Prognostic significance of cathepsin‐D expression in node‐positive breast carcinoma: An immunohistochemical study
- 30 September 1993
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 55 (3), 429-435
- https://doi.org/10.1002/ijc.2910550318
Abstract
The prognostic significance of cathepsin-D expression was evaluated by immunohistochemistry in 638 node-positive breast carcinomas diagnosed between 1980 and 1986. A minimum of 2.5 years of follow-up was available for each patient (maximum: 9.5 years). Cathepsin-D expression was assessed separately both in cancer and in stromal cells using a commercially available polyclonal antibody. While cancer-cell immunostaining was not associated with prognosis, positive staining of stromal elements was related to shorter metastasis-free survival. The difference in distant metastasis-free survival between positive and negative expressors was greatest in the sub-group of patients submitted to adjuvant chemotherapy, with a hazard ratio for occurrence of distant metastasis of 1.76 by multivariate analysis, but was lowest for those receiving hormone therapy. Cathepsin-D expression by stromal cells was related to HER-2/ neu oncoprotein expression, HSP-27 expression, poor nuclear grade, aneuploidy, and absence of estrogen and progesterone receptors. No association was found with the number of involved lymph nodes, tumor size, age, histologic grade, S-phase fraction, or vascular invasion. Our study suggests that cathepsin-D expression by stromal cells (and not by cancer cells) affects the prognosis of breast cancer, that stromal cells probably play a key role in local invasion and metastatic dissemination of the tumor, and that the prognostic significance of cathepsin-D expression may vary according to the type of adjuvant therapy.Keywords
This publication has 20 references indexed in Scilit:
- Prognostic Factors and Treatment Decisions in Axillary-Node-Negative Breast CancerNew England Journal of Medicine, 1992
- Prognostic relevance of cathepsin D versus oestrogen receptors in node negative breast cancersEuropean Journal of Cancer and Clinical Oncology, 1991
- Stress Response Protein (srp-27) Determination in Primary Human Breast Carcinomas: Clinical, Histologic, and Prognostic CorrelationsJNCI Journal of the National Cancer Institute, 1991
- A novel metalloproteinase gene specifically expressed in stromal cells of breast carcinomasNature, 1990
- Cathepsin D in breast cancerBreast Cancer Research and Treatment, 1990
- Cathepsin D assay in primary breast cancer and lymph nodes: Relationship with c-myc, c-erb-B-2 and int-2 oncogene amplification and node invasivenessEuropean Journal of Cancer and Clinical Oncology, 1990
- Cathepsin D and Prognosis in Breast CancerNew England Journal of Medicine, 1990
- Prediction of Relapse or Survival in Patients with Node-Negative Breast Cancer by DNA Flow CytometryNew England Journal of Medicine, 1989
- Human Breast Cancer: Correlation of Relapse and Survival with Amplification of the HER-2/ neu OncogeneScience, 1987
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958