AIM To explore the potential prognostic value of cyclin D1 in invasive breast cancer and its correlation with basic histopathological parameters, hormonal status (estrogen [ER] and progesterone receptor [PR]), and bcl-2. METHODS Medical records of 48 patients, diagnosed in 1998, from the Central Database of the Institute of Oncology, Clinical Center University of Sarajevo, were analyzed. The mean follow-up was 61 months (range: 4-103 months). Routine histopathological evaluation was performed for 48 formalin-fixed and paraffin-embedded tissue samples. For immunohistochemical staining, we used monoclonal antibodies for ER, PR, bcl-2, and cyclin D1. RESULTS Cyclin D1 expression inversely correlated with tumor grade (P=0.010) and tumor size (P=0.023), whereas significant positive association was found with ER (P=0.001) and bcl-2 (P=0.001) expression. Patients with higher cyclin D1 expression had longer both overall survival (P=0.014) and relapse-free survival (P=0.037). Cox regression analysis for overall survival (OS) showed that lymph node status, ER expression, therapy, and cyclin D1 expression were independent prognostic factors. (P range from 0.003 to 0.04). CONCLUSION Expression of cyclin D1 is associated with better disease outcome in breast cancer.
Bcl-2, the protein product of the Bcl-2 gene, is a member of the Bcl-2 family of proteins that play a crucial role in a complex mechanism of apoptosis. It was recently proposed that bcl-2 could inhibit cancer progression. In this study, we evaluated the expression patterns of Bcl-2, estrogen receptors (ER), progesterone receptors (PR) in 71 primary invasive breast carcinomas and their association with other clinicopathological parameters. Samples from 71 patients with invasive breast cancer with follow-up ranging from 4-103 months (median 57 months) were included in the study. Forty-six patients (66%) obtained a complete response, while 5 (9%) were considered non-responders during the follow up period of 103 months. Eighteen (25%) patients died, 15 (21%) from primary disease and 3 (4%) from other disease. In unvaried analysis, tumor size (<2 cm), lymph node (<4 lymph nodes), hormonal status and Bcl-2 expression are correlated with longer overall (OS) and relapse-free survival (RFS). Patients with 4 or more positive axillary lymph nodes had significantly shorter OS (p=0.01) and RFS (p=0.009). Higher expression of Bcl-2 was associated with longer OS (p=0.02) and RFS (p=0.03), and this result were independent of axillary lymph nodes and tumor size in Cox multivariate analysis.
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