CATHEPSIN-D DETECTED BY AUTOMATED AND QUANTITATIVE IMMUNOHISTOCHEMISTRY IN BREAST-CARCINOMAS - CORRELATION WITH OVERALL AND DISEASE-FREE SURVIVAL

Aim-To determine the prognostic significance and clinical relevance of cathepsin D detected by immunocytochemical assays (ICAs) in breast ca rcinomas. Methods-151 patients presenting with palpable or impalpable breast carcinomas and who had not received any kind of adjuvant chemot herapy or endocrine therapy who were operated from January 1986 to May 1987 were studied. ICAs of tumour specimens were performed in optimal technical conditions (frozen sections, automated immunoperoxidase tec hnique (Ventana), and computer assisted analysis of digitised coloured microscopic images (SAMBA)) to determine cathepsin D immunocytochemic al expression. Results of quantitative ICAs were correlated with overa ll and disease free survival over 8.4 years of follow up in axillary l ymph node positive and negative patients. Results-Cathepsin D immunocy tochemical expression in tumours of 15% or more was significantly asso ciated with poor overall survival in the whole group and in node posit ive patients (Kaplan Meier, log rank test p=0.003 and p = 0.007); howe ver, it was not correlated with survival in node negative patients. Ca thepsin D immunocytochemical expression (>15%) correlated with short d isease free (p = 0.015) and short recurrence free survival (p=0.021) i n the group as a whole but not when node positive and negative patient s were evaluated separately.Conclusions-In optimal conditions (automat ed and quantitative ICAs on frozen sections) cathepsin D immunohistoch emical expression is a significant prognostic indicator in terms of ov erall, disease free, and recurrence free survival; however, there is n o correlation when node negative patients are considered separately.