ABSTRACT
Objetivo: Os autores discutem o papel da hipóxia como causa e consequência da carcinogênese mamária e detalham a função de uma proteína, o fator induzível por hipóxia tipo 1 alfa (HIF-1a), como marcador prognóstico e o início de estudos em terapia-alvo com a utilização de inibidores. Métodos: Revisão bibliográfica da literatura. Resultados e Conclusão: A HIF-1a e um importante fator de mau prognóstico tanto em tumores iniciais quanto em localmente avançados e se encontra associado a diversas variáveis, como status axilar e positividade para a proteína Her-2. Contudo, ainda não existem trabalhos suficientes comprovando sua eficácia como fator preditivo.
Objective: The authors discuss the role of hypoxia as cause and consequence of breast carcinogenesis and emphasize a protein's function, hypoxia inducible factor type 1 alpha (HIP-1a), as a prognostic marker and initial studies in target therapy regarding the utilization of HIP-1a inhibitors. Methods: Bibliographic review of the literature. Results and Conclusion: HIP-1a is an important worse prognostic factor in initial and locally advanced tumors and that it is associated with diverse variables, such as axillary status and Her-2 positivity. However, there are fewer researches analyzing its efficacy as a predictive factor.
Subject(s)
Humans , Female , Cell Hypoxia/physiology , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Hypoxia-Inducible Factor 1, alpha Subunit , Hypoxia-Inducible Factor 1 , Biomarkers, Tumor , Breast Neoplasms/genetics , PrognosisABSTRACT
BACKGROUND: Locally advanced breast cancers are more prevalent in underdeveloped countries. Targeted therapy has been improved to identify hallmarks that are specific to these subtypes of tumors. OBJECTIVES: We aimed to prospectively assess the expression of Hypoxia inducible factor-1 α and vascular endothelial growth factor-C in locally advanced breast cancer patients. METHODS: Thirty women underwent incisional biopsies for the histopathological diagnosis of breast carcinoma and participated in neoadjuvant chemotherapy. The association of Hypoxia inducible factor-1 α and vascular endothelial growth factor-C with age, tumor size, histological grade, clinical staging, hormonal and axillary status, clinical and pathological response after neoadjuvant chemotherapy, expression of estrogen and progesterone receptors, and the presence of c-erbB-2 antigen was studied. RESULTS: Hypoxia inducible factor-1 α expression and Vascular endothelial growth factor-C expression were observed in 66.7 percent and 63.3 percent of all patients, respectively, and were marginally associated with each other (p = 0.06). Among the studied variables, only positive axillary status was associated with the presence of HIF-1α (p = 0.02). Complete pathological response was significantly associated (p = 0.04) with the expression of vascular endothelial growth factor-C prior to neoadjuvant chemotherapy. CONCLUSION: We concluded that Hypoxia inducible factor-1 α was associated with a poor prognosis and that vascular endothelial growth factor-C could be used as a predictive factor in locally advanced breast cancer patients with complete pathological response after neoadjuvant chemotherapy.