Determination of the prognostic value of cyclin D1, C-erb B-2, KI-67 and the nucleolar organizer regions [AgNORs] in breast cancer

ABSTRACT

Four different types of measurements of prognostic factors [cyclin Dl, C-erb B-2, Ki-67 and AgNORs] were applied to a series of 70 breast lesions representing, 35 cases of invasive ductal carcinoma, 10 cases of invasive lobular carcinoma, 5 cases of tubular carcinoma, 10 cases of ducted carcinoma in situ, 10 cases of atypical ductal hyperplasia [ADH], in addition to 7 cases of normal breast tissue as a control, in combination with clinicopathological parameters to evaluate their prognostic significance in breast cancer. Expression of cyclin Dl is negative in atypical ductal hyperplasia [ADH] and ductal carcinoma in situ [DCIS]. However, in 29/50 [58%] of invasive cancer breast, positive expression of cyclin Dl was observed. There is a significant association was observed between cyclin Dl expression and distant metastasis, recurrence, and five-year survival rate of the patients with breast cancer. There is also a significant correlation between C-erb B-2 expression and distant metastases, recurrence and 5-year survival rate. The Ki-67 label index and AgNORs count was found to correlate significantly and increased gradually with progression of breast lesions. The AgNORs size, shape and distribution was found to show a characteristic difference between benign, atypical and malignant groups. Malignant cells were characterized by an irregularly scattered distribution of AgNORs and by a pleomorphic size and shape of the dots in comparison to the round, uniform and regular size and shape of the AgNORs dots in benign lesions. Positive expression of cyclin DI C-erb B-2, Ki-67 and high AgNORs score could be serve as a poor prognostic markers for patients with breast carcinoma independent of nodal metastases and clinical parameters, also expression of cyclin Dl could help in diagnosis of early invasion of breast carcinoma