Ki67/SATB1 ratio is an independent prognostic factor of overall survival in patients with early hormone receptor-positive invasive ductal breast carcinoma
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Arvydas Laurinavicius1,2, Andrew R. Green3, Aida Laurinaviciene1,2, Giedre Smailyte1,4, Valerijus Ostapenko4, Raimundas Meskauskas2, Ian O. Ellis3
1Faculty of Medicine, Vilnius University, Vilnius, Lithuania
2National Center of Pathology, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
3Division of Cancer and Stem Cells, School of Medicine and Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, United Kingdom
4National Cancer Institute, Vilnius, Lithuania
Arvydas Laurinavicius, e-mail: [email protected]
Keywords: immunohistochemistry, digital image analysis, breast cancer, HIF-1α, SATB1
Received: July 08, 2015 Accepted: September 24, 2015 Published: October 15, 2015
Biological diversity of breast cancer presents challenges for personalized therapy and necessitates multiparametric approaches to understand and manage the disease. Multiple protein biomarkers tested by immunohistochemistry (IHC), followed by digital image analysis and multivariate statistics of the data, have been shown to be effective in exploring latent profiles of tumor tissue immunophenotype. In this study, based on tissue microarrays of 107 patients with hormone receptor (HR) positive invasive ductal breast carcinoma, we investigated the prognostic value of the integrated immunophenotype to predict overall survival (OS) of the patients. A set of 10 IHC markers (ER, PR, HER2, Ki67, AR, BCL2, HIF-1α, SATB1, p53, and p16) was used. The main factor of the variance was characterized by opposite loadings of ER/PR/AR/BCL2 and Ki67/HIF-1α; it was associated with histological grade but did not predict OS. The second factor was driven by SATB1 expression along with moderate positive HIF-1α and weak negative Ki67 loadings. Importantly, this factor did not correlate with any clinicopathologic parameters, but was an independent predictor of better OS. Ki67 and SATB1 did not reach statistical significance as single predictors; however, high Ki67/SATB1 ratio was an independent predictor of worse OS. In addition, our data indicate potential double prognostic meaning of HIF-1α expression in breast cancer and necessitate focused studies, taking into account the immunophenotype interactions and tissue heterogeneity aspects.
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