correlation between c-erbB-2 expression and other prognostic factors in breast cancer

Lee, Jin Sun; Park, Jong Hyun; Suh, Kwang Sun; Kim, Je Ryong; Chang, Eil Sung

Abstract

PURPOSE
Although the overexpression of c-erbB-2 has been reported to be associated with a poor clinical outcome in breast cancer, its prognostic value remains controversial. The overexpression of c-erbB-2 can be detected using immunohistochemical analysis which is cost-effective, but not ideal due to variations in tissue fixation and processing, different testing methods with variable sensitivity and the subjectivity in grading. The purpose of this study was to evaluate the grade of c-erbB-2 expression and compare the grading with the patient's prognosis. The grading was performed via immunohistochemical staining of the protein in the tissue obtained from breast cancer patients. METHODS: Between January 2000 and March 2004, 253 patients with breast cancer were studied. Immunoperoxidase staining for c-erbB-2 on paraffin blocks was interpreted as either negative or positive; the presence of circumferential membranous staining (+2 and +3) in tumor cells was interpreted as "positive" and the absence of staining, with the only the presence of cytoplasmic staining (without membranous staining) was interpreted as "negative"(0 and +1). RESULTS: Of the 253 breast cancer samples, c-erbB-2 expression was negative in 138 cases (54.5%) and positive in 115 cases (45.4%). The c-erbB-2 tissue assay grading results were G0: 62 (24.5%), G1+: 76 (30%), G2+: 53 (20.9%) and G3+: 62 (24.5%) cases. Of the prognostic factors, the histological grade (p = 0.010), P53 (p = 0.000) and the absence of estrogen receptors (p = 0.028) displayed a significant relationship (p < 0.05) with an increase in the c-erbB-2 expression grading, but the tumor size, lymph node metastasis, tumor stage, lymphovascular invasion and progesterone receptor state showed no significant differences with respect to the expression grading. CONCLUSION: The c-erbB-2 expression grading was found to be positively correlated with the histological grade, ER status and p53 but not with the tumor size, lymph node metastasis, lymphovascular invasion, tumor stage or PR status. In this study c-erbB-2 immunohistochemical staining result were insufficient to recommened the use of prognostic factor.