Hashmi Atif Ali, Naz Samreen, Hashmi Shumaila Kanwal, Hussain Zubaida Fida, Irfan Muhammad, Khan Erum Yousuf, Faridi Naveen, Khan Amir, Edhi Muhammad Muzzammil
1Liaquat National Hospital and Medical College, Karachi, Pakistan.
CMH Institute of Medical Sciences, Multan, Pakistan.
BMC Clin Pathol. 2018 Oct 3;18:9. doi: 10.1186/s12907-018-0077-0. eCollection 2018.
p16 and p53 genes are frequently mutated in triple negative breast cancer & prognostic value of these mutations have been shown; however, their role as immunohistochemical overexpression has not been fully validated. Therefore we aimed to evaluate the association of p16 and p53 overexpression in triple negative breast cancer with various prognostic parameters.
Total 150 cases of triple negative breast cancers were selected from records of pathology department archives that underwent surgeries at Liaquat National hospital, Karachi from January 2008 till December 2013. ER, PR and Her2neu immunohistochemistry were re-performed to confirm triple negative status. p16 & p53 immunohistochemistry was performed on all cases and association with various clinicopathologic parameters was determined.
Mean age of the patients involved in the study was 48.9 years. Most of the patients presented at stage T2 with a high mean ki67 index i.e. 46.9%. 42.7% of cases had nodal metastasis. Although 84% cases were of invasive ductal carcinoma; however a significant proportion of cases were of metaplastic histology (9.3%). Fifty-one percent (76 cases) of cases showed positive p53 expression while 49% (74 cases) were negative. Higher percentage of p53 expression was found to correlate with higher T stage, high ki67 index and higher nodal stage. On the other hand, strong intensity of p53 expression was positively correlated with higher tumor grade and ki67 index. Seventy-one percent (98 cases) of cases showed positive p16 expression, whereas 24.8% (34 cases) were negative and 3.6% (5 cases) showed focal positive p16 expression. However, no significant association was found between p16 expression and various clinical and pathologic parameters. Similarly, no significant association of either p16 or p53 over-expression was noted with recurrence status of patients.
On the basis of significant association of p53 over-expression with worse prognostic factors in triple negative breast cancer, therefore we suggest that more large scale studies are needed to validate this finding in loco-regional population. Moreover, high expression of p16 in triple negative breast cancer suggests a potential role of this biomarker in triple negative breast cancer pathogenesis which should be investigated with molecular based research in our population.
p16和p53基因在三阴性乳腺癌中经常发生突变，且这些突变的预后价值已得到证实；然而，它们作为免疫组化过表达的作用尚未得到充分验证。因此，我们旨在评估三阴性乳腺癌中p16和p53过表达与各种预后参数之间的关联。
从2008年1月至2013年12月在卡拉奇利亚卡特国家医院接受手术的病理科档案记录中选取150例三阴性乳腺癌病例。重新进行雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（Her2neu）免疫组化以确认三阴性状态。对所有病例进行p16和p53免疫组化，并确定其与各种临床病理参数的关联。
参与研究的患者平均年龄为48.9岁。大多数患者表现为T2期，平均Ki67指数较高，即46.9%。42.7%的病例有淋巴结转移。虽然84%的病例为浸润性导管癌；然而，相当一部分病例为化生组织学类型（9.3%）。51%（76例）的病例p53表达阳性，而49%（74例）为阴性。发现p53表达较高的百分比与较高的T分期、高Ki67指数和较高的淋巴结分期相关。另一方面，p53表达的高强度与较高的肿瘤分级和Ki67指数呈正相关。71%（98例）的病例p16表达阳性，而24.8%（34例）为阴性，3.6%（5例）表现为局灶性p16阳性表达。然而，未发现p16表达与各种临床和病理参数之间存在显著关联。同样，未观察到p16或p53过表达与患者复发状态之间存在显著关联。
基于p53过表达与三阴性乳腺癌预后较差因素之间的显著关联，因此我们建议需要更多大规模研究来在局部区域人群中验证这一发现。此外，三阴性乳腺癌中p16的高表达表明该生物标志物在三阴性乳腺癌发病机制中具有潜在作用？应通过我们人群中的分子研究进行调查。 ？此处原文似有遗漏表述
需注意，原文最后一句“which should be investigated with molecular based research in our population.”翻译时“which”指代不明，结合前文推测可能是说p16高表达在发病机制中的潜在作用需通过分子研究调查，但整体句子结构和指代关系在原文中不太清晰准确。译文尽量忠实于原文进行了翻译。
