Proliferating cell nuclear antigen and heat shock protein 70 immuno-localization in invasive ductal breast cancer not otherwise specified

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Abstract
A series of 80 female patients undergoing surgeryfor primary breast ductal infiltrating carcinoma not otherwisespecified (NOS) was immunohistochemically studied in order toverify any relationships between Proliferating Cell Nulear Antigen(PCNA) immunostaining, Heat Shock Protein 70 (HSP70) immunoreactivity,and several clinicopathological predictors.Positive PCNA scores (> 20% of strongly immunopositivemalignant nuclei) were observed in neoplastic cells' nucleiin 13 tumors (16.25%) and were intimately associatedwith axillary nodal involvement (p=0.0131), relativelyhigh tumor grades (p=0.0016), increased tumorsize (p=0.0312), and low or negativelevels of estrogen receptors (p=0.0323). HSP70positive immunoexpression in malignant cells' cytoplasm (percentage ofHSP70 immunoreactive cells > 10%) was detected in33 samples (41.25%). It correlated significantly with presenceof axillary lymph nodal metastases (p=0.0033)and rather poor tumor differentiation (p=0.0014),whereas an association of borderline statistical significance emergedbetween HSP70 immunoreactivity and high progesterone receptor status(p=0.0637).PCNA positive immunostaining demonstrates the tumors' proliferative fractionand might be used as an indicator ofincreased malignant potential in breast cancer since itwas associated with four adverse prognosticators. HSP70 immunodetectionis a probable marker of the biological stressexperienced by breast cancer cells, since it wasrelated to relatively high tumor grades. Since bothproteins may potentially predict disease outcome, their prognosticsignificance must be validated by direct relation tosurvival. A multivariate statistical analysis including the variableswith which both proteins were associated will revealany possible independent prognostic value of PCNA andHSP70 immunostaining in local, ductal invasive breast cancerNOS.

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