoperative bleeding after ultrasound-guided vacuum-assisted breast biopsy. Breast J 2019; 26:144-148. [PMID: 31650650 DOI: 10.1111/tbj.13484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 11/30/2022]
Abstract
Postoperative bleeding is the most frequent serious complications after vacuum-assisted breast biopsy (VABB). The aim of this study was to evaluate the clinical effect of using urinary balloon catheter to prevent postoperative bleeding after ultrasound-guided VABB. From May 2016 to June 2018, 324 patients who underwent ultrasound-guided VABB were randomized into the study group and control group. In the study group, an urinary balloon catheter was inserted into the excision cavity to prevent bleeding and hematoma. In the control group, compression with thorax pressure bandage was used for hemostasis. Postoperative subcutaneous ecchymosis and hematoma were recorded and compared between the two groups. The rates of postoperative ecchymosis and hematoma in the study group were significantly lower than that in the control group (5.6% vs 13.0%, P < .05; 8.0% vs 20.4%, P < .05). Among patients with lesions ≤1.5 cm, the rates of postoperative ecchymosis and hematoma were 2.9% and 4.3% in the study group, 6.5% and 11.7% in the control group, but there was no statistically significant difference between the two groups (P > .05). Among patients with lesions >1.5 cm, the rates of postoperative ecchymosis and hematoma in the study group were significantly lower than that in the control group (7.6% vs 18.8%, P < .05; 10.9% vs 28.2%, P < .05). Hemostasis with balloon urinary catheter is a safe and effective method to prevent postoperative bleeding after VABB.
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Affiliation(s)
- Zhen-Qiang Lian
- The First Clinical Medical College of Jinan University, Jinan University, Guangzhou, Guangdong, China.,Breast disease center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Hai-Yun Yu
- Breast disease center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - An-Qin Zhang
- Breast disease center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Si-Mei Xie
- Breast disease center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Qi Wang
- The First Clinical Medical College of Jinan University, Jinan University, Guangzhou, Guangdong, China.,Breast disease center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
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Lian ZQ, Wang Q, Zhang AQ, Zhang JY, Han XR, Yu HY, Xie SM. Erratum to: A nomogram based on mammary ductoscopic indicators for evaluating the risk of breast cancer in intraductal neoplasms with nipple discharge. Breast Cancer Res Treat 2016; 155:619. [PMID: 26895324 DOI: 10.1007/s10549-016-3723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Zhen-Qiang Lian
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China.
| | - Qi Wang
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China.
| | - An-Qin Zhang
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China
| | - Jiang-Yu Zhang
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China
| | - Xiao-Rong Han
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China
| | - Hai-Yun Yu
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China
| | - Si-Mei Xie
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, 511400, People's Republic of China
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Lian ZQ, Wang Q, Zhang AQ, Zhang JY, Han XR, Yu HY, Xie SM. A nomogram based on mammary ductoscopic indicators for evaluating the risk of breast cancer in intraductal neoplasms with nipple discharge. Breast Cancer Res Treat 2015; 150:373-80. [PMID: 25749733 DOI: 10.1007/s10549-015-3320-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
Mammary ductoscopy (MD) is commonly used to detect intraductal lesions associated with nipple discharge. This study investigated the relationships between ductoscopic image-based indicators and breast cancer risk, and developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge. A total of 879 consecutive inpatients (916 breasts) with nipple discharge who underwent selective duct excision for intraductal neoplasms detected by MD from June 2008 to April 2014 were analyzed retrospectively. A nomogram was developed using a multivariate logistic regression model based on data from a training set (687 cases) and validated in an independent validation set (229 cases). A Youden-derived cut-off value was assigned to the nomogram for the diagnosis of breast cancer. Color of discharge, location, appearance, and surface of neoplasm, and morphology of ductal wall were independent predictors for breast cancer in multivariate logistic regression analysis. A nomogram based on these predictors performed well. The P value of the Hosmer-Lemeshow test for the prediction model was 0.36. Area under the curve values of 0.812 (95 % confidence interval (CI) 0.763-0.860) and 0.738 (95 % CI 0.635-0.841) was obtained in the training and validation sets, respectively. The accuracies of the nomogram for breast cancer diagnosis were 71.2 % in the training set and 75.5 % in the validation set. We developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge based on MD image findings. This model may aid individual risk assessment and guide treatment in clinical practice.
