Significance of nm23 and cyclin E in a spectrum of preinvasive lesions, in-Situ carcinoma, IDC and Inflammatory Breast Cancer
Nashwa M. Emara*, Gamal E. Saleh**, Ayman Shedeid
Departments of Pathology*, General Surgery**, and Obstetrics and Gynecology***, Benha Faculty of Medicine, Benha University
Abstract

Background:
Breast cancer is the most common cancer in women of the developed countries, with the prognosis is determined primarily by the presence or absence of metastases in draining axillary lymph nodes, however, some high risk patients have an excellent prognosis and are cured with regional treatment alone, while others with low or intermediate risk groups finally die of their disease. These data highlight the need for more sensitive and specific prognostic indicators.
The nm23 gene/protein is a putative metastatic suppressor identified a decade ago in a melanoma cell line. Reduced Nm23 expression is related to poor prognosis in patients with many cancers. However its prognostic significane in breast cancer remains a controversial issue.
Cyclin E, the regulatory component of the cyclin/cyclin-dependent kinase (CDK) complex, is over-expressed in different tumor types and is often associated with a poor clinical outcome.
The present study was done to analyze the expression of Nm23 and cyclin E using immunohistochemistry in preinvasive and invasive breast lesions and also in inflammatory breast cancer as an entity with a special consideration and to determine their prognostic significance.
Methods:
Sections from 74 cases of breast lesions were studied and classified into: Atypical epithelial hyperplasia (11), carcinoma in situ (6), invasive duct carcinoma of different stages (40) and inflammatory breast cancer (17) and then subjected to immunohistochemical assessment of nm23 and cyclin E proteins levels to determine their relevance to adverse prognostic indicators.
Results:
Nm23 expression in these groups showed a progressive down regulation with increasing neoplastic transformation, with least expression in metastatic and inflammatory breast cancer (p < 0.01).
Cyclin E expression was an independent negative prognostic factor in the node positive breast cancer and inflammatory breast cancer variant (p < 0.01).
Conclusion:
It is concluded that nm23 and cyclin E proteins expression in a spectrum of breast lesions can be indicative of metastatic phenotype and help to predict the aggressiveness of disease.


Egyptian Journal of Pathology:27(2), Dec. 2007.