Expression of ABH/Lewis-related antigens as prognostic factors in patients with breast cancer

Abstract
Purpose: The prognostic value of altered blood group factor and Lewis-related carbohydrate antigen expression in breast cancers has not been fully determined. Methods: To this end, breast carcinoma samples from 87 radical mastectomy patients with primary cancer were analyzed by immunohistochemistry for the ABH factors, Lea, sialyl Lea, Lex, and sialyl Lex. Results: It was found that ABH, Lea, sialyl Lea, Lex, and sialyl Lex antigens were expressed in 25 (21.8%), 26 (22.6%), 26 (22.6%), 36 (31.3%), and 37 specimens (32.2%), respectively. Tumors with lymph node metastasis expressed Lex or sialyl Lex antigens more frequently than those without lymph node metastasis (P=0.0020 or P=0.039, respectively). The survival time of patient s after surgery was significantly shorter for those whose tumors expressed Lex or sialyl Lex than for those without Lex- or sialyl Lex-positive tumors (P=0.0028 and P=0.0029, respectively). Cox's multiple regression analysis revealed that sialyl Lex expression was an independent prognostic factor for patient survival regardless of primary tumor (T factor) and lymph node (N factor) status (hazards ratio, 3.80). Conclusions: Thus, expression of sialyl Lex antigen in tumor cells is associated with poor prognosis in patients with breast cancer and must be considered in the design of future therapeutic trials.

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