TY - JOUR
TI - Prognostic value of COX-2, P53, and EZH-2 evaluated by quantitative image analysis in premalignant and malignant breast lesions
AU - Nicolopoulou-Stamati, P.
AU - Tsipis, A.
AU - Chelidonis, G.
AU - Patsouris, E.
AU - Athanassiadou, P.
AU - Gonidi, M.
AU - Athanassiadou, A.M.
JO - Diagnostic Cytopathology
PY - 2015
VL - 43
TODO - 4
SP - 294-300
PB - John Wiley and Sons Inc
SN - 8755-1039, 1097-0339
TODO - 10.1002/dc.23217
TODO - cyclooxygenase 2;  protein p53;  transcription factor EZH2;  cyclooxygenase 2;  EZH2 protein, human;  polycomb repressive complex 2;  protein p53;  PTGS2 protein, human;  TP53 protein, human;  tumor marker, adult;  aged;  Article;  breast adenocarcinoma;  breast biopsy;  breast cancer;  breast carcinoma;  breast hyperplasia;  breast lesion;  breast tumor;  cancer cytodiagnosis;  cancer patient;  cancer prognosis;  correlational study;  diagnostic test accuracy study;  differential diagnosis;  disease association;  fine needle aspiration biopsy;  histopathology;  human;  human tissue;  image analysis;  imaging software;  immunocytochemistry;  immunohistochemistry;  major clinical study;  malignant neoplastic disease;  microscope;  middle aged;  precancer;  predictive value;  priority journal;  protein expression;  quantitative analysis;  tumor biopsy;  tumor differentiation;  tumor volume;  breast;  breast tumor;  female;  hyperplasia;  image processing;  metabolism;  pathology;  precancer;  procedures;  retrospective study;  very elderly, Adult;  Aged;  Aged, 80 and over;  Biopsy, Fine-Needle;  Breast;  Breast Neoplasms;  Cyclooxygenase 2;  Diagnosis, Differential;  Female;  Humans;  Hyperplasia;  Image Processing, Computer-Assisted;  Immunohistochemistry;  Middle Aged;  Polycomb Repressive Complex 2;  Precancerous Conditions;  Retrospective Studies;  Tumor Markers, Biological;  Tumor Suppressor Protein p53
TODO - Background Cytological differential diagnosis of atypical hyperplasia and well differentiated breast carcinoma may be challenging, because sometimes there is an overlap between the cytomorphological features of these lesions. The aim of the study was to investigate COX-2, EZH-2, p53 expression in carcinomas and the gray zone of breast cytology categories of atypical hyperplastic lesions with regard to biological behavior of the tumor. Methods FNA speciments from 100 patients with breast hyperplastic lesions and cancer were investigated by immunocytochemistry and a quantitative analysis for COX-2, p53, and EZH-2. Results Extent of staining for COX-2 correlated with percentage of positive for EZH-2 (P-<-0.0001) and p53 nuclei (P-<-0.001). The intensity of COX-2 was lower in the carcinoma group (118.57-±-12.43) than in the hyperplastic (127.16-±-11.71) group (P-=-0.006). On the contrary the mean value of staining extent was greater in the adenocarcinoma cases (15.96-±-13.03) than in hyperplastic (4.04-±-1.94) cases (P-<-0.0001). The percentage of EZH-2 and p53 positive cells correlated with the histological type of the lesions (P-=-0.001 and P-=-0.011, respectively). There was also a statistically significant relation between tumor size and expression of COX-2 (P-=-0.007) and EZH-2 (P-=-0.010). Conclusion Our study showed that the expression of COX-2, EZH-2, and p53 as determined by immunocytochemistry at quantitative level may be a predictor for distinguishing cytologically atypical hyperplastic from malignant breast lesions and may be regarded as potential prognostic factor in breast cancer patients. © 2014 Wiley Periodicals, Inc.
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