الفهرس 
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Abstract
Breast cancer is a major concern and one of the leading causes of cancer related
death world wide. in Egypt breast cancer came as number one in rankings of
malignant tumors 17.5% of total malignancies in both sexes.
The aim of this study was to evaluate the immunohistoc hemical expression of
PARP1 study in breast carcinoma in Egyptian women, and identifying its
prognostic and predictive significance.
The material of this consisited of archival paraffin blocks of 84 specimens of
breast carcinoma . They are composed of 94% of no special type (IDC, NST) .
only 6 cases were lobular carcinoma. The majority of the cases were found to have
grade II (74%), while grade I tumors represented only (13%).
Histologic type, tumor grade, tumor stage, stroma, LVI, spontaneous tumor
necrosis, mitotic and apoptotic countwere assessed in H&E stained sections.
Moreever ER, PR, Her2/neu status were assessed in immunohistochemical stained
sections. Then all caese investigated for PARP1 expression.
Regarding to hormonal and Her2/neu of studied malignant cases; more than
half of the cases were estrogen receptor positive (60%) and progesterone positive
(56 %), Most of the cases were Her2/neu negative (87%).
Regarding immunophenotyping classification of the tumors, the luminal
type constituted most of the cases (65%), while the triple negative constituted
(27%), and HER2 group represented the least one ( 9%).
Using the Quick score in the evaluation of n PARP1 in malignant cells of
pre-treatment cores, our results were: (48%) of the cases obtained high n
PARP1, (52%) obtained a low n PARP1. The majority of the cases were
positive in cytoplasm (79 %) .
The available adjacent normal breast ductal and lobular epithelial cells
exhibited diffuse and weak PARP1 staining in the nuclei and cytoplasm .Also
PARP1 was expressed in (80%) of the available adjacent CIS cases. No
significant staining was observed in fibroblasts, endothelial cells, although
significant staining was found in some lymphocytes.
Nuclear PARP1 expression was significantly associated with a higher
mitotic count (P= 0.009), and apoptotic count (P=0.04).
A near significant association between n PARP1 and Her2/neu positive cases
was detected (P=0.07). Also there was a tendency of 60% of non luminal
cases to have high n PARP1 expression, but this association did not reach
statistical significance (P=007).
Cytoplasmic pattern of PARP1 was significantly associated with absence
of necrosis (P=0.03) (Table 11).Also there was a near significant association
with tumor size (P=0.06), and LN involvement (P=0.09).
According to Miller-Payne grading system: 55% of tumors with
complete pathologic response exhibited high n PARP1. Also all of tumors with
complete pathologic response exhibited positive c PARP1 ( 100%), but these
results did not reach statistical significance.
According to Sataloff system, around half of post-treatment LN with
complete pathologic response obtained low n PARP1 expression (58%), and
majority of LN with complete response obtained positive c PARP1(79%)
However, this did not achieve statistical significance.
Regarding overall survival (OS), in the univariate Kaplan-Meier analysis, PR
negative status (P=0.02), and triple negative tumors (P=0.004) had statistically
significant association with longer overall survival.
Regarding disease free survival (DFS), the univariate Kaplan-Meier analysis
revealed that absence of LVI (P=0.04), and lower tumor grade (P=0.03) were
associated with better DFS rate..