The mean AgNOR values in relation to HER-2 neu overexpression in a series of Iraqi women with breast cancer

الملخص EN

organizer regions (AgNORs) in distinguishing HER-2 / neu positive from HER-2 / neu negative malignant breast lesions Methods : the present investigation was performed over a period starting from September 2007 to August 2008.

Formalin fixed, paraffin-embedded blocks from 90 patients with breast cancer were included in this study.

A group of 25 patients with benign breast lesions (fibro adenoma) was included as a comparative group.

Labeled Streptavidin-Biotin Complex (LSAB) method was employed for immunohistochemical detection of HER-2 / neu.

Standardized AgNORs analysis was performed on the above mentioned samples.

Results : the mean AgNOR values ± standard error of the ninety studied breast cancer cases were as follow : for invasive ductal carcinoma 6.4 ± 0.2, invasive lobular carcinoma 0.4 ± 2.8 IDC+DCIS 7.5±0.4, and for IDC+ Paget’s 8.1 ± 1.1.

There was significant difference of HER-2 / neu overexpression between ductal and lobular carcinoma and also Paget’s disease and the study improves significant HER-2 / neu overexpression in higher histological grades, paget's disease.

There was no significant difference between HER-2 / neu overexpression and stage of tumor.

The differences in mean AgNORs counts between benign and malignant cases was significant p < 0.05, also there was significant difference between mean AgNOR values of HER-2 / neu positive and negative ILC cases and IDC with DCIS cases respectively p value < 0.05 ,while there was no significant difference between mean AgNOR values of HER-2 / neu positive and negative IDC cases p > 0.05.Also there was significant difference between mean AgNOR values of HER-2 / neu positive and negative GIII cases p < 0.05 ; while well and moderately differentiated cases showed no significant difference between mean AgNOR values of HER-2 / neu positive and negative cases p > 0.05.

Regarding tumor stage there was significant difference between mean AgNOR values of HER-2 / neu positive and negative cases of stage II and III cases.

Conclusion : based upon the findings of this study, it can be concluded that the use of standardized AgNORs analysis may be regarded as an objective tool in distinction between those who are positive for HER-2 / neu from those negative for HER-2 / neu and thus its possible use in the future in developing countries like Iraq as a simple and cheap test that seem to have a significant impact on predicting aggressive behavior of breast cancer and hence in selecting patients that could benefit from Herceptest and its targeted therapy.