Correlations in survivin expression with the expression of p53 and bcl-2 in invasive ductal carcinoma of the breast.

This work studied the correlations between survivin, bcl-2 and p53 in infiltrating ductal carcinoma of the breast. A total number of 382 cases were collected from 3 hospitals in northeastern Malaysia. Survivin, bcl-2 and p53 were detected by immunohistochemistry on samples prepared from tissue blocks. Significant correlations were found between tumor histological grades and tumor size and lymph node involvement. Highly significant statistical correlations (p<0.001) were found in expression of the markers under study. It is concluded that such significant correlations may imply that the alterations in the expression take place in a concerted fashion, implying that many of these cases may share common abnormalities.

Survivin expression correlates with unfavourable prognoses in invasive ductal carcinoma of the breast.

Survivin is a 16.5-kDa intracellular protein also known as AP14 or BIRC5. It inhibits apoptosis and regulates cell division and belongs to the inhibitors of apoptosis (IAP) gene family. In the majority of neoplasms investigated for survivin expression, high levels of the IAP proteins were predictive of tumour progression, either in terms of disease-free survival or overall survival, thus providing significant prognostic information. Hence, the prognostic value of survivin expression in tumour masses of invasive ductal carcinoma has been investigated. It was found that negative and low expression of survivin correlated significantly with favourable outcomes. Conversely, high expression correlated with unfavourable outcomes. The five-year survival rate was higher among the cases with low and negative survivin expression, compared to those with higher survivin expression. However, this correlation was found to be insignificant statistically. Furthermore, a statistical model has been devised to explain the combined effects of survivin expression and its sub-cellular localisation, p-53 expression and lymph nodal involvement, on the outcomes of these patients.

Expression of survivin and its clinicopathological correlations in invasive ductal carcinoma of the breast.

INTRODUCTION: Survivin is a 16.5-kDa intracellular protein that inhibits apoptosis and regulates cell division, and belongs to the inhibitors of apoptosis gene family. It appears to have an important role in regulating apoptosis at the cell cycle checkpoints. Survivin has been found to have a differential distribution in cancer compared to normal tissue, as it is over-expressed in malignant tumours. METHODS: In addition to the demographical analysis of the disease, data from 382 women with invasive ductal carcinoma of the breast were collected from three hospitals in Northeast Malaysia, and analysed for survivin expression by immunohistochemistry. RESULTS: Invasive ductal carcinoma of the breast was found to be the most prevalent breast cancer type. Survivin was detected in 260 (68.1 percent) study cases. In addition, significant correlations have been shown between survivin expression on one hand, and tumour size and lymph node involvement on the other hand (p-value is less than 0.05). However, no significant correlations were found with other clinicopathological factors, such as tumour histological grade, tumour side, oestrogen and progesterone receptors. Nuclear expression of survivin was detected in 16.5 percent of the study cases, cytoplasmic expression was detected in 24.1 percent, and 27.5 percent of the cases expressed survivin in both nuclear and cytoplasmic locations simultaneously. The subcellular localisation of survivin was significantly correlated (p is less than 0.001) with the lymph node involvement indicating its value in predicting the aggressiveness of tumour cells, since it increases the resistance to apoptosis and promotes cell proliferation. CONCLUSION: This is the fi rst known report on survivin expression in cancer in West Malaysia and Southeast Asia. It emphasises the importance of the detection of survivin in breast cancer to aid in diagnosis, confirm malignancy, and to assess the disease progress and response to therapy.

Risk factors of breast cancer in women in Kelantan, Malaysia.

INTRODUCTION: Breast cancer is the commonest cancer for females in Malaysia, with a prevalence of 86.2 per 100,000 women in 1996. Breast cancer mortality rate shows an increasing trend in Malaysia from 0.61 in 1983 to 1.8 per 100,000 women in 1992. The aim of this study was to identify the risk factors for breast cancer in women in Malaysia. METHODS: A matched case-control study was carried out at referral hospitals in Kelantan from July 2000 to June 2001. A standardised questionnaire that comprised socio-demographical factors, obstetrical and gynaecological histories, anthropometric measurements, and other potential risk factors for breast cancer, was used to interview 147 histologically-confirmed breast cancer patients and 147 controls. Controls were non-breast cancer patients who were matched for age and ethnicity, and excluded those with malignancies, or having gynaecological, hormonal or endocrine problems. Simple and multiple conditional logistic regressions were used for analyses. RESULTS: Factors contributing toward increased risk of breast cancer were nulliparity (odds ratio [OR] of 15.3; 95 percent confidence interval [CI] of 3.2, 72.4), overweight (OR of 2.1; 95 percent CI of 1.1, 3.9), family history of breast cancer (OR of 4.3; 95 percent CI of 1.3, 14.1) and previous use of oral contraceptives (OR of 2.5; 95 percent CI of 1.3, 4.8). CONCLUSION: This study reconfirmed that similar risk factors identified in Western populations were responsible for the occurrence of breast cancer in Kelantan. It also supported the theory that breast cancer occurrence was related to oestrogen exposure and familial factors. It suggested the importance of having children, maintaining ideal body weight and caution for oral contraceptive users and women with a family history of breast cancer.