Year :
2020
| Month :
March
| Volume :
14
| Issue :
3
| Page :
EC21 - EC28
Full Version
Immunohistochemical Expression of Ki67 and p53 in Primary Breast Carcinoma and Combined Ki67-p53 Status Phenotypes in Hormone Receptor Positive Breast Carcinoma
Published: March 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/43546.13581
Rishiraj Baruah, Bukanakere Sangappa Sumana
1. Consultant Pathologist, Department of Pathology, Madonna Diagnostic and Research Centre, Jalan Nagar, Dibrugarh, Assam, India.
2. Professor, Department of Pathology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
Correspondence Address :
Bukanakere Sangappa Sumana,
15, RENUKA, 9th Main, 11th Cross, BDA Layout, HAL 3rd Stage, Jeevanbhimanagar,
Bengaluru, Karnataka, India.
E-mail: sumana.devanand@gmail.com
Abstract
Introduction: The conventional Immunohistochemical (IHC) biomarkers used to assess breast cancer patients include Hormone Receptor (HR) status and HER2 status. IHC analysis of Ki67 is useful to stratify the HR-positive tumours into good and bad prognosis categories; p53-status can identify patients likely to respond to chemotherapy.
Aim: To evaluate the IHC status of Ki67 and p53 in invasive primary breast carcinoma and to assess their relationship with HR status, HER2 status and clinico-pathologic factors.
Materials and Methods: This observational study conducted between August 2014 to April 2016 included fifty patients with invasive primary breast carcinoma comprising 48 ductal carcinoma, No Special Type (NST) and two mucinous carcinoma cases. Patients treated with neoadjuvant therapy were excluded from the study. The IHC analyses for ER, PR, HER2, Ki67 and p53 status were done on paraffin-embedded tissue sections. The Ki67 and p53 statuses were correlated with the clinicopathological parameters and ER, PR, HER2 status. Based on their IHC profiles, the tumours were classified into clinically definedtreatment oriented subtypes. The association between the clinicopathological parameters and positivity of IHC biomarkers were analysed using Chi-square test and Fisher’s-exact test. The p-value was calculated to ascertain a statistical significance.
Results: The 50 cases analysed comprised 54% postmenopausal and 46% premeno-pausal patients. Luminal cancers constituted 46% followed by 30% HER2- like and 24% basal-like tumours. Molecular subtypes showed significant correlation with age, menopausal status, and histologic grade. Ki-67 showed significant correlation with grade, HER2 status and molecular subtypes. p53 showed significant correlation with menopausal status and nodal status. The combined Ki67- p53 status showed a significant correlation with menopausal status, grade, nodal status and HER2 status of the HR-positive tumours.
Conclusion: The inclusion of Ki67 in the routine breast IHC panel, facilitates the subtyping of breast cancers into therapy oriented surrogate molecular subtypes. Further, when compared to Ki67 alone, the Ki67-p53 combination will provide even better cost-effective, predictive and prognostic information for the routine clinical management of breast cancers, especially for the HR-positive tumours.
Keywords
Biomarkers, Molecular subtypes, Tumour protein 53
DOI: 10.7860/JCDR/2020/43546.13581
Date of Submission: Jan 01, 2020
Date of Peer Review: Jan 22, 2020
Date of Acceptance: Feb 18, 2020
Date of Publishing: Mar 01, 2020
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 01, 2020
• Manual Googling: Jan 13, 2020
• iThenticate Software: Feb 25, 2020 (9%)
ETYMOLOGY: Author Origin
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