HELIX-POMATIA LECTIN AND C-ERBB-2 EXPRESSION VERSUS AXILLARY AND INTERNAL MAMMARY LYMPH-NODE METASTASES IN PROGNOSTIC ASSESSMENT OF BREAST-CANCER

The relationship between Helix pomatia lectin (HPA) staining, c-erbB-2 expression, and other prognostic factors in breast cancer, i.e., axil lary (AX) and internal mammary lymph node (IMN) metastases was assesse d. The prognostic value of HPA staining and c-erbB-2 expression in com bination was analyzed. HPA status was found to be significantly correl ated with tumor size, and with AX and IMN metastases, whereas c-erbB-2 was significantly correlated only with AX and IMN metastases. A univa riate study revealed that disease-free and overall survival were corre lated significantly with tumor size, with AX and IMN metastases, and w ith HPA and c-erbB-2 status. Moreover, c-erbB-2 status was predictive of a poorer prognosis in both HPA+ and HPA- groups, and HPA+/c-erB-2patients had the worst prognosis when compared to the other subgroups. In a multivariate study, however, only AX and IMN metastases were sig nificant prognostic factors. A combination of HPA staining and c-erbB- 2 expression failed to provide any additional prognostic information. In patients in whom regional lymph node dissection has not been perfor med, however, one should take into account not only HPA binding status , but also c-erbB-2 oncoprotein status to discriminate more precisely those sub-populations with a high recurrence risk and predicted short survival who would be candidates for more aggressive therapy.