Association of SDF-1 with Metastasis in Breast Cancer Patient at Sanglah Hospital, Bali

Abstract

Objectives: More than 24% breast cancer patients came to Sanglah Teaching Hospital with distant metastasis which cause 90% of cancer related death. Distant metastasis is complex process of interaction between tumor cells and its micro environment involving a chemoattractant cytokines which lead circulating tumor cells toward target organs. One of the most common cytokines involved in metastasis of multiple tumor is SDF-1, produces by target organ or tumor cells itselves. However, only few stucy ever evaluate the relationship between its concentrations in tumor tissue with metastasis. Method: A cross sectional analysis study was conducted involving clinical data and paraffin blocks from 46 patients. Samples were grouped into metastasis and non-metastasis group and level of tumor tissue SDF-1 was evaluated by immunohistochemistry method. Numerical conversion was done using modified “Mirisola” technique and statistical analysis was conducted using SPSS 16 software. Results: The overall median expression of SDF-1 was 4.83 in which the median is 4.08±2.25 in non-metastatic group and 5.71±2.61 in metastatic group (p=0.012). In addition, parenchymal carcinoma cell had significantly higher expression of SDF-1 compared with microenvironmental cell both in metastatic group (carcinoma cell vs microenvironment; 4,57+1,91 vs 3,68 +2,06; p=0,004) and non-metastatic group (3,19 +2,29 vs 2,16+1,11; p=0.011). Finally, logistic regression analysis of SDF-1 expression also gave significant result that MBC had significantly higher expression of SDF-1 (p=0.039). Conclusions: There was significant association between of SDF-1 expression and distant metastasis in breast cancer and majority of SDF was produced by cancer cells