Prognostic significance of the estrogen-regulated protein, cathepsin D, in breast cancer. An immunohistochemical study

Authors:
  • BAB. Angus
    B. Angus
  • BWB. R. Westley
    B. R. Westley
  • FMFelicity E. B. May
    Felicity E. B. May
  • SNS. Nicholson
    S. Nicholson
  • JCJ. Cairns
    J. Cairns
  • CHC. H. W. Horne
    C. H. W. Horne
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Abstract
Expression of the estrogen‐regulated lysosomal protease, cathepsin D, was studied in a series of 94 breast cancers using an immunohistochemical technique. Granular staining of tumor cell cytoplasm was detected in 62 cases. Positive staining was associated with a significant increase in overall time to relapse and when survival was analyzed in terms of intensity of cathepsin D staining there was a significant trend for both increased time to relapse and increased length of survival. The presence of estrogen receptor was associated with positive cathepsin D immunostaining, and in the subgroup of estrogen receptor‐positive tumors cathepsin D staining was associated with significantly prolonged survival; this was not the case for estrogen receptor‐negative tumors. Positive cathepsin D immunostaining was associated with significant prognostic advantage in patients with confirmed lymph node metastasis but not in node‐negative patients. It is suggested that cathepsin D expression reflects the functional integrity of the estrogen response pathway. Cathepsin D may prove a clinically useful adjunct to assessment of estrogen receptor status.

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