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Elevated levels of tumour apolipoprotein D independently predict poor outcome in breast cancer patients


AIMS: Apolipoprotein D (ApoD) is a protein that is regulated by androgen and oestrogen, and is a major constituent of breast cysts. Although ApoD has been reported to be a marker of breast cancer, its prognostic importance in invasive breast cancer is unclear. The aim of this study was to investigate the relationship between ApoD protein expression, oestrogen receptor-alpha (ERalpha) expression and androgen receptor (AR) expression in predicting breast cancer outcome. METHODS AND RESULTS: ApoD levels were measured by the use of immunohistochemistry and video image analysis on tissue sections from a breast cancer cohort (n = 214). We assessed the associations of ApoD expression with disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS). We also assessed the relationship between ApoD expression, AR expression and ERalpha expression in predicting OS. ApoD expression (>1% ApoD positivity) was found in 72% (154/214) of tissues. High ApoD positivity (>/=20.7%, fourth quartile) was an independent predictor of MFS and OS, and conferred a 2.2-fold increased risk of developing metastatic disease and a 2.1-fold increased risk of breast cancer-related death. ApoD positivity was not associated with AR or ERalpha nuclear positivity. However, patients with (>/=1%) ERalpha-positive cancers with low (<20.7%) ApoD positivity, or those showing high (>/=78%) AR positivity and low (<20.7%) ApoD positivity had better OS than other patient groups. CONCLUSIONS: ApoD expression could be used to predict breast cancer prognosis independently of ERalpha and AR expression.

Type Journal
ISBN 1365-2559 (Electronic) 0309-0167 (Linking)
Authors Jankovic-Karasoulos, T.; Bianco-Miotto, T.; Butler, M. S.; Butler, L. M.; McNeil, C. M.; O'Toole, S. A.; Millar, E. K. A.; Sakko, A. J.; Ruiz, A. I.; Birrell, S. N.; Sutherland, R. L.; Hickey, T. E.; Tilley, W. D.; Ricciardelli, C.
Responsible Garvan Author Prof Sandra O'Toole
Published Date 2020-06-30
Published Volume 76
Published Issue 7
Published Pages 976-987
Status Published in-print
DOI 10.1111/his.14081
URL link to publisher's version