La concentración de ácido hialurónico citosólico define ciertas propiedades clinicobiológicas del carcinoma ductal infiltrante de mama CD44v5 positivo

Histological Grade in Breast Cancer: Association with Clinical and Biological Features in a Series of 229 Patients

In order to study the association of histological grade (HG) with specific clinical and biological parameters which may influence the clinical behavior of infiltrating ductal carcinomas of the breast (IDC), we analyzed in 229 tissue samples the cytosolic concentrations of estrogen receptor (ER), progesterone receptor (PR), pS2, cathepsin D, hyaluronic acid (HA) and tissue-type plasminogen activator (t-PA), as well as those of the erbB2 oncoprotein, epidermal growth factor receptor (EGFR), HA, CD44v5 and CD44v6 in the cell membrane fraction. Likewise, we considered size, ploidy, S-phase fraction and axillary node involvement as variables of the study. The transition from HG1 to HG2 and from HG2 to HG3 was accompanied by a number of common features: global increase in size, greater number of tumors >2.0 cm, decrease in membrane hyaluronic acid concentrations, increased cell proliferation (S-phase >7%) and greater aneuploidy. Other events observed during the transition from HG2 to HG3 were a decrease in ER, PR, t-PA and cytosolic hyaluronic acid. These results led us to consider that HG is associated with certain clinical-biological changes that may help explain its value as a prognostic factor in breast carcinomas.

[Infiltrating ductal carcinomas of the breast in women over 60 years of age. Association with higher cellular proliferation and lower PS2, cell surface and cytosolic hyaluronic acid concentrations]

INTRODUCTION

There are several discrepancies in the literature concerning breast cancer behavior in elderly women. For this reason, we decided to study the possible clinical-biological differences between infiltrating ductal breast carcinomas in women older than 60 and those between 41 and 60 years old.

PATIENTS AND METHODS

The study group included 161 women with infiltrating ductal carcinomas of the breast, 90 of whom were women over 60 years and 71 whose ages ranged from 41 to 60 years old. Estrogen receptors (ER), progesterone receptors (PR), pS2, cathepsin D, tissue-type plasminogen activator (t-PA) and hyaluronic acid (HA) cytosolic concentrations were analyzed in addition to those of the epidermal growth factor receptor (EGFR), HA and erbB2/neuoncoprotein in cell surfaces. Size, axillary lymph node involvement, distant metastases, histological grade, ploidy and cellular S-phase fraction were also considered as study variables.

RESULTS

Infiltrating ductal carcinomas of the breast in women over 60 had lower pS2 concentrations (p: 0.0367), cell surface (p: 0.021) and cytosolic hyaluronic acid (p: 0.0019) levels than those of women whose ages ranged from 41 to 60 years old. Furthermore, the former had higher S-phase values (p: 0.0345) and percentage of cases with S-phase >7% (p: 0.0483).

CONCLUSIONS

The results obtained (higher cellular proliferation and lower pS2, cell surface and cytosolic hyaluronic acid concentrations) suggest that the infiltrating ductal carcinomas of the breast in women older than 60 could have a worse behavior, as has been suggested by other authors, even though further studies with more patients would be needed in order to observe if these biological differences still persist.