Homeoprotein DLX4 expression is increased in inflammatory breast cancer cases from an urban African-American population
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Jaehong Jeong1,2, Tammey J. Naab3, Aileen I. Fernandez1, Martin S. Ongkeko4, Kepher H. Makambi5 and Jan K. Blancato1
1Department of Oncology, Georgetown University Medical Center, Washington DC 20057, USA
2Comprehensive and Integrative Medicine Institute, Daegu 42473, South Korea
3Department of Pathology, Howard University Hospital, Washington DC 20059, USA
4Department of Pathology, Georgetown University Medical Center, Washington DC 20057, USA
5Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington DC 20057, USA
Jan K. Blancato, email: [email protected]
Keywords: DLX4; IBC; African-American; IHC; homeoprotein
Received: May 14, 2018 Accepted: July 05, 2018 Published: July 27, 2018
Protein expression of Distal-less homeobox 4 (DLX4) was analyzed in inflammatory breast cancer (IBC) cases from an African-American (AA) population to determine if a) DLX4 gene over expression exists in this cohort and b) if the overexpression is associated with breast cancer clinicopathological characteristics (ER, PR, HER2, triple-negative). Twenty-nine blocks of formalin-fixed paraffin-embedded (FFPE) tissue from well-characterized human IBC cases were used for immunohistochemical staining (IHC). IHC results were assigned an intensity and percentage score. Percentage scores were assigned as 0, 1, 2, 3, or 4 and intensity scores were assigned 0, 1+, 2+ or 3+. For the analysis of the IHC, a percentage score of 3 or 4 and an intensity score of 2+ or 3+ were categorized as high. Chi-square or Fisher's exact tests were used to compare the high and low groups.
In this cohort, 89.7% (26 out of 29) of IBC cases showed high percentages of positive cells staining for the DLX4 protein, while 40.0% (12 out of 30) of normal breast tissue from reduction mammoplasty cases demonstrated DLX4 expression (p < 0.01). In IBC patients, 65.5% of cases showed a high level of staining intensity, compared to 20.0% of normal breast tissues (test, p = 0.001). Intensity to DLX4 was higher in the HER2 negative status (78.3%) than the HER2 positive status (16.7%) (test, p = 0.011).
DLX4 expression is higher in the IBC cases in this study of an urban AA population than in normal breast tissue cases. HER2 negative status is positively associated with high intensity of DLX4.
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