TY - JOUR
T1 - Elevated levels of tumour apolipoprotein D independently predict poor outcome in breast cancer patients
AU - Jankovic-Karasoulos, Tanja
AU - Bianco-Miotto, Tina
AU - Butler, Miriam S.
AU - Butler, Lisa M.
AU - McNeil, Catriona M.
AU - O’Toole, Sandra A.
AU - Millar, Ewan K.A.
AU - Sakko, Andrew J.
AU - Ruiz, Alexandra I.
AU - Birrell, Stephen N.
AU - Sutherland, Robert L.
AU - Hickey, Theresa E.
AU - Tilley, Wayne D.
AU - Ricciardelli, Carmela
PY - 2020/6
Y1 - 2020/6
N2 - Aims: Apolipoprotein D (ApoD) is a protein that is regulated by androgen and oestrogen, and is a major constituent of breast cysts. Although ApoD has been reported to be a marker of breast cancer, its prognostic importance in invasive breast cancer is unclear. The aim of this study was to investigate the relationship between ApoD protein expression, oestrogen receptor-α (ERα) expression and androgen receptor (AR) expression in predicting breast cancer outcome. Methods and results: ApoD levels were measured by the use of immunohistochemistry and video image analysis on tissue sections from a breast cancer cohort (n = 214). We assessed the associations of ApoD expression with disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS). We also assessed the relationship between ApoD expression, AR expression and ERα expression in predicting OS. ApoD expression (>1% ApoD positivity) was found in 72% (154/214) of tissues. High ApoD positivity (≥20.7%, fourth quartile) was an independent predictor of MFS and OS, and conferred a 2.2-fold increased risk of developing metastatic disease and a 2.1-fold increased risk of breast cancer-related death. ApoD positivity was not associated with AR or ERα nuclear positivity. However, patients with (≥1%) ERα-positive cancers with low (<20.7%) ApoD positivity, or those showing high (≥78%) AR positivity and low (<20.7%) ApoD positivity had better OS than other patient groups. Conclusions: ApoD expression could be used to predict breast cancer prognosis independently of ERα and AR expression.
AB - Aims: Apolipoprotein D (ApoD) is a protein that is regulated by androgen and oestrogen, and is a major constituent of breast cysts. Although ApoD has been reported to be a marker of breast cancer, its prognostic importance in invasive breast cancer is unclear. The aim of this study was to investigate the relationship between ApoD protein expression, oestrogen receptor-α (ERα) expression and androgen receptor (AR) expression in predicting breast cancer outcome. Methods and results: ApoD levels were measured by the use of immunohistochemistry and video image analysis on tissue sections from a breast cancer cohort (n = 214). We assessed the associations of ApoD expression with disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS). We also assessed the relationship between ApoD expression, AR expression and ERα expression in predicting OS. ApoD expression (>1% ApoD positivity) was found in 72% (154/214) of tissues. High ApoD positivity (≥20.7%, fourth quartile) was an independent predictor of MFS and OS, and conferred a 2.2-fold increased risk of developing metastatic disease and a 2.1-fold increased risk of breast cancer-related death. ApoD positivity was not associated with AR or ERα nuclear positivity. However, patients with (≥1%) ERα-positive cancers with low (<20.7%) ApoD positivity, or those showing high (≥78%) AR positivity and low (<20.7%) ApoD positivity had better OS than other patient groups. Conclusions: ApoD expression could be used to predict breast cancer prognosis independently of ERα and AR expression.
KW - apolipoprotein D
KW - breast cancer
KW - prognosis
KW - survival outcome
UR - http://www.scopus.com/inward/record.url?scp=85084650127&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1130077
UR - http://purl.org/au-research/grants/NHMRC/1084416
UR - http://purl.org/au-research/grants/NHMRC/535903
UR - http://purl.org/au-research/grants/NHMRC/427601
UR - http://purl.org/au-research/grants/ARC/FT130101004
UR - http://purl.org/au-research/grants/NHMRC/349556
U2 - 10.1111/his.14081
DO - 10.1111/his.14081
M3 - Article
C2 - 31994214
AN - SCOPUS:85084650127
VL - 76
SP - 976
EP - 987
JO - HISTOPATHOLOGY
JF - HISTOPATHOLOGY
SN - 0309-0167
IS - 7
ER -