BCL2 as a Subtype-Specific Prognostic Marker for Breast Canceropen access
- Authors
- Eom, Yong Hwa; Kim, Hyung Suk; Lee, Ahwon; Song, Byung Joo; Chae, Byung Joo
- Issue Date
- Sep-2016
- Publisher
- KOREAN BREAST CANCER SOC
- Keywords
- B-cell lymphoma 2 protein; Breast neoplasms; Prognosis; Tumor biomarkers
- Citation
- JOURNAL OF BREAST CANCER, v.19, no.3, pp.252 - 260
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF BREAST CANCER
- Volume
- 19
- Number
- 3
- Start Page
- 252
- End Page
- 260
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/153958
- DOI
- 10.4048/jbc.2016.19.3.252
- ISSN
- 1738-6756
- Abstract
- Purpose
B-cell lymphoma 2 (BCL2) is an antiapoptosis protein and an important clinical breast cancer prognostic marker. As the role of BCL2 is dependent on the estrogen receptor (ER) status, this effect might differ according to molecular subtypes. The aim of this study was to evaluate the relationship between the prognostic outcomes and BCL2 expression among the molecular subtypes.
Methods
We retrieved the data of 1,356 patients who were newly diagnosed with malignant breast cancer between November 2006 and November 2011. Immunohistochemistry was used to measure ER, progesterone receptor, human epidermal growth factor receptor 2 (HER2), Ki-67, and BCL2 expression. We classified breast cancer into five molecular subtypes based on the 13th St. Gallen International Expert Consensus, including luminal A, luminal B (HER2-negative), luminal B (HER2-positive), HER2-overexpression, and triple-negative subtypes. We analyzed the clinicopathological features and assessed the correlation between BCL2 expression and clinical outcomes, such as relapse-free survival (RFS) and disease-specific survival (DSS) according to the five molecular subtypes.
Results
A total of 605 cases of breast cancer (53.8%) showed BCL2 expression. BCL2-positive expression was associated with young age (<50 years, p=0.036), lower histological grade (p<0.001), low Ki-67 level (<14%, p<0.001), hormone receptor positivity (p<0.001), HER2 negativity (p<0.001), luminal breast cancer (p<0.001), and low recurrence rate (p=0.016). BCL2-positive expression was also associated with favorable 5-year RFS (p=0.008, 91.4%) and DSS (p=0.036, 95.6%) in all the patients. BCL2-positive expression in luminal A breast cancer resulted in significantly favorable 5-year RFS and DSS (p=0.023 and p=0.041, respectively). However, BCL2 expression was not associated with the prognosis in the other subtypes.
Conclusion
The prognostic role of BCL2 expression in breast cancer is subtype-specific. BCL2 expression differs according to the molecular subtype and is a good prognostic marker for only luminal A breast cancer.
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