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. 2013 May 1:8:71.
doi: 10.1186/1746-1596-8-71.

Small breast epithelial mucin tumor tissue expression is associated with increased risk of recurrence and death in triple-negative breast cancer patients

Liang Liu  1 , Zhaozhe Liu, Shuxian Qu, Zhendong Zheng, Yongye Liu, Xiaodong Xie, Fulin Song
Affiliations

Small breast epithelial mucin tumor tissue expression is associated with increased risk of recurrence and death in triple-negative breast cancer patients

Liang Liu et al. Diagn Pathol. .

Abstract

Background: Small breast epithelial mucin (SBEM) has been implicated in tumor genesis and micrometastasis in breast cancer. Triple-negative breast cancer (TNBC) was characterized by high incidence in young women,early relapse and a very poor prognosis. The aim of this study was to evaluate the association of SBEM expression in tissues of TNBC with disease-free survival (DFS) and overall survival (OS).

Methods: SBEM protein expression was detected in 87 available formalin-fixed paraffin-embedded (FFPE) tissue specimens from TNBC patients by means of immunohistochemistry (IHC). We analyzed the correlation between the SBEM protein expression and DFS and OS during a 5 year follow-up period, respectively. And a SBEM cut-off value of prognosis was established associated with DFS and OS. SBEM was analyzed against other risk factors in multivariate analysis.

Results: SBEM 3+ score was cut-off value of prognosis and significantly correlated with DFS (p = 0.000) and OS (p = 0.001) in TNBC patients. There was a marked associations (p <0.05) between SBEM 3+ score and tumor size, grade, node status, TNM stage and Ki67. Multivariate analysis showed that patients with SBEM 3+ represented a higher risk of recurrence and mortality than those with a lower SBEM expression (HR = 3.370 with p = 0.008 for DFS and HR = 4.185 with p = 0.004 for OS).

Conclusions: SBEM is an independent risk predictor and may offer utility as a prognostic marker in TNBC patients.

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Figures

Figure 1
Figure 1
Immunohistochemical staining for SBEM. A: 0+: ≤5% of tumor cells staining with/without weakly stained was negative (original magnification × 200); B: 1+: >5% of tumor cells and with weak/focal positive staining or ≤5% of tumor cells with strongly stained (original magnification × 100); C: 2+: >5% of tumor cells and with moderate/focal positive staining (original magnification × 200); D: 3+: >5% of tumor cells and with strong/diffuse positive staining (original magnification × 200).
Figure 2
Figure 2
Kaplan-Meier estimates for DFS and OS by SBEM scores. No significant difference was found between different SBEM score (0, 1+ and 2+) and DFS (A) or OS (B) (p >0.05). But, there was a marked difference between SBEM 3+ score and SBEM score of 0, 1+ and 2+ (p <0.05) on DFS (A) and OS (B).
Figure 3
Figure 3
Kaplan-Meier estimates for DFS and OS by SBEM < 3+ group and SBEM = 3+ group. There was a significant difference between SBEM =3 + group and SBEM score <3+ group on DFS (A) and OS (B) (p = 0.000, p = 0.001, respectively).
Figure 4
Figure 4
Kaplan-Meier estimates for DFS and OS in lymph node positive and negative group. SBEM score of 3+ was significant associated with DFS and OS in both lymph node positive (A, B) and negative group (C, D) (p <0.05).
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