Abstract

OBJECTIVES: Overexpression of the epidermal growth factor receptor family genes, which include ErbB-1, 2, 3 and 4, has been implicated in a number of cancers. We have studied the extent of ErbB-2 overexpression among Indian women with sporadic breast cancer. METHODS: Immunohistochemistry and genomic polymerase chain reaction (PCR) were used to study the ErbB2 overexpression. ErbB2 status was correlated with other clinico-pathological parameters, including patient survival. RESULTS: ErbB-2 overexpression was detected in 43.2% (159/368) of the cases by immunohistochemistry. For a sub-set of patients (n = 55) for whom total DNA was available, ErbB-2 gene amplification was detected in 25.5% (14/55) of the cases by genomic PCR. While the ErbB2 overexpression was significantly higher in patients with lymphnode (chi2 = 12.06, P < or = 0.001), larger tumor size (chi2 = 8.22, P = 0.042) and ductal carcinoma (chi2 = 15.42, P < or = 0.001), it was lower in patients with disease-free survival (chi2 = 22.13, P < or = 0.001). Survival analysis on a sub-set of patients for whom survival data were available (n = 179) revealed that ErbB-2 status (chi2 =25.94, P < or = 0.001), lymphnode status (chi2 = 12.68, P < or = 0.001), distant metastasis (chi2 = 19.49, P < or = 0.001) and stage of the disease (chi2 = 28.04, P < or = 0.001) were markers of poor prognosis. CONCLUSIONS: ErbB-2 overexpression was significantly greater compared with the Western literature, but comparable to other Indian studies. Significant correlation was found between ErbB-2 status and lymphnode status, tumor size and ductal carcinoma. ErbB-2 status, lymph node status, distant metastasis and stage of the disease were found to be prognostic indicators.

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