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World J Surg. 2012 May;36(5):1189-94. doi: 10.1007/s00268-012-1514-3.

Cancer stem cell marker Bmi-1 expression is associated with basal-like phenotype and poor survival in breast cancer.

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Department of Radiation Oncology, General Hospital of Ningxia Medical University, Yinchuan, No. 804 Shengli Str, Yinchuan, 750004, Ningxia, China.



The purpose of present study was to examine the expression of cancer stem cell marker Bmi-1 in breast cancer tissue and to evaluate the clinical implication of Bmi-1 expression for these patients.


A total of 171 breast cancer patients who received surgical treatment in our hospital were enrolled in this study. Bmi-1 expression in breast cancer tissue was assayed by immunohistochemistry. Statistical analyses were applied to test the relationship between expression of Bmi-1 and clinicopathologic features and patient survival. The relationship between Bmi-1 and the basal-like phenotype of breast cancer also was analyzed in this study.


Positive Bmi-1 expression was detected in 89 of 171 (52%) invasive breast cancers patients. The Bmi-1 status was significantly correlated to histological grade III (p = 0.001) and basal-like phenotype (p < 0.001). The 5 year overall survival of the patients with Bmi-1-positive and -negative cancers were 78 and 91.9%, respectively (p = 0.03). Histological grade (p = 0.046) and Bmi-1 status (p = 0.012) were detected as the independent prognostic factors in the Cox regression test.


Bmi-1 status is an independent prognostic factor, which also is associated with tumor histological grade and basal-like phenotype. The high proportions of positive Bmi-1 expression in basal-like breast cancer may be related to the high aggressiveness behavior of this subtype of breast cancer.

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