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KMID : 1134120070100010019
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Journal of Breast Cancer
2007 Volume.10 No. 1 p.19 ~ p.28
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Prognostic Value of Apoptosis and the Survivin, bcl-2, and p53 Expressions in Breast Cancer Patients
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Son Myoung-Won
Woo Hee-Doo
Sohn Doo-Min
Bae Sang-Ho
Lee Hwa-Soo
Kang Gil-Ho
Kim Sung-Yong
Baek Moo-Jun
Lim Cheol-Wan
Lee Moon-Soo
Lee Min-Hyuk
Kim Chang-Ho
Kim Tae-Yoon
Min Young-Gi
Oh Mee-Hye
Kim Eui-Han
Kim Chang-Jin
Cho Moo-Sik
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Abstract
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Purpose: Survivin is a member of the inhibitor of apoptosis (IAP) protein family, and it is involved in the regulation of cell division. The over-expression of survivin has been reported to be associated with the parameters for a poor prognosis in ost human cancers, including lung, breast, colon, stomach, esophagus, pancreas, etc. In this study, we examined the expression of a member of a novel IAP protein family, survivin, in breast cancer and its association with tumor cell apoptosis and the overall prognosis.
Methods: 80 cases of formalin-fixed paraffin-embedded breast cancer tissue were immunostained with, using polyclonal survivin (Novus Biologicals, Littleton, USA), monoclonal bcl-2 (DAKO, Carpinteria, USA), and monoclonal p53 antibodies (DAKO, Carpinteria, USA). The histochemical method used for the analysis of apoptosis was based on ApopTag. Peroxidase In Situ OligoLigation (ISOL) Apoptosis Detection Kit (CHEMICON International Inc. Temecula, USA).
Results: Immunohistochemical analysis showed that cytoplasmic survivin expression was positive in 43 of 80 cases (53.8%) of breast carcinomas and it was positive for 70% of the cases that showed a bcl-2 expression tumors. Statistical analysis revealed that the survivin expression was correlated with lymph node metastasis, the tumor stage, and the histological grade. Although the survivin expression was not correlated with p53 mutations, the survivin positive cases were associated with a bcl-2 expression (p=0.015) and a reduced apoptotic index (p=0.024). On the Cox proportional hazard model analysis, the apoptotic index was not identified as a significant independent predictor of overall survival (p=0.072), although the patients with a low apoptotic index (<0.2%) had a worse survival rates than those patient in the group with a high apoptotic index (≥0.2%).
Conclusion: The results suggest that apoptosis inhibition of apoptosis by survivin may be a prognostic parameter for a worse outcome in breast carcinoma patients.
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KEYWORD
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Breast cancer, Apoptosis, Survivin, bcl-2, p53
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