Dw. Miles et al., EXPRESSION OF SIALYL-TN PREDICTS THE EFFECT OF ADJUVANT CHEMOTHERAPY IN NODE-POSITIVE BREAST-CANCER, British Journal of Cancer, 70(6), 1994, pp. 1272-1275
Sialyl-Tn (STn) is a carcinoma-associated carbohydrate determinant exp
ressed on cancer-associated mucins and has the structure NANA alpha(2-
6)alpha GalNAc. Expression of STn in colon and ovarian cancer is assoc
iated with a poor prognosis independent of tumour grade, stage or hist
ological type. We have examined 237 cases of primary breast cancer for
expression of this antigen using the antibody HB-STn (Dako). The freq
uency of STn expression was 31% in the whole group, 36% in the node-ne
gative and 28% in the node-positive group. Survival was lower, but not
significantly so, in the STn-positive group (P = 0.07), but this effe
ct was highly significant for patients with node-positive disease (P <
0.002), the curves for node-negative disease being coincident (P = 0.
31). In node-positive disease the effect was limited to those receivin
g adjuvant chemotherapy (P = 0.001). In a multivariate (Cox) analysis
on the whole group STn staining, combined with adjuvant chemotherapy,
showed a highly significant correlation with survival. In STn-negative
cases, adjuvant chemotherapy improved survival (relative risk 2.3, 95
% confidence intervals 1.4-3.9), whereas adjuvant chemotherapy did not
influence survival in patients which expressed sTn (relative risk 1.1
, 95% confidence intervals 0.6-2.2). Thus, by either direct or indirec
t mechanisms, STn positivity appears to be a marker of resistance to a
djuvant chemotherapy.