Relationship Between Nestin Expression And Other Clinico-pathological Factors In Breast Cancer

ObjectiveTo investigate the Nestin expression in breast tumors and analyze the relationship between it and other clinic-pathological characteristics, in order to determine the prognostic impact of Nestin expression.Materials and Methods1.Clinical PathologyWe selected 120 patients who were histologically confirmed breast cancer, and underwent radical operations in the Surgical Oncology Department of the First Affiliated Hospital of the China Medical University. The inclusion criteria were as follows:(a) curative operations were performed; (b) resected specimens were pathologically examined; (c) more than 10 lymph nodes were pathologically examined after operation; and (d) complete medical records were available.2.Empirical MethodImmunohistochemistry was carried out using the strept avidin-peroxidase-conjugated method. Monoclonal mouse anti-human Nestin were from Santa Cruz Biotechnology (Santa Cruz, CA). Positive controls included samples of normal breast, where Nestin is consistently expressed in myoepithelial cells and in endothelial cells. Negative controls were prepared by substituting PBS for primary antibody. Nestin expression was classified semi-quantitatively according to the following criteria:0 if< 1%of neoplastic cells discretely expressed Nestin in their cytoplasm; 1+if> 1 and< 10%of morphologically unequivocal neoplastic cells discretely expressed Nestin in their cytoplasm; and 2+if> 10%of morphologically unequivocal neoplastic cells discretely expressed Nestin in their cytoplasm. Samples scored as 1+or 2+were considered positive. 3.Statistical AnalysisRelationships between tumor markers and other parameters were studied using chi-square test and independent t-test. The SPSS 13.0 (SPSS Inc., Chicago, USA) was used for all calculations. A p value of less than 0.05 was considered significant. All reported p values were two-sided.ResultsNestin expression was observed in 16.67%(20/120) cases. Triple-negative breast cancers had higher expression rate for Nestin than the other cancers (47.62%vs 10.10%, P＜0.001). The mean age of patients were similar between the positive and the negative groups of Nestin (49.80 vs 49.94, P=0.960). Cases with T3 tumors got a higher expression rate for Nestin than others (5.56%vs 13.92%vs 34.78%for pT1 vs pT2 vs pT3 respectively, P=0.036). The Nestin expression rate in carcinomas in situ was lower than in invasive carcinomas, but was not significantly different (P= 0.479). Moreover, there was no significantly difference between patients with lymph node metastasis and those without (P= 0.617)Nestin expression rate was found to be lower in the positive groups of ER and PR than in the negative of ER or PR ones (P= 0.046 and 0.001 respectively). However, HER2 expression was not found to be related to Nestin expression (P= 1.000).ConclusionTriple-negative breast cancers had higher expression rates for Nestin. Nestin expression is significantly associate with tumor size and ER, PR expression. It demonstrated that Nestin might be a new potential marker for breast cancer. However, the prognostic impact of Nestin expression and the underlying mechanisms of Nestin's involvement are still unclear, so more and larger studies are required.