الفهرس 
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Abstract
BC is the furthermost common malignancy generally among females worldwide, and particularly in Middle East. As BC is the primary cause of death among women, finding a reliable diagnosis tool to manage successfully the disease is crucial.
In addition to histopathology, a limited number of biomarkers can be used to support the diagnosis such as paired related homeobox 1 (PRRX1), and tumor suppressor protein (p53) immune-expressions
P53 is one of the furthermost frequently mutated genes in human malignances and it is involved in tumor metastasis in addition to tumor evolution. It plays a crucial role in the cellular response to numerous stresses comprising DNA destruction besides induction of apoptosis. Increased p53 expression is associated with p53 gene mutation on a molecular level and that p53 is involved in tumor metastasis in addition to tumor progress
PRRX1 is a member of the paired-type family of homeobox transcription factors, which have essential roles in the regulation of developing morphogenetic processes. Its expression is linked with cell immigration and invasion throughout BC progression.
The current research aimed to evaluate immunohistochemical expression of PRRX1 gene in association with tumor suppressor protein P53 in malignant breast cancer tissue to assess the prognostic significance of divergent PRRX1 expression as pro-invasive molecular marker.
For achieving this aim, sixty breast tissue samples were the subjects of this study and comprised 20 normal breast tissue samples adjacent to the malignant tissue, 20 benign tumor samples and 20 malignant tumor breast tissue samples. Histopathological, and immunohistochemical studies of P53 and PRRX1 along with clinicopathological parameters (age, tumor size, pathological type, hormonal status and vascular invasions).
Histopathological results: The present findings displayed that all benign cases were diagnosed as fibroadenoma, while the bulk of the malignant cases was identified as IDC of GII in addition to 95% of malignant group accompanied with positive vascular invasion.
The results showed ordinary breast architecture in normal breast sections stained with H&E. Benign breast sections exhibited breast parenchyma with breast ducts of tubular or dilated shape separated by fibrous stroma. Sections of ductal carcinoma in situ revealed focal heavy lymphocytic infiltration with follicle formation. Trabeculae and nests of malignant ductal cells having pleomorphic vesicular nuclei of malignant ductal cells tumor breast tissue sections of IDC grade II. Abundant fibroblastic stroma and dispersed lymphocytic infiltration adding to focal areas of necrosis were seen in sections of invasive ductal carcinoma grade III.
Immunohistochemical and Image Analysis Results:
Immunostaining of P53:
The current results showed P53 immunostaining reaction was confined chiefly to the nuclei and occasionally to the cytoplasm as brown color with positivity ranged from weak,
moderate and strong. Malignant breast tissues revealed p53 immunoreaction positivity in all studied cases (80% grade II and 20 % grade III). Image analysis for area % for P53 protein displayed significantly difference in malignant grade III comparing with benign breast tissue and no significant different as compared with grade II
Immunostaining of PRRX1:
Immunostaining expression of PRRX1 displayed a positive immunoreaction in breast sections in 30% and 40% of cases from control and benign breast tissues respectively. Sections of breast carcinoma specimens in 60% of grade II and 10% of grade III exhibited positivity of PRRX1 immunoreaction ranged from weak, moderate and strong. By image analysis, area percentage of immunostaining positivity of PRRX1 protein in malignant grade II showed significant difference in comparison with grade III and highly significant difference when compared with benign tissue.