IMMUNOHISTOCHEMICAL DETECTION OF RECEPTOR S, PROTEASES, TUMOR-SUPPRESSOR PROTEINS AND PROLIFERATING MARKERS AS PROGNOSTIC INDICATORS FOR PRIMARY BREAST-CANCER PATIENTS

Objective: We tested whether immunohistochemical detection of oestroge n and progesterone receptor (ER, PR), the oestrogen-dependent protein pS2, the growth hormone receptors p 185(neu) and EGF-R, the tumour sup pressor protein p53, the tissue proteases Cathepsin D and Urokinase, a nd the proliferation marker PCNA are of prognostic relevance in breast cancer patients. Method: Expression of the proteins listed above was evaluated in formalin-fixed and paraffin-embedded sections of 311 prim ary breast cancer specimens using modified Avidin-Biotin-Complex metho ds. Results were correlated to clinical and morphological parameters ( age, menopausal status, nodal status, tumour size, tumour grade), and clinical course of disease (complete follow-up in 301 women, median ob servation time 62 months) utilising univariate and multivariate statis tical analyses. Results: If univariate analyses and multivariate regre ssion analyses,according to the Cox-model were applied, only Cathepsin D correlated to an elevated risk for recurrence in nodally negative p atients (n=135). In nodally positive women (n=161), increasing tumour size, tumour grade, lack of ER and PR, expression of p185(neu), p53, a nd PCNA indicated a significantly increased relative risk. Conclusions : Immunohistochemistry allows the detection of parameters which may in dicate prognosis in subgroup of breast cancer patients.