Abstract: Breast cancer is a heterogeneous disease with distinct biological subtypes that have a diverse natural history and presents with a varied spectrum of clinical, pathological and molecular features that have different prognostic and therapeutic implications. Amongst Zambian women, breast cancer is the second most frequent cancer and yet the prevalence of basal-like breast cancer, the subtype known to be associated with poor prognosis and resistant to chemotherapy is not known. It has been shown that a combined determination of CK5/6, CK14 and CK17 in breast cancer tissue samples by Immunonohistochemistry assists greatly in determining tumour growth behaviour, metastatases and outcome of the cancer. The objective of this study was to determine the frequency of expression of basal cytokeratins 5/6, 14 and 17 in breast cancer samples at the University Teaching Hospital (UTH) in Lusaka, Zambia.
Methodology: Randomly selected cases for the period January 2012 – December 2013 were identified and samples retrieved from the archives (n = 50). Sections were cut at 4 µm and stained with Haematoxylin and Eosin to determine the histological types and were evaluated for expression of CK5/6, CK14 and CK17 using immunohistochemical staining with Vectastain Elite Kit. Expression was also correlated with age, histological grade and tumour size. Data was analysed using SPSS software version 17.
Results: The majority of samples examined were from patients below the age of 50 years (n=28, 56%) and 46% (n=22) were those from patients aged 50 years or older. The most frequent histological type of breast cancer was invasive ductal carcinoma (n=45, 90%). Of the 50 samples 22 (44%) expressed CK5/6, 11(22%) CK14, and 6 (12%) CK17. Combined basal cytokeratin expression was 32 (64%). There was significant statistical association between expression of CK5/6 and CK14 with larger tumour size equal or greater than 2.0 cm (p=0.05 and p=0.003 respectively).
Conclusion: The most prevalent histological type was invasive ductal carcinoma (90%) and CK5/6 was the most frequently expressed basal marker (44%). Expression of CK14 was strongly associated with larger tumours when the three markers were combined with high histological grade.
Keywords: Breast Cancer, Basal-like breast cancer, Immunohistochemistry, CK5/6, CK14, CK17.
Title: Selective Prognostic Markers of Breast Cancer Using Expressed CK5/6, Ck14 and CK17 in Invasive Breast Cancer Tissue of Indigenous Black Zambian Women Presenting At the University Teaching Hospital, Lusaka, Zambia
Author: John Nkhoma, Trevor Kaile, Clemence Marimo, Aaron Shibemba
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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