Chemokine receptor CXCR4 overexpression predicts recurrence for hormone receptor-positive, node-negative breast cancer patients

• Published in: Surgery Vol. 149; no. 2; pp. 193 - 199
• Main Authors: Chu, Quyen D., MD, Holm, Neal T., MD, Madumere, Prince, BS, MPH, Johnson, Lester W., MD, Abreo, Fleurette, MD, Li, Benjamin D.L., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2011; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Breast Neoplasms - chemistry; Breast Neoplasms - mortality; Disease-Free Survival; Female; General aspects; Gynecology. Andrology. Obstetrics; Humans; Lymphatic Metastasis; Mammary gland diseases; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - etiology; Proportional Hazards Models; Prospective Studies; Receptor, ErbB-2 - analysis; Receptors, CXCR4 - analysis; Receptors, CXCR4 - physiology; Receptors, Estrogen - analysis; Receptors, Progesterone - analysis; Surgery; Tumors; Human; Relapse; Breast disease; Prediction; Gene overexpression; Patient; Early stage; Breast cancer; Chemokine receptor; Malignant tumor; Medicine; Mammary gland diseases; Treatment; Surgery; Mammary gland; CXC chemokine; Predictive factor; CXCR4 chemokine receptor; Cancer; Biological receptor; Hormonal receptor
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2010.05.016

Background The expected outcome for hormone receptor-positive, node-negative patients should be favorable. However, some patients do develop metastatic disease and the mechanism for this observation is poorly understood. CXCR4 is a chemokine receptor that has been implicated to play a pivotal role in breast cancer growth and metastasis. Its predictive role has not been fully evaluated. We determined to see whether CXCR4 can predict outcome in this subset of patients. Methods We accrued and analyzed data from 101 patients with hormone receptor-positive, node-negative breast cancers. The CXCR4 level was detected using Western blots and its level was defined as either low (<6.6-fold) or high (≥6.6-fold). Primary end points were systemic cancer recurrence and death. Statistical analysis performed included Spearman's correlation, Kaplan-Meier survival analysis, and Cox proportional hazard model. Results Although benign breast tissues had an undetectable level of CXCR4, all 101 cancer specimens had overexpressed CXCR4 (mean 6.4 ± 3.4-fold). There were 79 patients in the low CXCR4 group and 22 patients in the high CXCR4 group. High CXCR4 overexpression was predictive of both cancer recurrence ( P = .002) and overall survival ( P = .0012). Conclusion High CXCR4 overexpression in primary tumors was predictive of worse outcomes in hormone receptor-positive, node-negative breast cancer patients.