Prognostic value of cytosolic markers (estrogen and progesterone receptors, pS2, cathepsin-D and p53) of breast cancer stage I and II. Survival analysis

Objective: This study was launched with the objective of identifying cytosolic markers with prognostic value for overall survival (S) in breast cancer patients. Materials And Methods: We analyzed 254 tumor samples of patients diagnosed with stage I and II breast cancer. Cytosols were prepared following a standard technique, and estrogen (ER) and progesterone receptors (PR) were determined by using an immunoenzymatic method (cut-off 15 fmol/mg), pS2 (cut-off 11 ng/mg) and cathepsin-D (cut-off 35 pmol/mg) by an immunoradiometric assay and p53 (cut-off 0.15ng/mg) by an immunoluminometric technique. Results: Mean follow-up of patients was 40.21 months. 73% of patients were postmenopausal. 19% were classified as Stage I and 81% as Stage II. We found a statistically significant association between ER and PR expression and hormonal status (p<0.01), tumor size (p<0.05), histologic grade (p<0.001), and pS2 (p<0.001) and p53 (p<0.01) expressions. The expression of cathepsin-D was associated with the positivity of axillary lymphatic nodes (p<0.02). The positivity of p53 was associated to tumor size (p<0.05), histologic grade (p<0.001) and positive axillary nodes (p<0.05). Univariate analysis of overall survival identified ER expression (p=0.03) as a prognostic factor, and the multivariate analysis assigned a significant value to the expression of p53 (p<0.03), among other survival prognostic factors. Conclusion: The expression of cathepsin-D and p53 identified a sub-group of patients with higher probability of axillary node involvement and therefore poorer prognosis