RESUMO
Different treatment outcomes and prognoses in patients with breast cancer can be observed with similar clinical predictors; this is because the biology of breast cancer is complex and heterogenous, involving multiple unknown contributing factors. We looked for plasma human mammaglobin (hMAM) mRNA by RT-PCR in 82 Korean patients with breast cancer to determine if there is an association between the presence of plasma hMAM mRNA in these patients and known prognostic factors. The prognostic usefulness of detection of plasma hMAM mRNA expression in these patients was also evaluated by determining overall survival and event-free survival. A significant difference was observed in the rate of positivity of plasma hMAM mRNA between the early stages of cancer (stages I-II, 23.4%) and advanced stages (stages III-IV, 82.9%). The expression rates of estrogen receptor, progesterone receptor, and HER-2/neu in the breast tissue of these patients, by immunohistochemistry, were 69.5, 75.6, and 20.7%, respectively. In the univariate analysis, plasma hMAM expression was significantly correlated with high histological and nuclear grades, nodal metastasis, and negative estrogen receptor and progesterone receptor status. Patients negative for plasma hMAM mRNA had significantly higher rates of event-free survival compared to the patients positive for plasma hMAM mRNA. However, no significant association with overall survival was observed for expression of plasma hMAM mRNA (P = 0.16). Qualitative detection of plasma hMAM mRNA appears to be associated with unfavorable prognostic factors and lower rates of event-free survival in patients with breast cancer.
Assuntos
Neoplasias da Mama/sangue , Neoplasias da Mama/genética , Mamoglobina A/sangue , Mamoglobina A/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Células MCF-7 , Pessoa de Meia-Idade , RNA Mensageiro/sangue , RNA Mensageiro/genéticaRESUMO
OBJECTIVE: A one-tube nested RT-PCR protocol was set up and used to detect mammaglobin A (MGA) expression in blood samples from breast cancer patients. The correlation of MGA detection with prognostic factors was analyzed. DESIGN AND METHODS: Total RNA from nucleated blood cells was extracted from 65 breast cancer patients (before surgery and after the treatments) and 18 healthy subjects and used to detect MGA expression by a modified nested RT-PCR. RESULTS: MGA expression was detected in 38.4% of patients before surgery, and in 50% and 36.8% of post-treatment samples from patients that expressed MGA or were MGA negative before surgery, respectively. MGA detection was associated with the absence of tumor estrogen receptors (p=0.004). CONCLUSIONS: MGA detection by the modified nested RT-PCR is a specific marker for circulating tumor cells in patients with breast carcinoma and a negative prognostic factor for the disease.