The Protein Expression Of MAPK And Snail With Their Clinical Study In Triple-negative Breast Carcinoma

Objective Breast cancer is worldwide malignance tumor in female. Ithas been reported in CA online that breast cancer alone is expected to accountfor29%of all new cancer cases among women and it’s mortality rate is14%becoming the second leading cause of death, in America, following bronchuscancer the most common causes of cancer death. In China, breast cancer is themost commonly diagnosed type of cancer, the fifth leading cause of cancerrelated deaths in women. The incidence is up to47.64/105and the mortality is10.41/105. A subtype of particular interest is the triple-negative breast cancer(TNBC). This subtype of caner is definded as lack expression of estrogenreceptor, progesterone receptor and HER2/neu. In research studies, consideringit’s immounochemistry features, patients with TNBC, who can not benefit from endocrine and tamoxin therapy, had significantly shorter disease free and overallsurvival times than other types of breast cancer. MAPK is short formitogen-activated protein kinasea which participated in many processes such ascell growth and differentiation,etc. Snail is a zinc finger transcription factorwhich triggers the epithelial-mesenchymal transition (EMT). Reports haveshowen that patients with a higher expression of MAPK and Snail have a higherrates of invasion, metastasis and poorer prognosis. But up to now theexpression of MAPK and Snail in triple-negative breast cancer has not beenreported. To summarize the expression of MAPK and Snail protein in TNBCand it’s clinical features, pathological features, stage, recurrence and metastasisand prognosis to provide reference for TNBC recurrence, metastasis andprognostic evaluation.Methods The5-year follow-up data were collected from40TNBC and40non-TNBC patients with pathological established diagnosis of breast cancertreated in the General Hospital of Ningxia Medical University and YinchuanPeople’s Hospital between Jan.2002to Dec.2004. Immunohistochemistry technique was used to analysis MAPK and Snail in protein level in paraffinsection of40TNBC,40non-TNBC and20normal breast tissues(from thecancer tissue≥5cm). The expression of MAPK and Snail in breast cancer andthe the correlation between the two proteins were investigated. The results werestatistically analysed by SPSS16.0.Results1.MAPK and Snail in TNBC, the positive parts of the tumor cellslocated in the cytoplasm and a part of nucleus, adjacent normal breast tissue hadno expression or low expression. The positive expression of MAPK and Snail inTNBC tissue were45.0%(18/40) and55%(22/40);15%(3/20) and25%(5/20)in normal breast issue. Expression of MAPK and Snail in TNBC were markedlyhigher than those in the normal breast tissues (P <0.05).2. The positiveexpression rates of MAPK were not significantly correlated with age, menstrualconditions, family history of cancer, ethnic, pathological types and histologicalgrades in TNBC patients, so does Snail protein (P>0.05).3. The positiveexpression rates of MAPK were not significantly correlated with tumor size, thenumber of lymph node metastasis and TNM staging (P>0.05). The positive expression rates of Snail were not significantly correlated with tumor size; Snailwas associated with the number of lymph node metastasis and TNM staging(P<0.05), which it’s positive expression rates in lymph node N0,N1andN2+3were35.0%,66.7%and81.8%respectively and it’s positive expression rates inTNM stage Ⅰ, Ⅱ andⅢ were20.0%,43.5%and91.7%respectively.4.Recurrence and metastasis rates was significantly worse for those with a higherexpression of MAPK and Snail (P <0.05); MAPK and Snail expression rates inrecurrence and metastasis group were68.4%(13/19) and89.5%(17/19)respectively; Following an equivalent comprehensive treatment, there were nosignificant correlation between the expression of MAPK and Snail in TNBC andnon-TNBC group (P>0.05).5. The TNBC patients with MAPK and Snailpositively expression showed significantly lower5-year survival rates than thosewith MAPK and Snail negatively expression (P <0.05). The5-year survival ratesfor MAPK negative and positive are77.3%and44.4%and the rates for Snail are88.9%and40.9%in TNBC group. Parallel to these data, the5-year survivalrates of our patients whose MAPK and Snail protein positively expression are not significantly different compared with TNBC and non-TNBC.6. Logisticmultivariate analysis showed that MAPK expression and TNM stage are theindependence risk factors for TNBC.7. MAPK and Snail expression in breastcancer was positively related (r=0.245, P <0.05).Conclusions1. MAPK and Snail showed higher expression in TNBC andnon-TNBC tissue compared with breast normal tissues.2. Triple-negative breastcancer with MAPK and Snail positive expression have higher rates of recurrenceand metastasis, poorer prognosis and a lower rate of5-year survival morerecurrence than those with negative expression. MAPK and Snail protein arecorrelated with each other.3.MAPK expression and TNM stage are theindependence risk factors for TNBC.