The Effect of P-Glycoprotein (P-gp), Nuclear Factor-Kappa B (Nf-κb), and Aldehyde Dehydrogenase-1 (ALDH-1) Expression on Metastases, Recurrence and Survival in Advanced Breast Cancer Patients

摘要

Objective: To investigate the level of three drug resistance proteins; P-glycoprotein 1 (P-gp), nuclear factorkappa-light-chain-enhancer of activated B cells (NF-κB) and aldehyde dehydrogenase isoform 1 (ALDH1) expressionand their relationship to metastasis, recurrence and survival in advanced breast cancer patients that received neoadjuvantchemotherapy. Methods: This study is a combination of prospective and retrospective cohort study involving onehundred and thirty one cases of advanced stage invasive breast cancer that have received neoadjuvant chemotherapy.Initial biopsy specimens (incisional biopsy or core biopsy) were taken from paraffin blocks. Immunohistochemistry(IHC) was used to detect P-gp, NF-κB, and ALDH1 expression. Prospectively analysed patients were followed for fiveyears and evaluated for recurrence and death. Results: The expression of P-gp has no significant statistical correlationto metastases (p = 0.659), recurrence (p = 0.862) and survival (p = 0.835) in advanced stage breast cancer patientswho received neoadjuvant chemotherapy. Similarly, ALDH1 was not correlated to metastases (p=0.120), recurrence(p = 0.186) and survival (p = 0.254) statistically. We found that NF-κB expression showed a significant correlation tometastases (p=0.004), recurrence (p = 0.016) and overall survival (p = 0.041) in advanced stage breast cancer patientsafter neoadjuvant chemotherapy. Conclusion: NF-κB expression is a potential marker that can be used to assess orto predict increasing risk of metastases, recurrence and survival in advanced stage breast cancer patients who receiveneoadjuvant chemotherapy.