EndoPredict versus uPA/PAI‐1 in breast cancer: Comparison of markers and association with clinicopathological parameters

Abstract

We retrospectively investigated concordance of EndoPredict (EPclin) with urokinase plasminogen activator and plasminogen activator inhibitor-1 (uPA/PAI-1) in 72 breast cancer patients and compared the results with grading, molecular subtype and chemotherapy recommendation. Compared to uPA/PAI-1, EPclin proved to be more conservative concerning correlation with clinicopathological parameters and was significantly associated with the recommendation of adjuvant chemotherapy. K E Y W O R D S breast cancer, prognosis, proteases | 451 JAKUBOWICZ et Al. was 57.5 years. The patients were submitted to lumpectomy or mastectomy in Augsburg at the Klinikum Augsburg, Josefinum Hospital or Diakonissen Hospital between the year 2011 and 2016. The information about chemotherapy was attained from the medical records of interdisciplinary tumor conference reports of Klinikum Augsburg or from the clinical and population-based cancer registry Augsburg. Recommendation concerning adjuvant chemotherapy was correlated with uPA/PAI-1 and EPclin results. The uPA/PAI-1 testing was performed in Klinikum Augsburg. Representative tumor tissue was obtained according to protocol as a part of routine gross pathology examination. The sample was submitted for evaluation with the use of commercial enzyme-linked immune sorbent assay (ELISA) test (Femtelle Test (EF 899), Sekisui Diagnostics, Stamford, CT). The test was conducted according to the manufacturer's protocol as described before. 9 The levels of uPA and PAI-1 were expressed in nanograms per milligram (ng/mg) of tumor protein. The cut-off-level for uPA and PAI-1 were 3 ng/mg protein and 14 ng/mg protein respectively. The specimen was preserved in 10% formaldehyde and processed into FFPE tissue, sectioned and stained with hematoxylinand-eosin (HE). For immunohistochemical analysis, paraffin sections measuring approximately 3 μm were processed in streptavidin-biotin-peroxidase and incubated with estrogen, progesterone, ki67, How to cite this article: Jakubowicz E, Martin B, Hoffmann R, et al. EndoPredict versus uPA/PAI-1 in breast cancer: Comparison of markers and association with clinicopathological parameters. Breast J. 2019;25:450-454.

Impact of uPA/PAI-1 and disseminated cytokeratin-positive cells in breast cancer

“…Despite this, the adherence to adjuvant chemotherapy in cases of elevated proteinases was low, with approximately 25% cases without adjuvant therapy in the high-risk groups (Table 1). Recently, we and others evaluated the effect of proteinases and multigene-assay testing on therapy decisions and concordantly found a lower impact of proteinase testing [17, 18]. We have no data elucidating the reason for that.…”