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Affiliation(s)
- Zhen-Qiang Lian
- Breast Disease Center, Guangdong Women and Children Hospital of Jinan University, Guangzhou, 511400, People's Republic of China,
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Lian ZQ, Wang Q, Li WP, Zhang AQ, Wu L. Screening of significantly hypermethylated genes in breast cancer using microarray-based methylated-CpG island recovery assay and identification of their expression levels. Int J Oncol 2012; 41:629-38. [PMID: 22581028 DOI: 10.3892/ijo.2012.1464] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 04/17/2012] [Indexed: 11/06/2022] Open
Abstract
To screen candidate methylation markers for early detection of breast cancer and to explore the relationship between methylation and gene expression, we performed methylated-CpG island recovery assay (MIRA) combined with CpG island array on 61982 CpG sites across 4162 genes in 10 cancerous and 10 non-cancerous breast tissues. Direct bisulfite sequencing and combined bisulfite restriction analysis (COBRA) were carried out in independent cancerous and non-cancerous samples. Gene expression was analyzed by microarrays and validated using RT-PCR. We detected 70 significantly hypermethylated genes in breast cancer tissues, including many novel hypermethylated genes such as ITGA4, NFIX, OTX2 and FGF12. Direct bisulfite sequencing showed widespread methylation occurring in intragenic regions of the WT1, PAX6 and ITGA4 genes and in the promoter region of the OTX2 gene in breast cancer tissues. COBRA assay confirmed that the WT1, OTX2 and PAX6 genes were hypermethylated in breast cancer tissues. Clustering analysis of the gene expression of 70 significantly hypermethylated genes revealed that most hypermethylated genes in breast cancer were not expressed in breast tissues. RT-PCR assay confirmed that WT1 and PITX2 were only weakly expressed in the breast cancer tissues and were not expressed in most non-cancerous breast tissues. OTX2 and PAX6 were not expressed in either breast cancer or non-cancerous tissues. In conclusion, these results will expand our knowledge of hypermethylated genes and methylation sites for early detection of breast cancer and deepen our understanding of the relationship between methylation and gene expression. The MIRA approach can screen candidate methylated genes for further clinical validation more effectively than gene expression microarray-based strategy.
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Affiliation(s)
- Zhen-Qiang Lian
- Guangdong Women and Children Hospital of Guangzhou Medical College, Guangzhou, People's Republic of China
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Tang J, Wang X, Wu YP, Wang X, Lian ZQ, Fu JH, Yang MT. Significance of methylene blue dye for localization biopsy of nonpalpable breast lesions. Ai Zheng 2009; 28:79-81. [PMID: 19448424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND OBJECTIVE With advances in mammographic equipment and techniques, more and more nonpalpable breast lesions have been detected. This study was to investigate the application of methylene blue dye for localized biopsy to diagnose nonpalpable breast lesions. METHODS In total 138 patients with suspicious malignant, nonpalpable breast lesions between August 2002 and October 2006 were enrolled. A small dose of methylene blue was injected into the lesion under mammographic guidance. The dyed tissues were excised completely via an optimal incision, and radiographys was obtained to confirm the removal of the nonpalpable lesion. The specimen weight and incision length were measured. RESULTS Suspicious lesions in all 138 patients were accurately excised. Eighty-four (60.9%) patients were confirmed as breast cancer, and 54 (39.1) were diagnosed with benign lesions. The mean length of the incision was 4.6 cm (range 3.2-5.3 cm), and the mean weight of the resected specimen was 42 g (range18-86 g). All patients achieved stage I healing. CONCLUSIONS Excisional biopsy is recommended for nonpalpable breast lesions which are highly suggestive of malignancy by imaging examination. Methylene blue guided localization and excisional biopsy is a safe, relatively simply procedure with high diagnostic accuracy.
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Affiliation(s)
- Jun Tang
- State Key Laboratory of Oncology in South China
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Yang MT, Lian ZQ. [Advancement in endocrine therapy for breast cancer]. Ai Zheng 2007; 26:440-4. [PMID: 17430670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Endocrine therapy with certain effect is an important part of combined therapy for hormone receptor-positive breast cancer. The endocrine therapy for breast cancer has made progress with the development of new endocrine drugs. Now, tamoxifen is still the standard endocrine therapeutic drug for the premenopausal patients, but aromatase inhibitors can bring more benefit for the postmenopausal patients. Several large-scale clinical trials about aromatase inhibitors and medical ovarian ablation are ongoing and attract attention widely. This review overviewed the endocrine therapy for breast cancer, and mainly introduced its recent advancement.
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Affiliation(s)
- Ming-Tian Yang
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
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Lian ZQ, Yang MT, Hou JH, Luo RZ, Wang X, Tang J. [Expression and clinical significance of adhesive molecule CD44v6 in breast invasive ductal carcinoma]. Ai Zheng 2006; 25:1291-5. [PMID: 17059779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND & OBJECTIVE Many researches suggest that CD44v6 is associated with the occurrence, invasion, and metastasis of breast cancer. However the reports about the relationship between CD44v6 expression and the prognosis of breast cancer are conflicting. This study was to investigate the expression of CD44v6 and its correlation to clinicopathologic characteristics and prognosis of breast cancer. METHODS CD44v6 expression in 84 specimens of breast cancer and 20 specimens of para-tumor breast tissues was detected by SP immunohistochemistry. COX proportional hazards model was used to analyze the prognosis. RESULTS The positive rate of CD44v6 in the epithelial cells of breast cancer was significantly higher than that in para-tumor breast tissues (78.6% vs. 5.0%, P<0.05). The expression of CD44v6 was closely correlated to TNM stage, tumor size, and lymph node metastasis (P<0.05). The median follow-up period was 60 months. The overall survival rate was significantly higher in CD44v6-negative group than in CD44v6-positive group (P<0.05). The survival curve had a tendency to decline with the stronger expression of CD44v6. Cox model revealed that ER, TNM stage, and CD44v6 were independent prognostic factors of breast cancer. CONCLUSIONS CD44v6 is highly expressed in breast cancer, and positively correlated to TNM stage, tumor size, and lymph node metastasis. CD44v6 is an independent prognostic factor of breast cancer.
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Affiliation(s)
- Zhen-Qiang Lian
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China
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