title: Expression and clinical significance of apolipoprotein D in male breast cancer and gynaecomastia.
abstract: BACKGROUND
  Apolipoprotein D (Apo D) is a protein component of the human plasma lipid transport system which is present in benign and malignant human breast tissues. This study analysed the expression of Apo D in men with gynaecomastia or breast cancer, and evaluated its use as a prognostic marker in breast cancer.
  
  
  METHODS
  Immunohistochemical expression of Apo D was examined in specimens from 15 men with gynaecomastia, two with in situ breast carcinoma and 68 with invasive male breast cancer. Median follow-up in patients with breast cancer was 44 months.
  
  
  RESULTS
  All gynaecomastia specimens, both in situ carcinomas and 57 invasive carcinomas (84 per cent) stained positively for Apo D. Apo D values were significantly correlated with axillary node involvement and histological grade of the tumours. In men with breast cancer univariate analysis showed a statistical association between node status and Apo D content with relapse-free survival (P < 0.001) and overall survival (P < 0.05). Cox multivariate analysis showed that Apo D was a significant indicator of relapse-free survival (P = 0. 0089), but node status was the strongest factor able to predict both relapse-free (P = 0.0336) and overall (P = 0.0346) survival.
  
  
  CONCLUSIONS
  Apo D was expressed in gynaecomastia and a high percentage of male breast carcinomas. There was a positive association of Apo D content in male breast tumours with favourable outcome. Apo D expression was a significant independent indicator of relapse-free survival in male breast cancer.
authors.affiliation: Servicio de Cirurgía General, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Serra Díaz
authors.forename: F
authors.initials: F
authors.lastname: Vizoso
authors.forename: M L
authors.initials: ML
authors.lastname: Lamelas
authors.forename: J C
authors.initials: JC
authors.lastname: Rodríguez
authors.forename: L O
authors.initials: LO
authors.lastname: González
authors.forename: A
authors.initials: A
authors.lastname: Baltasar
authors.forename: J
authors.initials: J
authors.lastname: Medrano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001053:Apolipoproteins / Q000378:metabolism*; D053399:Apolipoproteins D; D015415:Biomarkers; D018567:Breast Neoplasms, Male / Q000378:metabolism*; D002278:Carcinoma in Situ / Q000378:metabolism*; D018572:Disease-Free Survival; D006177:Gynecomastia / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D001053:Apolipoproteins; D053399:Apolipoproteins D; D015415:Biomarkers