The Expression Of Topo Ⅱα,P53 Protein In Different Molecular Subtypes Of Breast Cancer And Their Prognostic Values

Objectives:Basal-like and HER2 overexpression breast cancer have the worst prognosis between molecular subtypes. This study compared triple negative breast cancer and HER2 overexpression breast cancer prognosis, and detected the topoisomeraseⅡα(TopoisomeraseⅡ, Topo Ila), P53 protein expression in the two subtypes and prognosis, in relation to the reasonable clinical prognosis and rational use of drugs to provide better theoretical basis.Methods:In this study, the 546 breast cancer patients were selected from Tianjin Medical University Cancer Hospital after surgery between January to July in 2004. We got the ER, PR, HER2 protein expression status by immunohistochemical method. According to ER, PR and HER2 expression, we selected triple negative breast cancer and HER2 overexpression breast cancer 101 respectively, and compared the clinical and pathological features and prognosis between the two types. Further test TopoⅡα, P53 protein expression by immunohistochemical methods in two types of breast cancer, and the relation to prognosis.Results:1.Compared with the triple negative breast cancer, HER2 overexpression breast cnacer has a higher positive lymph node status (71.4% & 51.4%), and a higher percentage of of the larger tumor size, the difference was statistically significant (P= 0.039,0.045). The 5-year disease free survival(DFS) of Triple negative breast cancer and HER2 overexpression breast cancer were 61.4% and 73.3%, the difference was statistically significant (P=0.039). The 5-year overall survival rates were both 78.2% and 86.1%, the difference was not significant (P> 0.05).2.TopoⅡprotein expression were 62.4% in HER2 overexpression breast cancer, and 65.3% in triple negative breast cancer, the difference was no significance(P>0.05). Topo Ila protein expression had no correlation with the age, tumor size, clinical stage, axillary lymph node status, histological grade, pathological type and other clinicopathological parameters (P> 0.05)..3.The 5-year DFS rate was 81.0% in TopoⅡαand HER2 co-expression subtype. Topo Ila protein negative HER2 positive group was 60.5%, the difference was statistically significant (P=0.037). The 5-year overall survival rate was 92.1% in TopoⅡαand HER2 protein co-expression, and it was 76.3% in TopoⅡαprotein negative HER2 positive group, the difference was statistically significant (P=0.047). Multivariate Cox regression analysis showed that TopoⅡαwas prognostic factor in HER2 overexpression breast cancer.4.Triple negative breast cancer, TopoⅡαprotein positive and negative 5-year DFS rates were 69.7% and 82.4%, the difference was statistically significant (P=0.044) (Figure 4), the OS rates were 75.0% and 84.5%, the difference was not significant (P =0.927).5.P53 protein positive rate was 39.5% in HER2 overexpression breast cancer, and 40.9% in triple negative breast cancer, there was no significant difference in the two(P> 0.05).6. In triple negative breast cancer, the 5-year DFS rates were 61.1% and 84.6% in P53 protein positive and negative subtype, the difference was statistically significant (P= 0.023), no significant difference exited in overall survival (P>0.05). But there was no significant difference in HER2 overexpression breast cancer in DFS and OS. Multivariate Cox regression analysis showed that P53 was prognostic factor in triple negative breast cancer7. In triple negative breast cancer, The DFS rate of P53 and TopoⅡαCo-expression subtype was 43.5%, and the P53 or Topo Ila single positive subtype was 79.2%, and 82.6% in P53 and TopoⅡαbothe negative subtype. The difference was statistically significant (P=0.046).Conclusions:1.In Chinese breast cancer population, Compared to HER2 overexpression breast cancer, triple negative breast cancer has a worse prognosis, it should further strengthen the follow-up for such patients.2.In HER2 overexpression breast cancer,TopoⅡαprotein expression had the better prognosis, suggesting that this type patients can benefit from anthracycline chemotherapy, it provide a theoretical basis for clinical use.3.In the triple negative breast cancer patients, P53 and TopoⅡαprotein co-expression had poorer prognosis than P53 or TopoⅡαpositive subtype, suggesting that we should pay close attention to clinical prognosis of these patients.