Title : Expression of catenin and bcl 2 as prognostic determinants in different immune subsets of triple negative breast cancer in pakistani patients
Background: Triple negative breast cancer (TNBC) is generally associated with poor outcome, high rates of local recurrence and metastatic disease. Objective: To study the presentation, pathology and prognostic parameters in triple negative breast cancer
Patient and methods: 100 cases of breast carcinoma cases were selected who were negative for ER, PR & HER2-neu on immunohistochemistry from 2015 to 2016 at CMH, AFIP Rawalpindi. Clinicopathological characteristics were noted. Further analysis was performed by using antibodies against CD4, CD8, β-catenin and bcl-2. CD 4+ & CD 8+ TILs were calculated in 10 stromal areas on HPF (high power field) and their percentages were categorized into 3 tier model (TILs60%=3) as per Saldago criteria 2014. The intensity of membranous Bcl-2 and β- catenin was scored as 3 (strong), 2 (moderate), 1 (weak) or 0 (no staining). A score of ≤2 was regarded as reduced expression.
Results: Out of 100 patients, low immune subset of TNBC with high expression of bcl-2 and β-catenin were directly correlated with positive axillary lymph node status and high stage of the patient (p<0.05).
Conclusions: Bcl-2 and β-catenin expression provides discriminative prognostic power in different immune subsets of TNBC, thus reinforcing the important role of immune cells and cell adhesion molecules in the process of tumor metastasis.