TOPOISOMERASE IIα DETERMINS THE PROGNOSIS AND RESPONSE TO CHEMOTHERAPY IN PATIENTS WITH OPERABLE BREAST CANCER
Keywords:
breast cancer, topoisomerase IIα, Ki-67 proliferation index, survival, chemotherapy, triply negative subtype, logistic model, prognosis.Abstract
Summary. Objective: to study the possibility of using
the expression level of the topoisomerase IIα (Topo IIα)
protein in tumor tissue samples of operable breast cancer (BC) patients as a prognostic marker of the effectiveness of chemotherapy. Object and methods: a retrospective study of tumor tissue samples and medical records of 107 patients with invasive BC who underwent
treatment at the National Cancer Institute for the period from 2008 to 2013 was conducted. Data of patients
who did not undergo (n = 52) or conducted (n = 55)
neoadjuvant chemotherapy (NACT) to assess the level
of expression of Topo IIα were analyzed. The following indicators were used as the factor signs: patient age,
molecular tumor subtypes, Ki-67 proliferation index,
absence or conduct of NACT, adjuvant chemotherapy, overall survival. All data were analyzed using statistical software packages MedCalc 17.9.2 (MedCalc
Software BVBA, 1993–2017). Results: the analysis
of the coefficients of logistic models showed a correlation between the level of the Ki-67 proliferation index and the probability of the expression of Topo IIα:
the latter increases with an increase in the Ki-67 index
(odds ratio (OR) = 1.03; 95% confidence interval (CI)
1.01–1.05) for every 1%. A positive relationship was
found between the expression of Topo IIα and the triple negative BC subtype (p = 0.04), which allows the
expression of this protein to be considered an important reference for CT of this subtype of BC (OR = 2.7;
95% CI 1.1–7.1). High expression of Topo IIα in the
primary tumor without NACT was accompanied by a
decrease in the overall survival of patients (p = 0.03),
which allows us to consider it as a predictor of BC.
Conclusion: the expression of Topo IIα can be considered as one of the additional predictive and prognostic markers for the treatment of BC.
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