title: Clinicopathological significance of tissue homeostasis in Indian breast cancer.
abstract: BACKGROUND
  Tissue homeostasis and the maintenance of cell populations depend on a delicate balance between the rates of cell proliferation and cell death. Disruption of this balance is an important factor in development and progression of tumors. In the present study we evaluated the growth index in a large group of breast cancer patients and correlated it with various clinical and histopathological features of the tumor.
  
  
  METHODS
  Estimation of apoptosis was determined by TUNEL assay while immunocytochemistry for proliferating nuclear cell antigen (PCNA) was used as a measure of proliferation. Necrosis was identified morphologically by haematoxylin and eosin staining.
  
  
  RESULTS
  A positive correlation was observed between the percentage of PCNA positive cells and the frequency of mitosis (r=0.6117, p<0.0001). A highly statistical significant correlation was observed between type of tissue analyzed and growth index (r=0.46869, p<0.0001). No significant association was observed between hormone receptor status and growth index.
  
  
  CONCLUSIONS
  The growth index was found to be higher in carcinoma cells that metastasised into lymph nodes compared with primary lesions with no nodal metastasis. Growth index was particularly prominent in high-grade tumors in which increased proliferative activity was evident. Apoptotic cells were detected more frequently in tumor cells with higher rather than lower proliferative activity. This suggests that not only proliferative activity but also capacity for apoptosis is altered in breast tumors.
authors.affiliation: Division of Laboratory Medicine, Regional Cancer Center, Thiruvananthapuram-695 011, Kerala State, India. mrpillai@vsnl.com
authors.forename: A Lakshmi
authors.initials: AL
authors.lastname: Kesari
authors.forename: Divya
authors.initials: D
authors.lastname: Chandrasekhar S
authors.forename: Balakrishnan
authors.initials: B
authors.lastname: Rajan
authors.forename: Beela S
authors.initials: BS
authors.lastname: Mathew
authors.forename: M Radhakrishna
authors.initials: MR
authors.lastname: Pillai
mesh_terms: D017209:Apoptosis; D001940:Breast / Q000166:cytology; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D018275:Carcinoma, Lobular / Q000473:pathology; D016022:Case-Control Studies; D002455:Cell Division; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D007194:India; D008207:Lymphatic Metastasis; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism
chemical_list: D018809:Proliferating Cell Nuclear Antigen