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Donnish Journal of Medical Laboratory and Diagnosis

June 2015 Vol. 1(1), pp. 001-009

Copyright 2015 Donnish Journals




Original Research Paper


Immunohistochemical Evaluation of Triple Markers (ER, PR and HER-2/neu) in Carcinoma of the Breast in the North of Iraq.


Wahda Mohammed Taib Al-Nuaimy1*, Abeer Hashem Ahmed2 and Hatim Abd-AlMajeed Al-Nuaimy2

1Department of Pathology, College of Medicine, University of Mosul, Nineveh Province, Iraq.
2Unit of Histopathological Examination, Laboratory of Jumhuri Teaching Hospital, Nineveh Health Office, Nineveh Province, Iraq.

Corresponding Author E-mail: drwahda62@yahoo.com

Accepted 14th May, 2015.



Abstract


Objective: The aim of this study is to evaluate the patterns of expression of ER and PR and HER-2 /neu over expression in carcinoma of the breast in Nineveh Province (north of Iraq), to correlate the expression of the triple markers with other prognostic parameters and to compare the result of this study with those of others. Patient and Methods: A cross sectional study of 128 female breast cancers, were collected in Nineveh Province (north of Iraq), from Jan.2014 to Jan. 2015. The expression of the triple markers were assessed immunohistochemically on formalin fixed paraffin embedded tissue of tumor. The pattern of expression of the triple markers was divided into four groups. The results of these were correlated with age, tumor size, types and grade and lymph node status. Results: Each of hormonal receptors (ER and PR) were expressed in 63.3% of the cases, while HER-2/neu over expression was found in 18% of the cases. The pattern of expression of ER+, PR +and HER-2 /neu-ve was found in 56.3% of the cases. While the triple immunonegative pattern was observed in 25.8% of the cases. The mean age of patients with positive ER and PR expression was 57.4 years as opposed to 45.7 years among patients lacking hormonal expression. The mean age of patients with positive HER-2/neu was 48 years, which is 10 years younger than those who lack HER-2/neu over expression. The mean size of tumors expressing both ER and PR was 3.7 cm versus 5.2 cm for those lacking ER and PR expression. Tumors with strong HER-2/neu over expression tended to be larger than those lacking over expression, with mean sizes of 4.9 cm and 4.3cm respectively. An inverse relationship between hormonal receptors expression and the grading of the tumor. While there is a direct relationship between HER-2 over expression and the grading of the tumor. No statistical significant association was detected between both hormone receptors and HER-2 /neu positive cases on one hand and lymph node metastasis on the other hand. Conclusions: HER-2/neu over expression was found in 18% of breast carcinoma. This over expression is associated with young age at presentation, large tumor size, high histological grade and lack of ER and PR expression. In contrast, each of hormonal receptors (ER and PR) were expressed in 63.3% of the cases. The triple immunonegative pattern was observed in 25.8% of the cases. The pattern of expression of the triple markers was statistically significant correlate with histopathological typing, grading and lymph node status.

Keywords: Breast carcinoma, hormone receptors, HER-2/neu, triple markers, immunohistochemistry.

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Cite This Article:

Wahda Mohammed Taib Al-Nuaimy, Abeer Hashem Ahmed and Hatim Abd-AlMajeed Al-Nuaimy. Immunohistochemical Evaluation of Triple Markers (ER, PR and HER-2/neu) in Carcinoma of the Breast in the North of Iraq. Donnish Journal of Medical Laboratory and Diagnosis 1(1) 2015 pp. 001-009.


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