ЕКСПРЕСІЯ АНТИАПОПТОТИЧНОГО ПРОТЕЇНА СУРВІВІНА ТА ЙОГО ГЕНУ BIRC5 В КЛІТИНАХ ПЕРВИННОЇ КАРЦИНОМИ МОЛОЧНОЇ ЗАЛОЗИ В ЯКОСТІ ПРОГНОСТИЧНОГО МАРКЕРУ ПРОГРЕСУВАННЯ ЗАХВОРЮВАННЯ
Keywords:
breast cancer, survivin, BIRC5, survival, prognosis.Abstract
Aim: to study the expression of the anti-apoptotic survivin protein, as well as the expression of the BIRC5 gene of its encoding primary breast carcinoma as a potential predictive marker. Object and methods: using methods of immunohistochemistry and real-time PCR 67 samples (biopsy) of the primary breast carcinoma were studied for the presence of expression of the survivin protein and the gene BIRC5. Results: expression of survivin was determined in 47 mammary carcinoma samples, which was 70.15%. Expression of survivin was most often determined in medium and high grade ductal carcinoma (G2–G3), and was associated with lymphovenous stromal invasion (LVSI+). Expression of the survivin protein correlated with the expression of HER2-neu. In 59.6% of cases, survivin was expressed in tumors with a low Ki-67 index. Most often, survivin was expressed with luminal A and luminal B molecular-biological tumor subtype. Real-time PCR determined the expression of the BIRC5 gene in all 67 carcinoma samples. The level of normalized expression of the BIRC5 gene significantly moderately correlated with the expression of the own product of the survivin protein (r = 0.704, p <0.01) and slightly correlated with the expression of the oncoprotein HER2-neu (r = –0.285, p <0.05). The median follow-up was 40 months. The overall survival (OS) in the first group of patients without survivin expression in the primary tumor was 100%, the OS in the second group of patients with the presence of expression was 77.16 (74.6–80.1) (p = 0.041). Disease-free survival (DFS) in the first group was 100%, in the second – 71.9 (70.1–74.2) (p = 0.037). The ratio of progression risks in the survivin expression group was RR = 10.6 (CI 95% 0.85–132.2) (p = 0.041). Conclusion: expression of the protein of survivin and its gene – BIRC5, is an independent adverse prognostic factor and can be used as a predictive marker.
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