Relation between Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-α expression in invasive ductal breast cancer patients and correlations with prognosis.

Jian Yan,Xiao-Yuan Yu,Lu-Zhe Han,Liang-Chun Yin,Xiao-Long Liu,Can-Liang Tan,Gang Xiao,Xiao-Ping Huang,Ning-Lei Li,Li-Xin Liu,Li-Juan Ling,Yi-Nan Deng

doi:10.7314/apjcp.2015.16.2.823

Abstract

The aim of the present study was to investigate the expression of the transcription factor Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-α in the tumor tissue of patients with invasive ductal carcinoma(IDC); in addition, we examined correlations between these markers. Two hundred and sixteen IDC patients, who were not previously been treated with chemo- or radiotherapy, were included in the study. All tumors were grade I-III. Expression of molecular markers was determined by immunohistochemical analysis on paraffin-embedded tissue sections. Follow-up data were collected for 3 months to 10 years and analyzed for tumor recurrence, survival time, and prognostic risk factors. We determined Ki-67 expression correlates with the expression of ER, PR, HER-2, EGFR, and TOP-α, as well as lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in IDC. Positive Ki-67 expression was a risk factor for rapid tumor recurrence and may help tumor progression, leading to poor prognosis in IDC. Ki-67 was directly correlated with EGFR, TOP II-α, lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in the hormone receptor subtypes of breast cancer. In triple negative breast cancer, Ki-67 correlated with TOP II-α. Expression of Ki-67 correlated with that of ER, PR, HER-2, EGFR, TOP II-α, and p21. In addition, the biomarker Ki-67 has a role as a prognostic factor and indicates a poor prognosis in IDC.

Highlights

Breast cancer (BC) is the most frequent malignancy in women, and the main cause of death in women aged 35-55 years old
The aim of the present study was to investigate the expression of the transcription factor Ki-67, ER, PR, Her2/neu, p21, EGFR, and TOP II-α in the tumor tissue of patients with invasive ductal carcinoma(IDC); in addition, we examined correlations between these markers
Our results indicated that Ki-67 expression correlates with ER, PR, HER-2, EGFR, TOP II-α, lymph node involvement, high tumor grade, lymphovascular invasion, high tumor stage, and high TNM stage in IDC

Summary

Introduction

Breast cancer (BC) is the most frequent malignancy in women, and the main cause of death in women aged 35-55 years old. Research on the tumor’s molecular features led to a greatly improved prognosis of the disease course. Most molecular markers, such as Ki-67, p21, EGFR, and TOP II-α, determine the ability of cells to grow malignantly (Hanahan, 2000). Patients who are determined to be positive for these steroid hormone receptors (HRs) generally have high sensitivity to hormone therapy. A positive HER-2 status in patients with BC correlates with high sensitivity to targeted therapy with trastuzumab. These biomarkers play an important role in clinical practice by individualizing treatment and determining adequate chemotherapeutic schemes for patients. About 20% of patients with BC are negative for all three markers mentioned above, and their tumors are more resistant to traditional therapy schemes

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