Prognostic impact of CD10 expression in clinical outcome of invasive breast carcinoma
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Early diagnosis and treatment for breast cancers has greatly improved in recent years, however, subset of this disease with early recurrence have remained to be unpredictable. Several studies has addressed that strong CD10 expression in tumor stroma is associated with poor survival rate of breast cancers, but no correlation between CD10 expression and disease-free survival has been elucidated yet. For these reasons, this study with modified immunohistochemical (IHC) staining evaluated the expression of CD10 in invasive breast carcinomas (IBCs) and analyzed correlations between CD10 expression on tumor cells, stromal cells and myeloid-like cells with clinicopathological parameters and recurrence status.
IHC staining method was performed on formalin-fixed paraffin-embedded sections of 73 cases of primary IBCs, with record of pathological characteristics of subjects followed up from 1998 to 2007.
Stromal CD10 expression was observed in 39/73 cases (53.4 %) with strong expression in 41.0 %. Three cases stained positive for myeloid-like cells and five for carcinomatous cells, of which 6 cases had recurrence and/or regional LN status. Stromal CD10 expression was significantly higher in the unfavorable group (69.6 %; 16/23 cases) compared with the favorable group (32.1 %; 9/28 cases) (p = 0.048). The levels of CD10 expression showed significant difference among clinical outcomes (recurrence or non-recurrence), independent of regional LN status (p = 0.034), histology type (p = 0.044), ER status (p = 0.042), PgR status (p = 0.039), Her2 status (p = 0.038) and Ki67 index (p = 0.036) (partial Pearson correlations). Cox proportional-hazards regression showed that risk factors for disease-free survival were stromal CD10 expression [CD10±, CD10+ versus CD10++; p = 0.003; HR 2.824 (1.427–5.591)]; regional LN status [N0, N1, N2, versus N3; p = 0.004; HR 2.107 (1.262–3.517)] and PgR status [negative versus positive, p = 0.006, HR 0.172 (0.049–0.596)].
CD10 expression on stroma with or without other positive tumor cells and/or myeloid-like cells may function as a powerful prognostic factor for IBC disease-free survival rates, predicting of potential recurrence. It can be determined by a simple modified IHC staining method, which is independent of other prognostic morphologic markers and biomarkers in IBC.
KeywordsCD10± (negative or very weakly positive staining) CD10+ (weakly positive staining) CD10++ (strongly positive staining) Invasive breast carcinoma (IBC) Lymph-node (LN)
We are grateful for the cooperation of all clinicians and technicians of our departments in contributing samples, for follow-up clinicopathological data and for technical support. In particular, we thank Professor Hiroyuki Sugihara and Associate Professor Ken-ichi Mukaisho (Pathology Department, Shiga University of Medical Science) for critical discussion and efficient facilities.
Conflict of interest
The authors declare that they have no conflict of interests in the article.
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