Association of p53 expression with poor prognosis in patients with triple-negative breast invasive ductal carcinoma

Jing Ping Li, Xiang Mei Zhang, Zhenzhen Zhang, Li Hua Zheng, Sonali Jindal, Yun Jiang Liu

Research output: Contribution to journalArticle

Abstract

TP53 gene is mutated in approximately 80% of triple-negative breast cancer (TNBC). However, the prognostic significance of immunohistochemical (IHC)-detected p53 protein expression remains controversial in TNBC. In this study, we retrospectively analyzed the association between IHC-detected p53 expression and the prognosis in a cohort of 278 patients with stage I-III triple-negative breast invasive ductal carcinoma (IDC), who received surgery at the department of breast surgery in the Fourth Hospital of Hebei Medical University from 2010-01 to 2012-12. We found a positive expression ratio of IHC-detected p53 in triple-negative breast IDC of 58.6% (163/278). Furthermore, levels of expression were significantly associated with vessel tumor emboli and higher histologic grade (P = .038, P = .043, respectively), with the highest expression level observed in G3 breast cancer (64.7%). Additionally, Kaplan-Meier analysis showed that p53 expression indicated worse overall survival (OS) in the whole cohort (79.6% vs 89.6%, Log-rank test P = .025) as well as in stratified prognostic stage II patients (90.8% vs 100%, Log-rank test P = .027). The mortality risk of p53 expression patients was 2.22 times higher than that of p53 negative patients (HR: 2.222; 95%CI: 1.147-4.308). In addition, p53 expression was also associated with poor disease-free survival (DFS) (76.7% vs 86.8%, P = .020). Cox proportional hazard ratio model showed p53 expression was an independent risk factor for OS (P = .018) and DFS (P = .018) after controlling for tumor size, lymph node status, and vessel tumor emboli. Altogether, our data showed that IHC-detected p53 expression is a promising prognostic candidate for poor survival in triple-negative breast IDC patients. However, more studies are needed to determine if p53 may be applied to clinical practice as a biomarker and/or novel therapeutic target for TNBC.

Original languageEnglish (US)
Pages (from-to)e15449
JournalMedicine
Volume98
Issue number18
DOIs
StatePublished - May 1 2019

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Carcinoma, Ductal, Breast
Triple Negative Breast Neoplasms
Embolism
Disease-Free Survival
Survival
Neoplasms
p53 Genes
Kaplan-Meier Estimate
Proportional Hazards Models
Breast
Biomarkers
Lymph Nodes
Breast Neoplasms
Mortality
Proteins

ASJC Scopus subject areas

  • Medicine(all)

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Association of p53 expression with poor prognosis in patients with triple-negative breast invasive ductal carcinoma. / Li, Jing Ping; Zhang, Xiang Mei; Zhang, Zhenzhen; Zheng, Li Hua; Jindal, Sonali; Liu, Yun Jiang.

In: Medicine, Vol. 98, No. 18, 01.05.2019, p. e15449.

Research output: Contribution to journalArticle

Li, Jing Ping ; Zhang, Xiang Mei ; Zhang, Zhenzhen ; Zheng, Li Hua ; Jindal, Sonali ; Liu, Yun Jiang. / Association of p53 expression with poor prognosis in patients with triple-negative breast invasive ductal carcinoma. In: Medicine. 2019 ; Vol. 98, No. 18. pp. e15449.
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title = "Association of p53 expression with poor prognosis in patients with triple-negative breast invasive ductal carcinoma",
abstract = "TP53 gene is mutated in approximately 80{\%} of triple-negative breast cancer (TNBC). However, the prognostic significance of immunohistochemical (IHC)-detected p53 protein expression remains controversial in TNBC. In this study, we retrospectively analyzed the association between IHC-detected p53 expression and the prognosis in a cohort of 278 patients with stage I-III triple-negative breast invasive ductal carcinoma (IDC), who received surgery at the department of breast surgery in the Fourth Hospital of Hebei Medical University from 2010-01 to 2012-12. We found a positive expression ratio of IHC-detected p53 in triple-negative breast IDC of 58.6{\%} (163/278). Furthermore, levels of expression were significantly associated with vessel tumor emboli and higher histologic grade (P = .038, P = .043, respectively), with the highest expression level observed in G3 breast cancer (64.7{\%}). Additionally, Kaplan-Meier analysis showed that p53 expression indicated worse overall survival (OS) in the whole cohort (79.6{\%} vs 89.6{\%}, Log-rank test P = .025) as well as in stratified prognostic stage II patients (90.8{\%} vs 100{\%}, Log-rank test P = .027). The mortality risk of p53 expression patients was 2.22 times higher than that of p53 negative patients (HR: 2.222; 95{\%}CI: 1.147-4.308). In addition, p53 expression was also associated with poor disease-free survival (DFS) (76.7{\%} vs 86.8{\%}, P = .020). Cox proportional hazard ratio model showed p53 expression was an independent risk factor for OS (P = .018) and DFS (P = .018) after controlling for tumor size, lymph node status, and vessel tumor emboli. Altogether, our data showed that IHC-detected p53 expression is a promising prognostic candidate for poor survival in triple-negative breast IDC patients. However, more studies are needed to determine if p53 may be applied to clinical practice as a biomarker and/or novel therapeutic target for TNBC.",
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AU - Jindal, Sonali

AU - Liu, Yun Jiang

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AB - TP53 gene is mutated in approximately 80% of triple-negative breast cancer (TNBC). However, the prognostic significance of immunohistochemical (IHC)-detected p53 protein expression remains controversial in TNBC. In this study, we retrospectively analyzed the association between IHC-detected p53 expression and the prognosis in a cohort of 278 patients with stage I-III triple-negative breast invasive ductal carcinoma (IDC), who received surgery at the department of breast surgery in the Fourth Hospital of Hebei Medical University from 2010-01 to 2012-12. We found a positive expression ratio of IHC-detected p53 in triple-negative breast IDC of 58.6% (163/278). Furthermore, levels of expression were significantly associated with vessel tumor emboli and higher histologic grade (P = .038, P = .043, respectively), with the highest expression level observed in G3 breast cancer (64.7%). Additionally, Kaplan-Meier analysis showed that p53 expression indicated worse overall survival (OS) in the whole cohort (79.6% vs 89.6%, Log-rank test P = .025) as well as in stratified prognostic stage II patients (90.8% vs 100%, Log-rank test P = .027). The mortality risk of p53 expression patients was 2.22 times higher than that of p53 negative patients (HR: 2.222; 95%CI: 1.147-4.308). In addition, p53 expression was also associated with poor disease-free survival (DFS) (76.7% vs 86.8%, P = .020). Cox proportional hazard ratio model showed p53 expression was an independent risk factor for OS (P = .018) and DFS (P = .018) after controlling for tumor size, lymph node status, and vessel tumor emboli. Altogether, our data showed that IHC-detected p53 expression is a promising prognostic candidate for poor survival in triple-negative breast IDC patients. However, more studies are needed to determine if p53 may be applied to clinical practice as a biomarker and/or novel therapeutic target for TNBC.

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