A Prospective study on Nottingham Prognostic Index and its correlation with Estrogen receptor, Progesterone receptor, HER2/neu and Ki-67 status in Breast Cancer

Mahitha, A (2021) A Prospective study on Nottingham Prognostic Index and its correlation with Estrogen receptor, Progesterone receptor, HER2/neu and Ki-67 status in Breast Cancer. Masters thesis, Thanjavur Medical College, Thanjavur.

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Abstract

INTRODUCTION: Breast cancer is now the most common cancer in Indian women having recently overtaken cervical cancer in this respect. According to health ministry of India, breast cancer ranks as the number one cancer in Indian females with rate as high as 25.8 per 1,00,000 women and mortality of 12.7 per 1,00,000 women. Prognosis and treatment of patients with breast carcinoma of no special type is dependent on a few established parameters like tumour size, histological grade, lymph node status, expression of estrogen receptor, progesterone receptor, HER-2/neu and proliferative index (Ki-67). The Nottingham prognostic index (NPI) employs a three-tiered classification system that stratifies patients with breast cancer into good, moderate and poor prognostic groups. The aim of our study is to use immunohistochemical markers like ER, PR, HER-2/neu and Ki-67 and to correlate differences in the expression of these markers when patients are stratified according to the Nottingham prognostic index. AIM OF THE STUDY: 1.To classify IDC-NOS type of breast cancer patients into three prognostic groups according to Nottingham prognostic index. 2.To correlate the differences in expression of ER, PR, HER-2/neu and Ki-67 in all the three prognostic groups of breast cancer patients. STUDY PERIOD: 2017-2020. MATERIALS AND METHODS: Paraffin blocks from 100 female patients treated with modified radical mastectomy and axillary dissection, diagnosed as invasive breast carcinoma NOS were collected from the Department of Pathology archive. These patients were graded according to Nottingham modification of Scarff-Bloom-Richardson grading system and NPI was calculated with the data available. Patients were classified into 3 prognostic groups (good, moderate and poor) using the NPI. The samples were stained for immunohistochemical markers (ER, PR, HER-2/neu, Ki-67) and the differences in expression of these markers were observed in all the three prognostic groups of breast cancer patients. RESULT: In this study, including 100 cases of IDC(NOS) majority of cases were of histologic grade 2 and majority were in the moderate prognosis group of NPI. A significant correlation of NPI prognostic groups with histologic grade, tumour size and lymph node metastasis were observed. Cases under good prognostic group were found to be associated with increased ER and PR positivity, conversely moderate and poor prognosis groups were associated with increased ER and PR negativity. It was observed that HER-2/neu expression increases with increasing NPI categories. Low Ki-67 index was significantly associated with good prognosis group, whereas moderate and poor prognosis groups were associated with increasing Ki-67 index. CONCLUSION: This study confirms that the original 3-tiered Nottingham Prognostic Index (NPI) correlates with the expression of prognostic IHC markers in invasive breast carcinoma (NOS).

Item Type: Thesis (Masters)
Additional Information: 201813202
Uncontrolled Keywords: IDC(NOS), breast carcinoma, NPI, Nottingham prognostic index, ER, PR, Her-2/neu, Ki-67.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 16 May 2021 17:50
Last Modified: 09 Jan 2022 13:41
URI: http://repository-tnmgrmu.ac.in/id/eprint/16837

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