TITLE:
Prognostic Value of Lymphocyte Vascular Density and E-Cadherin in Inflammatory Breast Cancer
AUTHORS:
Paul H. Levine, Heather J. Hoffman, Audra MacNeil, Salman Hashmi, Sherry X. Yang, Stephen Hewitt, Kenneth L. van Golen, Sandra M. Swain
KEYWORDS:
IBC, Prognostic Markers, E-Cadherin, Lymphocyte Vascular Density
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.14,
December
3,
2014
ABSTRACT: Background: We recently evaluated four laboratory assays,
vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel
density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE),
which showed notable differences between inflammatory breast cancer (IBC) and
non-inflammatory locally advanced breast cancer (LABC). In this study we
investigated the potential of the three most quantitatively measured markers,
E-cadherin, LVD and VEGF-D, to predict survival in the IBC patients. Materials
and Methods: This study involved the 100 cases identified in the Inflammatory
Breast Cancer Registry (IBCR) whose tumors were previously evaluated for the
four assays noted above. Living patients were recontacted and survival data
were available for up to 17 years. Overall survival (OS) was analyzed through
the Kaplan-Meier method stratified by E-cadherin, LVD, VEGF-D, and response to
chemotherapy. The differences in OS curves were compared using the log-rank
test. Results: The median OS for patients with high LVD was 6.63 years (95% CI:
4.06 to 10.14), compared to median at 10 years not reached in those with low
LVD (p = 0.03). There was a trend towards a longer median OS in patients with
high E-cadherin (10.14, 95% CI: 6.63 to 11.67), compared with those with low
E-cadherin (6.26, 95% CI: 3.42 to undeterminable). VEGF-D levels showed no
correlation with survival. Conclusion: Low LVD significantly predicts better survival. High E-cadherin
expression, as with non-IBC breast cancer and several other malignancies, tends
to be associated with a better prognosis.