Maspin mRNA expression in sentinel lymph nodes predicts non‐SLN metastasis in breast cancer patients with SLN metastasis

• Published in: Histopathology Vol. 73; no. 6; pp. 916 - 922
• Main Authors: Umekita, Yoshihisa, Ohi, Yasuyo, Iwaya, Orie, Souda, Masakazu, Sagara, Yasuaki, Tamada, Shugo, Yotsumoto, Daisuke, Tanimoto, Akihide
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2018
• Subjects: Biopsy; Breast cancer; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Carcinoma, Ductal, Breast - metabolism; Carcinoma, Ductal, Breast - pathology; Female; Gene expression; Humans; Lymph nodes; Lymphatic Metastasis - pathology; Lymphatic system; maspin; Mastectomy; Metastases; Metastasis; Middle Aged; Nucleic acids; OSNA; Prognosis; sentinel lymph node; Sentinel Lymph Node - metabolism; Sentinel Lymph Node - pathology; Sentinel Lymph Node Biopsy; Serpins - metabolism; Tumors; breast cancer; sentinel lymph node; OSNA; maspin
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/his.13718

Aims Maspin is known to be a tumour suppressor protein, but its prognostic significance in breast cancer patients is controversial. There is no report focusing on maspin expression in metastatic carcinoma of sentinel lymph nodes (SLNs); we thus investigated maspin mRNA expression in SLNs using the remaining specimens after the one‐step nucleic acid amplification (OSNA) assay. Methods and results Ninety‐three breast cancer patients with SLNs metastasis detected by the OSNA assay were enrolled. All patients experienced additional axillary lymph nodes (LNs) dissection and all dissected LNs were examined histopathologically. Maspin mRNA expression in SLNs was detected in 49.5% (46 of 93) and was correlated significantly with the presence of non‐SLN metastasis (P < 0.0001) and ≥4 LN metastases (P = 0.029). In a multivariate logistic analysis, maspin mRNA expression in SLNs (P = 0.0015) had the most significant effect on predicting non‐SLN metastasis, followed by pathological tumour size (P = 0.0039) and lymphovascular invasion (P = 0.009). The status of maspin mRNA expression in SLNs was correlated significantly with that of maspin protein expression in the primary carcinoma (P < 0.0001). Conclusions This is the first study, to our knowledge, demonstrating that maspin mRNA expression in SLNs is an independent predictor of non‐SLN metastasis and the presence of ≥4 LN metastases in breast cancer patients with SLN metastasis. The investigation of maspin mRNA expression in SLNs using the remaining specimens after the OSNA assay may be useful for predicting the further progression of metastatic carcinoma in breast cancer patients with SLNs metastasis.