Expression of ABH/Lewis-related antigens as prognostic factors in patients with breast cancer

Abstract.

Purpose: The prognostic value of altered blood group factor and Lewis-related carbohydrate antigen expression in breast cancers has not been fully determined. Methods: To this end, breast carcinoma samples from 87 radical mastectomy patients with primary cancer were analyzed by immunohistochemistry for the ABH factors, Le^a, sialyl Le^a, Le^x, and sialyl Le^x. Results: It was found that ABH, Le^a, sialyl Le^a, Le^x, and sialyl Le^x antigens were expressed in 25 (21.8%), 26 (22.6%), 26 (22.6%), 36 (31.3%), and 37 specimens (32.2%), respectively. Tumors with lymph node metastasis expressed Le^x or sialyl Le^x antigens more frequently than those without lymph node metastasis (P=0.0020 or P=0.039, respectively). The survival time of patient s after surgery was significantly shorter for those whose tumors expressed Le^x or sialyl Le^x than for those without Le^x- or sialyl Le^x-positive tumors (P=0.0028 and P=0.0029, respectively). Cox's multiple regression analysis revealed that sialyl Le^x expression was an independent prognostic factor for patient survival regardless of primary tumor (T factor) and lymph node (N factor) status (hazards ratio, 3.80). Conclusions: Thus, expression of sialyl Le^x antigen in tumor cells is associated with poor prognosis in patients with breast cancer and must be considered in the design of future therapeutic trials.