Original Article
Mod Pathol 2002;15(11):1154–1161
Stromelysin-3 Protein Expression in Invasive Breast Cancer: Relation to Proliferation, Cell Survival and Patients' Outcome
Lydia Nakopoulou M.D.1, Effie G Panayotopoulou B.Sc.1, Ioanna Giannopoulou B.Sc.1, Paraskevi Alexandrou1, Sophia Katsarou1, Pauline Athanassiadou M.D.1 and Antonios Keramopoulos M.D.1
1Department of Pathology, Medical School, The National and Kapodistrian University of Athens, and Department of Pathology, "Alexandra's Hospital," Athens, Greece
Correspondence: Lydia Nakopoulou, Associate Professor in Pathology, Department of Pathology, Medical School, The National and Kapodistrian University of Athens, 75 Mikras Assias Str., Goudi, GR-11527, Athens, Greece. e-mail: lnakopou@cc.uoa.gr; fax: 0030-10-7462157
Accepted 4 September 2002.
Abstract
Matrix metalloproteinases constitute one of the major extracellular matrix degrading enzymic families implicated in cancer development. Stromelysin-3 in particular, a member of the matrix metalloproteinases belonging to the stromelysins' subgroup, seems to be closely related to invasiveness and tumor progression. In this study, we proceeded to the evaluation of stromelysin-3 protein's expression in paraffin sections of 133 cases of invasive breast carcinomas and statistically estimated its relations with known clinicopathological prognostic parameters and patients' survival, proliferation markers Ki-67 and TopoII
and the antiapoptotic protein bcl-2. Presence of stromelysin-3 was immunodetected, in the 73% of our cases, in stromal cells (65%) and in epithelial tumor cells (26.26%). Stromelysin-3 epithelial positivity presented statistically significant correlations with TopoII
and Ki-67 proliferation indices (P = .042 and P = .031, respectively) and worse disease outcome through multivariate statistics (P = .014). Stromelysin-3 fibroblastic expression was significantly associated with nuclear grade (P = .024), ductal histological type (P = .037), TopoII
(P = .001) and Ki-67 (P = .019), inversely with bcl-2 protein (P = .027) and with adverse overall survival through univariate analysis (P = .017). The subgroup of patients with stromelysin-3 co-expression in stromal and malignant epithelial cells showed statistically significant associations with Ki-67 and TopoII
(P = .019, P < .0001, respectively), an inverse one with bcl-2 protein (P = .027) and furthermore with impaired survival (P = .002) through multivariate analysis. In conclusion, stromelysin-3 protein expression correlated with proliferation indices TopoII
and Ki-67 and the anti-apoptotic protein bcl-2, data confirming stromelysin-3's contribution to breast cancer progression. Moreover its expression was shown to have a direct negative effect on patients' survival, especially in the subgroup of patients with simultaneous epithelial and stromal expression.
Keywords:
Breast cancer, Immunohistochemistry, Prognosis, Stromelysin-3

