HtrA1 loss is related to aggressive behavior parameters in sentinel node positive breast cancer
Renato Franco1, Francesca Collina1, Maurizio Di Bonito1, Gerardo Botti1, Donatella Montanaro2, Luigi Di Maio3, Bruno Vincenzi4, Gabriella Landi5, Massimiliano D’Aiuto5, Michele Caraglia6 and Alfonso Baldi2,7
1Pathology Unit, National Cancer Institute “Fondazione Giovanni Pascale”, Naples, 2CEINGE, Biotecnologie Avanzate, Naples, 3Department of Surgery, Spirito Santo Hospital, Pescara, 4Department of Medical Oncology, University Campus Bio-Medico, Rome, 5Breast Oncology Department, National Cancer Institute “Fondazione Giovanni Pascale”, Naples, 6Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples and 7Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Naples, Italy
Offprint requests to: Prof. Alfonso Baldi, CEINGE, Biotecnologie Avanzate, Via Gaetano Salvatore, 80145 Naples, Italy. e-mail: firstname.lastname@example.org or Dr. Renato Franco, Pathology Unit, National Cancer Institute “Giovanni Pascale”, Via Mariano Semmola, 80131 Naples, Italy. e-mail: email@example.com
Summary. Aim: HtrA1, a member of the High Temperature Requirement Factor A family of oxidative stress-response proteases seems to play a role as a tumor suppressor, being down-regulated in a series of human cancers during their progression. Particularly, low HtrA1 mRNA levels have been observed in breast cancer patients with more aggressive clinical features. These have been shown to relate to a longer disease free and overall survival, with more pronounced effects in axillary nodes positive patients. Subjects and Methods: We have analyzed for immunohistochemical HtrA1 expression a series of 66 sentinel node positive breast cancers through Tissue Micro Array technology. Results: HtrA1 was absent to low in 29 cases, medium in 19 cases and high in 18 cases. Our data revealed a positive significant relation between HtrA1 expression level and estrogen (p=0,002) and progestinic receptor expression (p=0.003) and a negative correlation with histological grading (p=0.028), proliferation index (p=0.05), common BC histotypes (p=0.040), luminal A and B subtypes (p=0.001), metastasis development (p<0.0001) and local relapse (p<0.0001). Finally, no correlation was recorded between HtrA1 expression level and breast cancer histology type and metastasis to non sentinel nodes. Interestingly HtrA1 loss in SLN metastasis was able to predict positive non sentinel nodes (p=0.001).
Conclusions: Low HtrA1 expression is significantly related to breast cancer poor prognosis parameters, and HtrA1 loss in sentinel nodes is related to metastasis of non sentinel nodes, offering a further marker useful for BC prognostic stratification. Histol Histopathol 30, 707-714 (2015)
Key words: Breast Cancer, HtrA1, Tumor suppressor, Tissue MicroArray