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Published Online First: 10 February 2006. doi:10.1136/jcp.2005.030296
Journal of Clinical Pathology 2006;59:692-698
Copyright © 2006 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

ORIGINAL ARTICLE

Relationship of p53, Bcl-2, Ki-67 index and E-cadherin expression in early invasive breast cancers with comedonecrosis as an accelerated apoptosis

N Hosaka1, T Ryu2, W Cui2, Q Li2, A Nishida2, T Miyake2, T Takaki2, M Inaba2 and S Ikehara2

1 Department of Clinical Pathology, Toyooka Hospital, Toyooka, Hyogo, Japan
2 First Department of Pathology, Kansai Medical University, Moriguchi, Osaka, Japan

Correspondence to:
Correspondence to:
Dr Susumu Ikehara
First Department of Pathology, Kansai Medical University, 10–15 Fumizono-Cho, Moriguchi, Osaka 570-8506, Japan; ikehara{at}takii.kmu.ac.jp

Aims: To study the relationship between comedonecrosis formation and morphology, apoptosis, and p53, Bcl-2, Ki-67 index and E-cadherin expression in early invasive breast cancer.

Experimental design: Early invasive breast cancers were first divided into two groups according to the presence (CN+ tumours) or absence (CN– tumours) of comedonecrosis. The histological grade, apoptosis, and expression of E-cadherin, Ki-67, p53 and Bcl-2 in the cancer-affected area, and in normal ducts from the specimen, were then examined.

Results: Less tubule and gland formation was seen in CN+ tumours than in CN– tumours, although the histological grade between the groups was not different. During early comedonecrosis, cells undergo apoptosis and subsequent necrosis. p53 was higher in CN+ tumours than in CN– tumours and normal ducts, whereas Bcl-2 was lower in CN+ tumours than in CN– tumours and normal ducts. Both tumours had higher Ki-67 than in normal ducts, but no difference was evident between the tumours. CN+ tumours had slightly higher E-cadherin than that in CN– tumours, but lower than that in normal ducts. The level of comedonecrosis was positively correlated with p53, but inversely correlated with Bcl-2 in all tumours, and p53 and Bcl-2 were inversely correlated with each other. Furthermore, comedonecrosis and p53 were correlated with Ki-67 in CN+ tumours, and Bcl-2 was correlated with Ki-67 in CN– tumours.

Conclusion: Comedonecrosis may be actively regulated through an apoptotic procedure in massive cancers for their survival and progression, and the above proteins may be associated cooperatively in this process. CN+ and CN– tumours may have opposite proliferative systems under the p53–Bcl-2 pathway.

Abbreviations: HER2, human epidermal growth factor receptor 2; TUNEL, terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate-biotin nick end-labelling; ssDNA, single-strand DNA


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