Prognostic value of estrogen receptor status can be improved by combined evaluation of p53, Bcl2 and PgR expression: an immunohistochemical study on breast carcinoma with long-term follow-up

• Published in: International journal of oncology Vol. 15; no. 6; p. 1137
• Main Authors: Mauri, F A, Maisonneuve, P, Caffo, O, Veronese, S, Aldovini, D, Ferrero, S, Cozzaglio, F, Dalla Palma, P, Galligioni, E, Barbareschi, M
• Format: Journal Article
• Language: English
• Published: Greece 01.12.1999
• Subjects: Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Female; Follow-Up Studies; Humans; Immunohistochemistry; Multivariate Analysis; Neoplasm Recurrence, Local; Predictive Value of Tests; Prognosis; Proto-Oncogene Proteins c-bcl-2 - biosynthesis; Receptors, Estrogen - analysis; Receptors, Progesterone - biosynthesis; Survival Analysis; Time Factors; Tumor Suppressor Protein p53 - biosynthesis
• ISSN: 1019-6439
• DOI: 10.3892/ijo.15.6.1137

Steroid receptor analysis is the only widely accepted prognostic/predictive marker in breast cancer (BC) treatment. In the present study we evaluated the prognostic role of ER/PgR with p53 and Bcl2, in a series of 277 BC (153 pN1/2, 122 pNO, 2 pNx) with a long-term follow-up (67 months for DFS, 75 months for OS). Our results, besides confirming the usefulness of ER immunohistochemical expression as a prognostic marker, showed that PgR expression alone had a borderline/not significant prognostic value in the whole series (p=0.08 for DFS and p=0.09 for OS), while showed to be prognostic in N+ cases (p=0.02 for DFS and p=0.03 for OS). PgR prognostic value, however, was not independent at the multivariate analysis. By combining ER with PgR, p53 and Bcl2, we showed that ER/p53 and ER/Bcl2 phenotypes had a better discriminant role than ER/PgR phenotype. The ER+/p53+ phenotype was at higher risk of relapse/death as compared with ER+/p53- phenotype. Conversely ER-/p53+ phenotype showed the most unfavourable prognosis. Similar results could be observed concerning ER/Bcl2 phenotypes. Our study showed that the combined evaluation of ER/PgR weakly enhanced the prognostic/predictive power of ER status alone. On the contrary, the combined evaluation of ER/p53 and ER/Bcl2, improved this prognostic/predictive capability and allowed the separation of ER positive and ER negative cases into subgroups with different prognosis.