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Breast. 2019 Aug;46:101-107. doi: 10.1016/j.breast.2019.05.007. Epub 2019 May 3.

Stromal coexpression of uPA/PAI-1 protein predicts poor disease outcome in endocrine-treated postmenopausal patients with receptor-positive early breast cancer.

Author information

1
Department of OB/GYN, Comprehensive Cancer Center, Medical University of Vienna, Austria. Electronic address: christian.singer@meduniwien.ac.at.
2
Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.
3
Institute of Pathology, Medical University of Graz, Graz, Austria.
4
Department of Surgery, Medical University of Vienna, Vienna, Austria.
5
Department of Medicine III, Paracelsus Medical University Salzburg, Salzburg, Austria.
6
Department of Medicine, Medical University of Graz, Graz, Austria.
7
Department of Surgery, LKH Wiener Neustadt, Wiener Neustadt, Austria.
8
Department of OB/GYN, Comprehensive Cancer Center, Medical University of Vienna, Austria.
9
Department of Surgery, Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
10
Department of OB/GYN, Technical University of Munich, Munich, Germany.
11
Institute for Clinical Pathology, Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
12
MD for the Austrian Breast and Colorectal Cancer Study Group. Department of Surgery, Medical University of Vienna, Vienna, Austria.

Abstract

BACKGROUND:

To evaluate whether uPA/PAI-1 protein in hormone receptor-positive (HR+) breast tumor can predict prognosis in early breast cancer (BC).

METHODS:

606 women with HR + BC who had ≥5 years of endocrine therapy and in whom tumor tissue was available were included in this analysis. Stromal uPA/PAI-1 protein expression was evaluated by immunohistochemistry and correlated with distant recurrence-free survival (DRFS) and overall survival (OS).

RESULTS:

Stromal uPA was detected in 292/538 tumors (54.3%) while 269/505 samples (53.3%) exhibited stromal PAI-1. Co-expression of both proteins was found in 163/437 (37.3%) samples. Stromal uPA/PAI-1 co-expression was not associated with tumor size, age, nodal status, grading, or receptor status. Tumor stroma with both uPA and PAI-1 protein expression were more likely to have a shorter DRFS (HR: 1.87; 95%CI 1.18-2.96; p = 0.007) and OS (HR: 1.29; 95%CI 0.93-1.80; p = 0.129) than women without uPA/PAI-1 co-expression. After a median follow-up of 10 years, women with uPA/PAI-1-positive tumors experienced a significantly shorter DRFS (86.5% vs 72.4%; p < 0.001) and OS (70.4% vs 58.9%; p = 0.020) compared to women with uPA/PAI-1 negative tumors.

CONCLUSION:

Stromal co-expression of uPA and PAI-1 in breast cancer predicts poor DRFS and OS in postmenopausal women with HR + early-stage BC who receive endocrine therapy.

KEYWORDS:

Breast cancer; Immunohistochemistry; PAI-1; Prognosis; uPA

PMID:
31132475
DOI:
10.1016/j.breast.2019.05.007
[Indexed for MEDLINE]

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