Determination of GP88 (progranulin) expression in breast tumor biopsies improves the risk predictive value of the Nottingham Prognostic Index

Ginette Serrero; Douglas M. Hawkins; Pablo A. Bejarano; Olga Ioffe; Katherine R. Tkaczuk; Robert E. Elliott; Jonathan F. Head; Jeffrey Phillips; Andrew K. Godwin; Jo Ellen Weaver; David Hicks; Binbin Yue

doi:10.1186/s13000-016-0520-4

Determination of GP88 (progranulin) expression in breast tumor biopsies improves the risk predictive value of the Nottingham Prognostic Index

Ginette Serrero, Douglas M. Hawkins, Pablo A. Bejarano, Olga Ioffe, Katherine R. Tkaczuk, Robert E. Elliott, Jonathan F. Head, Jeffrey Phillips, Andrew K. Godwin, Jo Ellen Weaver, David Hicks, Binbin Yue

Statistics (Twin Cities)

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Abstract

Background: The Nottingham Prognostic Index (NPI), which combines numerical values for nodal status, tumor size and histological grade, is used in the standard of care to provide predictive value information on post-surgery survival for patients with primary breast cancer. Attempts to improve the performance of the NPI algorithm have been carried out by testing the inclusion of other biomarker expression and morphological features such as vascular invasion. In the present study, we investigated whether expression of the autocrine growth and survival factor GP88 (progranulin), known to be overexpressed in breast cancer, would improve NPI's predictive value. Methods: We examined by immunohistochemistry (IHC) the GP88 expression in 508 cases of estrogen receptor positive invasive ductal carcinoma with known clinical outcomes and for which NPI had been determined. GP88 IHC expression was scored by two board certified pathologists and classified into two score groups of GP88 <3+ (0, 1+, 2+) and GP88=3+. The correlation between GP88 scoring, NPI and disease-free (DFS) or overall survival (OS) outcomes was then examined by Kaplan-Meier analysis, Cox proportional Hazard (CPH) ratio and Pearson's X ² test. Results: Kaplan-Meier survival graphs of cases categorized by their NPI scores (<3.4, 3.4-5.4, >5.4) and GP88 expression showed that for patients within the same NPI subgroup, patients having tumors with a high GP88 expression (GP88 IHC score of 3+) had a worse DFS than patients with tumors that had a low GP88 expression (GP88 IHC score <3+). When adjusted for NPI, high GP88 score was significantly associated with recurrence with a hazard ratio of 3.30 (95% CI 2.12 to 5.14). Conclusions: The data suggest that the determination of GP88 tumor expression at time of diagnosis for early stage breast cancer patients can provide additional survival information to that provided by NPI alone and thus may be useful for risk management of patients diagnosed with breast cancer.

Original language	English (US)
Article number	71
Journal	Diagnostic Pathology
Volume	11
Issue number	1
DOIs	https://doi.org/10.1186/s13000-016-0520-4
State	Published - Aug 8 2016

Bibliographical note

Funding Information:
The study was supported by grants R43CA124179, and U01CA113916 from the National Cancer Institute and 07-2007-064 from the Avon Foundation.

Publisher Copyright:
© 2016 The Author(s).

Keywords

Biomarker
Breast Cancer
GP88
Immunohistochemistry
Nottingham Prognostic Index
Prognostic
Progranulin

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Serrero, G., Hawkins, D. M., Bejarano, P. A., Ioffe, O., Tkaczuk, K. R., Elliott, R. E., Head, J. F., Phillips, J., Godwin, A. K., Weaver, J. E., Hicks, D., & Yue, B. (2016). Determination of GP88 (progranulin) expression in breast tumor biopsies improves the risk predictive value of the Nottingham Prognostic Index. Diagnostic Pathology, 11(1), Article 71. https://doi.org/10.1186/s13000-016-0520-4

Serrero, G, Hawkins, DM, Bejarano, PA, Ioffe, O, Tkaczuk, KR, Elliott, RE, Head, JF, Phillips, J, Godwin, AK, Weaver, JE, Hicks, D & Yue, B 2016, 'Determination of GP88 (progranulin) expression in breast tumor biopsies improves the risk predictive value of the Nottingham Prognostic Index', Diagnostic Pathology, vol. 11, no. 1, 71. https://doi.org/10.1186/s13000-016-0520-4

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abstract = "Background: The Nottingham Prognostic Index (NPI), which combines numerical values for nodal status, tumor size and histological grade, is used in the standard of care to provide predictive value information on post-surgery survival for patients with primary breast cancer. Attempts to improve the performance of the NPI algorithm have been carried out by testing the inclusion of other biomarker expression and morphological features such as vascular invasion. In the present study, we investigated whether expression of the autocrine growth and survival factor GP88 (progranulin), known to be overexpressed in breast cancer, would improve NPI's predictive value. Methods: We examined by immunohistochemistry (IHC) the GP88 expression in 508 cases of estrogen receptor positive invasive ductal carcinoma with known clinical outcomes and for which NPI had been determined. GP88 IHC expression was scored by two board certified pathologists and classified into two score groups of GP88 <3+ (0, 1+, 2+) and GP88=3+. The correlation between GP88 scoring, NPI and disease-free (DFS) or overall survival (OS) outcomes was then examined by Kaplan-Meier analysis, Cox proportional Hazard (CPH) ratio and Pearson's X 2 test. Results: Kaplan-Meier survival graphs of cases categorized by their NPI scores (<3.4, 3.4-5.4, >5.4) and GP88 expression showed that for patients within the same NPI subgroup, patients having tumors with a high GP88 expression (GP88 IHC score of 3+) had a worse DFS than patients with tumors that had a low GP88 expression (GP88 IHC score <3+). When adjusted for NPI, high GP88 score was significantly associated with recurrence with a hazard ratio of 3.30 (95% CI 2.12 to 5.14). Conclusions: The data suggest that the determination of GP88 tumor expression at time of diagnosis for early stage breast cancer patients can provide additional survival information to that provided by NPI alone and thus may be useful for risk management of patients diagnosed with breast cancer.",

