Expression of p53 Breast Cancer in Kurdish Women in the West of Iran: a Reverse Correlation with Lymph Node Metastasis

Mehrdad Payandeh,Seyed-Hamid Madani,Edris Sadeghi,Masoud Sadeghi

doi:10.7314/apjcp.2016.17.3.1261

Mehrdad Payandeh, Seyed-Hamid Madani + Show 2 more

Open Access

https://doi.org/10.7314/apjcp.2016.17.3.1261

Copy DOI

Abstract

In breast cancer (BC), it has been suggested that nuclear overexpression of p53 protein might be an indicator of poor prognosis. The aim of the current study was to evaluate the expression of p53 BC in Kurdish women from the West of Iran and its correlation with other clinicopathology figures. In the present retrospective study, 231 patients were investigated for estrogen receptor (ER) and progesterone receptor (PR) positivity, defined as ≥10% positive tumor cells with nuclear staining. A binary logistic regression model was selected using Akaike Information Criteria (AIC) in stepwise selection for determination of important factors. ER, PR, the human epidermal growth factor receptor 2 (HER2) and p53 were positive in 58.4%, 55.4%, 59.7% and 45% of cases, respectively. Ki67 index was divided into two groups: 54.5% had Ki67<20% and 45.5% had Ki67 ≥20%. Of 214 patients, 137(64%) had lymph node metastasis and of 186 patients, 122(65.6%) had vascular invasion. Binary logistic regression analysis showed that there was inverse significant correlation between lymph node metastasis (P=0.008, OR 0.120 and 95%CI 0.025-0.574), ER status (P=0.006, OR 0.080, 95%CI 0.014-0.477) and a direct correlation between HER2 (P=005, OR 3.047, 95%CI 1.407-6.599) with the expression of p53. As in a number of studies, expression of p53 had a inverse correlation with lymph node metastasis and ER status and also a direct correlation with HER2 status. Also, p53-positivity is more likely in triple negative BC compared to other subtypes.

Highlights

Breast cancer (BC) is the most frequent malignancy among women worldwide and is a heterogeneous disease with distinct pathological and histological features, and can be classified into several subtypes based on the expression of 3 receptors: estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) (Payandeh et al, 2015a) that can be a leading cause of death through middle-aged women and this cancer accounts about one fifth of all female malignancy
The prognostic and predictive value of p53 expression in axillary lymph node metastasis in patients with breast carcinoma needs to be further evaluated in larger trials with longer follow-up (Arun et al, 2003)
A number of studies reported that the expression of p53 had direct correlation with tumor size (Osanai et al, 2005), histological grade (Qing et al, 2014; Osanai et al, 2005; Sirvent et al, 1995; Bertheau et al, 1998), nuclear grade (Jasar et al, 2015), lymph-vascular invasion (Osanai et al, 2005), the proliferation index Ki67 (Jasar et al, 2015) and ER status (Osanai et al, 2005; Li et al, 2015), but other studies showed that the expression of p53 had inverse correlation with histological grade(el-A Helal et al, 2000), lymph-vascular invasion (Jasar et al, 2015), non-sentinel lymph node invasion (Vernet et al, 2015) and estrogen (Sirvent et al, 1995) and progesterone receptors (Sirvent et al, 1995; Bertheau et al, 1998)

Summary

Introduction

Breast cancer (BC) is the most frequent malignancy among women worldwide and is a heterogeneous disease with distinct pathological and histological features, and can be classified into several subtypes based on the expression of 3 receptors: estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) (Payandeh et al, 2015a) that can be a leading cause of death through middle-aged women and this cancer accounts about one fifth of all female malignancy. Many genetic traits common to aggressive breast carcinoma have been identified; yet little is known about the interrelationships of such traits during tumor development, especially in women prone to aggressive cancer (Howard et al, 2004) Conventional clinicopathological parameters such as age of the patient, the degree of histological differentiation, nuclear grade, the size of the primary tumor, the status of axillary lymph nodes and in the recent era the immunohistochemistry (IHC), determining hormone status, proliferative index, severity or amplification the HER2 gene and p53 gene mutations have been shown as important prognostic parameters regarding the course and outcome of the disease (Lacroix et al, 2006; De Azambuja et al, 2007). P53-positivity is more likely in triple negative BC compared to other subtypes

Objectives

Methods

Results

Conclusion