Cathepsin D expression detected by immunohistochemistry has independent prognostic value in axillary node-negative breast cancer.

Abstract

These results indicate that CD expression determined by immunohistochemistry is a powerful prognostic factor in ANN breast cancer. The most significant prognostic information was obtained when CD expression (predicting metastatic activity) was combined with estimate of cell-proliferation rate (S-phase fraction).

Relationship between cathepsin-D content and disease-free survival in node-negative breast cancer patients: a meta-analysis

“…One advantage of the meta-analytical approach is that it enables the circumvention of the lack of statistical power as a result of the relatively small sample size of many studies. The choice to carry out this meta-analysis on the prognostic role of cathepsin-D in nodenegative breast cancer patients stems from the following reasons: (1) evidence has been reported about the direct relationship of cathepsin-D with tumour cell invasiveness and metastatic behaviour (Garcia et al, 1990;Pujol et al, 1993;Winstanley et al, 1993;Gion et al, 1995); (2) cathepsin-D has been included among the biological factors potentially useful for discrimination between high-and lowrisk patients to avoid adjuvant overtreatment in the latter group (Bevilacqua et al, 1994); (3) although the negative prognostic role of high cathepsin-D levels in node-negative breast cancer patients has been demonstrated by several authors (Spyratos et al, 1989;Thorpe et al, 1989;Tandon et al, 1990;Kute et al, 1992;Isola et al, 1993), conflicting results have also been reported (Namer et al, 1991;Kandalaft et al, 1993;Janicke et al, 1993;Pujol et al, 1993). Our study demonstrated that elevated cathepsin-D values identify nodenegative breast cancer patients characterized by unfavourable prognosis in terms of disease-free survival.…”

“…In particular, it has been found that stromal and macrophage-like cells are cathepsin-D positively immunostained in approximately 35% of cases defined as negative according to tumour cell immunoreactions irrespective of the use of monoclonal (Isola et al, 1993) or polyclonal (Domagala et al, 1992) antibodies. However, Roger et al (1994) reported that cytosolic cathepsin-D levels correlated with cathepsin-D expression in cancer cells, and several studies agree with the finding that cathepsin-D contents in stromal and cancer cells are directly correlated (Isola et al, 1993;Eng Tan et al, 1994;Ravdin et al, 1994).…”

“…On the other hand, results obtained by immunohistochemistry showed the highest degree of heterogeneity, probably because of differences in the antibodies used and in cathepsin D positivity criteria (see Table 2); some studies demonstrated the adverse prognostic role of tumour cell cathepsin-D content (Isola et al, 1993;Winstanley et al, 1993;Roger et al, 1994), while others failed to find any relationship between tumour cell cathepsin-D expression and clinical outcome (Domagala et al, 1992;Kandalaft et al, 1993;Armas et al, 1994) and only one ) showed a favourable impact of tumour cell cathepsin-D on prognosis. Ravdin et al (1994) suggested that cathepsin-D assessment by Western blot should not be routinely used for the prognostic characterization of breast cancer patients.…”

“…However, at present, the clinical usefulness of cathepsin-D measurement remains controversial; evidence has been reported that high cathepsin-D levels are associated with an unfavourable prognosis in node-negative breast cancer patients (Spyratos et al, 1989;Thorpe et al, 1989;Tandon et al, 1990;Kute et al, 1992;Isola et al, 1993), but some authors failed to find any relationship between cathepsin-D and clinical outcome (Namer et al, 1991;Kandalaft et al, 1993;Janicke et al, 1993;Pujol et al, 1993).…”

Prognostic value of cathepsin D expression and association with histomorphological subtypes in breast cancer

“…Winstanley et al ( 1993) showed a prognostic difference in patients, depending on node-positive or node-negative status. Another study analysed cathepsin D tumour expression in node-negative cases and found a significantly poorer prognosis regarding relapse-free and overall survival in patients with cathepsin D-expressing tumours (Isola et al, 1993). Kandalaft et al (1993) investigated cathepsin D tumour expression in both node-positive and -negative patients and found only a trend to poor prognosis for overall survival in node-positive cases.…”