keywords = "Biomarker, Breast Cancer, GP88, Immunohistochemistry, Nottingham Prognostic Index, Prognostic, Progranulin",

author = "Ginette Serrero and Hawkins, {Douglas M.} and Bejarano, {Pablo A.} and Olga Ioffe and Tkaczuk, {Katherine R.} and Elliott, {Robert E.} and Head, {Jonathan F.} and Jeffrey Phillips and Godwin, {Andrew K.} and Weaver, {Jo Ellen} and David Hicks and Binbin Yue",

note = "Funding Information: The study was supported by grants R43CA124179, and U01CA113916 from the National Cancer Institute and 07-2007-064 from the Avon Foundation. Publisher Copyright: {\textcopyright} 2016 The Author(s).",

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AU - Hawkins, Douglas M.

AU - Bejarano, Pablo A.

AU - Ioffe, Olga

AU - Tkaczuk, Katherine R.

AU - Elliott, Robert E.

AU - Head, Jonathan F.

AU - Phillips, Jeffrey

AU - Godwin, Andrew K.

AU - Weaver, Jo Ellen

AU - Hicks, David

AU - Yue, Binbin

N1 - Funding Information: The study was supported by grants R43CA124179, and U01CA113916 from the National Cancer Institute and 07-2007-064 from the Avon Foundation. Publisher Copyright: © 2016 The Author(s).

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Y1 - 2016/8/8

N2 - Background: The Nottingham Prognostic Index (NPI), which combines numerical values for nodal status, tumor size and histological grade, is used in the standard of care to provide predictive value information on post-surgery survival for patients with primary breast cancer. Attempts to improve the performance of the NPI algorithm have been carried out by testing the inclusion of other biomarker expression and morphological features such as vascular invasion. In the present study, we investigated whether expression of the autocrine growth and survival factor GP88 (progranulin), known to be overexpressed in breast cancer, would improve NPI's predictive value. Methods: We examined by immunohistochemistry (IHC) the GP88 expression in 508 cases of estrogen receptor positive invasive ductal carcinoma with known clinical outcomes and for which NPI had been determined. GP88 IHC expression was scored by two board certified pathologists and classified into two score groups of GP88 <3+ (0, 1+, 2+) and GP88=3+. The correlation between GP88 scoring, NPI and disease-free (DFS) or overall survival (OS) outcomes was then examined by Kaplan-Meier analysis, Cox proportional Hazard (CPH) ratio and Pearson's X 2 test. Results: Kaplan-Meier survival graphs of cases categorized by their NPI scores (<3.4, 3.4-5.4, >5.4) and GP88 expression showed that for patients within the same NPI subgroup, patients having tumors with a high GP88 expression (GP88 IHC score of 3+) had a worse DFS than patients with tumors that had a low GP88 expression (GP88 IHC score <3+). When adjusted for NPI, high GP88 score was significantly associated with recurrence with a hazard ratio of 3.30 (95% CI 2.12 to 5.14). Conclusions: The data suggest that the determination of GP88 tumor expression at time of diagnosis for early stage breast cancer patients can provide additional survival information to that provided by NPI alone and thus may be useful for risk management of patients diagnosed with breast cancer.

AB - Background: The Nottingham Prognostic Index (NPI), which combines numerical values for nodal status, tumor size and histological grade, is used in the standard of care to provide predictive value information on post-surgery survival for patients with primary breast cancer. Attempts to improve the performance of the NPI algorithm have been carried out by testing the inclusion of other biomarker expression and morphological features such as vascular invasion. In the present study, we investigated whether expression of the autocrine growth and survival factor GP88 (progranulin), known to be overexpressed in breast cancer, would improve NPI's predictive value. Methods: We examined by immunohistochemistry (IHC) the GP88 expression in 508 cases of estrogen receptor positive invasive ductal carcinoma with known clinical outcomes and for which NPI had been determined. GP88 IHC expression was scored by two board certified pathologists and classified into two score groups of GP88 <3+ (0, 1+, 2+) and GP88=3+. The correlation between GP88 scoring, NPI and disease-free (DFS) or overall survival (OS) outcomes was then examined by Kaplan-Meier analysis, Cox proportional Hazard (CPH) ratio and Pearson's X 2 test. Results: Kaplan-Meier survival graphs of cases categorized by their NPI scores (<3.4, 3.4-5.4, >5.4) and GP88 expression showed that for patients within the same NPI subgroup, patients having tumors with a high GP88 expression (GP88 IHC score of 3+) had a worse DFS than patients with tumors that had a low GP88 expression (GP88 IHC score <3+). When adjusted for NPI, high GP88 score was significantly associated with recurrence with a hazard ratio of 3.30 (95% CI 2.12 to 5.14). Conclusions: The data suggest that the determination of GP88 tumor expression at time of diagnosis for early stage breast cancer patients can provide additional survival information to that provided by NPI alone and thus may be useful for risk management of patients diagnosed with breast cancer.

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KW - Nottingham Prognostic Index

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KW - Progranulin

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Determination of GP88 (progranulin) expression in breast tumor biopsies improves the risk predictive value of the Nottingham Prognostic Index

Abstract

Bibliographical note

Keywords

UN SDGs

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