LEA.135 expression: its comparison with other prognostic biomarkers for patients with primary breast carcinoma

The purpose of this retrospective study was to examine the prognostic value of expression of luminal epithelial antigen (LEA.135) for recurrence and o verall survival of patients with primary invasive breast carcinoma by both univariate and multivariate analyses. The possible prognostic value of LEA. 135 was also compared with some widely utilized prognostic biomarkers arch as c-erbB 2, topoisomerase II.alpha (TPII.alpha) MIB 1, estrogen receptor (ER) and progesterone receptor (PR), as well as age of the patients and cli nicopathologic parameters. The study was carried out by immunohistochemical methods on formalin-fixed/ paraffin-embedded tissue sections in a series o f 225 patients with median follow-up Of 8.5 years. Prognostic significance of the biomarkers was deter-mined by two-sided p value. In this series of p atients, among the age and clinicopathologic parameters, only age, was sign ificantly associated with a decreased overall survival (logrank p=0.027). A mong the prognostic biomarkers TPII a expression at high (>50% positive cel ls) or moderate (6-50% positive cells) level was associated with an increas ed rate of recurrence (logrank p<0.001). However; the association of TPII.a lpha expression with a decreased overall survival failed to reach a statist ically significance. Expression of c-erbB 2 showed a trend of being associa ted with an increased probability of recurrence, but the association did no t reach statistical significance The remaining biomarkers were not associat ed with either the probability of recurrence or overall survival. LEA. 135 expression was observed in 163 (72.4%) of the 225 patients The patients wit h high (>50% positive cells) or moderate (6-50% positive cells) level of LE A.135-positive cancel cells showed a significantly decreased probability of recurrence (logrank p<0.001) and an increased overall survival (logrank p< 0.001) compared with those with LEA.135-negative cancer cells. The associat ion remained significant by multivariate analysis for recurrence (likelihoo d ratio test p<0.001) and overall survival (likelihood ratio test p<0.001) when assessed with other prognostic parameters. Futhermore, the combination of LEA.135 with other prognostic biomarkers stratified four. subgroups of patients with distinct clinical oulcome. The subgroup of patients who were LEA.135+/TPII.alpha- showed the lowest probability of recurrence and the lo ngest overall survival compared with those who were LEA.135-ITPII.alpha+ (l ogrank p<0.001). Interestingly, the patients whose cancer cells were LEA.13 5+/TPII.alpha+, LEA.135+ MIB.1 or LEA.135+/c-erbB 2+ experienced a decrease d probability of recurrence and an increased-overall survival compared with those with LEA.135-/ TPII.alpha+, LEA. 135- MIB.1+ or LEA. 135-/c-erbB 2 (logrank p < 0.001). The results demonstrated that LEA.135 is an independe nt and favorable prognostic biomarker for patients with primary invasive br east carcinoma that the loss of LEA. 135 expression is associated with aggr essive phenotype of cancer cells during the breast cancer progression, and that its continued expression seems to override the adverse effects of expr ession of an oncogene or cell proliferation-associated molecules.