Evaluation of high molecular weight cytokeratin (HMWCK), p27, C-X-C chemokine receptor type 4 (CXCR-4) and stromal cell-derived factor 1 (SDF-1) expressions related to tumor progression in breast cancer

Abstract

Objectives: Breast cancer is the most common cancer and the most common reason for cancer death in womenpopulation. The immunohistochemical markers which could have prognostic information are always needed.Methods: This study included 365 cases of invasive ductal carcinoma (IDC), ductal carcinoma in situ (DCIS)and ductal epithelial hyperplasia. The cases divided into the following two groups according to the presenceof cancer: 1) cancer group (298 cases; cases with IDC and DCIS), 2) non-cancer group (67 cases withoutcancer; cases with usual ductal epithelial hyperplasia [UDH] and atypical ductal epithelial hyperplasia [ADH]).All histological slides stained with high molecular weight cytokeratin (HMWCK), p27, C-X-C chemokinereceptor type 4 (CXCR-4), stromal cell-derived factor 1 (SDF-1) immunohistochemically.Results: IDC was present in 277 cases, of which 213 had pure IDC, and 64 had DCIS component adjacent tothe invasive tumor. Twenty-one cases had only DCIS. Of 67 cases with epithelial hyperplasia, 31 had ADH,and 36 had UDH. Among cases with IDC, 143 had lymph node excision, of which 73 had metastasis in one ormore lymph nodes, and 70 did not have metastatic disease. The expression of p27 was found to be significantlylower in the cancer group as compared to that in the non-cancer group (p < 0.0001). CXCR-4 expression inIDC was found to be higher than that of DCIS group. SDF-1 expression was observed to be significantly higherin cancer cases than that of non-cancer cases (p = 0.03).Conclusions: The higher CXCR-4 and SDF-1 expressions are associated with tumor progression, tumor size,and lymph node status. In benign proliferative lesions, both HMWK and p27 expressions were helpful indifferential diagnosis of borderline atypical ductal hyperplasia and DCIS.