Abstract
Background: Triple-negative breast cancer (TNBC) is associated with characteristically poor prognosis. Tumor invasion and metastasis lead to high mortality of patients with breast cancer. The identification of biomarkers that allow early detection of metastasis is essential for therapeutic success in the treatment of breast cancer. This study aimed to asses the immune-histochemical expression of Rock-1 and claudin-4 in triple negative breast cancer and comparing them with classic prognostic parameters as age, grade, lymph node state, distant metastasis and stage to evaluate their prognostic significance in triple negative breast cancer. Material and methods: Forty cases of triple negative breast cancer were examined immunohistochemically using antibodies against claudin 4 and ROCK 1. Results: There was a difference in the expression of claudin 4 and Rock 1 among different clinicopathological parameters. A statistically significant relationship was found between high claudin 4 expression and higher age at time of diagnosis, advanced tumor stage, presence of distant metastasis and increased number of nodal involvement (p=0.041, 0.006, 0.001 and < 0.001 respectively). A highly statistically significant relationship was detected between high Rock 1 expression and increased number of nodal involvement (p <0.001). Also the expression of Rock 1 was different according to different age groups, tumor grades, tumor stages and presence or absence of distant metastasis but this difference was statistically insignificant (p=0.388, 0.602, 0.699 and 0. 944 respectively). Conclusion: our data suggest that claudin 4 and ROCK 1 are biomarkers of poor prognosis of patients with triple negative breast cancer.
Highlights
A statistically significant relationship was found between high claudin 4 expression and higher age at time of diagnosis, advanced tumor stage, presence of distant metastasis and increased number of nodal involvement ( p=0.041, 0.006, 0.001 and < 0.001 respectively) (Table 2) Figure (4, 5)
A highly statistically significant relationship was detected between high Rock 1 expression and increased number of nodal involvement (p
High levels of claudin 4 cytoplasmic expression were detected in 62.5% of Triple-negative breast cancer (TNBC) cases and this expression was significantly associated higher age at time of diagnosis, higher tumor grade, advanced tumor stage, increased number of nodal involvement and presence of distant metastasis (p
Summary
Breast cancer is one of the most common malignant tumors in women, more than 1,300,000 cases and 450,000 deaths each year worldwide [1].Breast cancer rates are increasing in Egypt, due to aging of the population, increased age at the time of first pregnancy, decrease in number of children and in breast feeding, and a move toward high-calorie Western diets [2].Management of breast cancer depends on clinical and pathologic features of the tumor, including patient age, tumor size, histologic type and grade, lymph node stage, and lympho-vascular invasion [3].Molecular markers such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) have been proven to provide therapeutic, predictive, and prognostic value [4].Triple-negative breast cancer (TNBC) is defined by the loss of expression of receptor ER, PR, and Her2neu expressions and associated with biological aggressive-eness and poor prognosis. Management of breast cancer depends on clinical and pathologic features of the tumor, including patient age, tumor size, histologic type and grade, lymph node stage, and lympho-vascular invasion [3]. Molecular markers such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) have been proven to provide therapeutic, predictive, and prognostic value [4]. A statistically significant relationship was found between high claudin 4 expression and higher age at time of diagnosis, advanced tumor stage, presence of distant metastasis and increased number of nodal involvement (p=0.041, 0.006, 0.001 and < 0.001 respectively). Conclusion: our data suggest that claudin 4 and ROCK 1 are biomarkers of poor prognosis of patients with triple negative breast cancer
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