Abstract
Background Invasive breast carcinoma of no special type (IBC-NST) is the most widespread invasive carcinoma subtype causing primarily regional metastases of the lymphatic node (LNM). The capacity of CD44 variant exon 6 (CD44v6) expression as an LNM predictor biomarker in IBC-NST was explored. Methods We conducted a cross-sectional research with 48 paraffin blocks containing IBC-NST primary tumors that were divided into two groups by LNM. The assessment has been carried out in terms of age, tumor size, tumor grade, lymphovascular invasion (LVI), and CD44v6 expression. The expression of CD44v6 was analyzed on the grounds of immunohistochemical (IHC) staining, while other data were taken from archives. Statistical analysis is carried out by univariate, multivariate, and AUROC. Results CD44v6 exhibits a dominant expression in IBC-NST tumor cells. Univariate analysis revealed a significant association between CD44v6 and LNM status (p = 0.001). Multiple logistic regression results showed that CD44v6 expression and LVI were significantly associated with LNM with OR 10.7 (95% CI: 2.43 to 47.08) and 6.22 (95% CI: 1.4 to 27.88), respectively. CD44v6 expression was able to discriminate against LNM with AUROC 0.863 ± 0.053 (95% CI: 0.759 to 0.967) at the H-score cut-off 133.889 (75% sensitivity and 83.3% specificity). Conclusion CD44v6 expression and LVI are potential predictors of LNM in IBC-NST. The H-score cut-off of the CD44v6 expression can also be used as a threshold for classification in further investigation.
Highlights
Breast cancer is the most prevalent and lethal form of cancer in women
In order to promote the diagnosis of cancer, the histological classification of breast cancer is classified into two groups, depending on their connection to the basement membrane, namely, noninvasive and invasive carcinoma [3, 4]
Samples of tumor cells with different staining groups are given in each image, including high positive (a), positive (b), low positive (c), and no staining (d). All of these images come from the same patient. This shows that one patient can have various types of intensity of CD44 variant exon 6 (CD44v6) expression
Summary
Breast cancer is the most prevalent and lethal form of cancer in women. Twenty-five percent of cancers that occur in women are breast cancers. In order to promote the diagnosis of cancer, the histological classification of breast cancer is classified into two groups, depending on their connection to the basement membrane, namely, noninvasive and invasive carcinoma [3, 4]. Both of these forms have subtypes of their own. Invasive breast carcinoma of no special type (IBC-NST) is the most widespread invasive carcinoma subtype causing primarily regional metastases of the lymphatic node (LNM). CD44v6 expression and LVI are potential predictors of LNM in IBC-NST. The H-score cut-off of the CD44v6 expression can be used as a threshold for classification in further investigation
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