title: Overexpression of Cripto and its prognostic significance in breast cancer: a study with long-term survival.
abstract: BACKGROUND
  Cripto is a founding member of the EGF-CFC family, and plays an important role in tumourigenesis, tumour cell proliferation and migration. We aimed to determine the significance of Cripto expression on the survival of patients with breast cancer.
  
  
  METHODS
  Immunohistochemical detection of Cripto was performed by using mAb C13 on 120 formalin-fixed paraffin-embedded breast tumour specimens in tissue microarrays. This cohort comprises a series of 120 patients with primary operable breast cancer diagnosed between 1989 and 1995, retrieved from the Concord Repatriation General Hospital breast carcinoma database.
  
  
  RESULTS
  Using a cutoff value of 80%, Cripto overexpressed in 57 of the 120 (47.5%) patients. We found significant associations between overexpression of Cripto and the Nottingham Prognostic Index (NPI, p<0.01), histological grade (p<0.01), pathological tumour type (p=0.04), PR (p=0.02) as well as Ki-67 (p=0.02). Univariate analysis reveals that there is a significant correlation between overexpression of Cripto and survival (p=0.0003). Cox regression analysis indicates that the overexpression of Cripto is an independent prognostic factor in breast cancer (HR 2.79, 95%CI 1.20-6.50).
  
  
  CONCLUSIONS
  The unique epitope recognized by mAb C13 is overexpressed on breast tumour tissues. In this series of invasive breast cancers, overexpression of Cripto was more often found in high grade and poor prognosis tumours compared to low grade and good prognosis breast cancers. Moreover, overexpression of Cripto was significantly associated with decreased patient survival.
authors.affiliation: Department of Breast Endocrine Surgery, Concord Repatriation General Hospital, Hospital Road, Concord NSW 2137, Australia.
authors.forename: Y P
authors.initials: YP
authors.lastname: Gong
authors.forename: P M
authors.initials: PM
authors.lastname: Yarrow
authors.forename: H L
authors.initials: HL
authors.lastname: Carmalt
authors.forename: S Y
authors.initials: SY
authors.lastname: Kwun
authors.forename: C W
authors.initials: CW
authors.lastname: Kennedy
authors.forename: B P C
authors.initials: BP
authors.lastname: Lin
authors.forename: P X
authors.initials: PX
authors.lastname: Xing
authors.forename: D J
authors.initials: DJ
authors.lastname: Gillett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality; D004815:Epidermal Growth Factor / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D058851:GPI-Linked Proteins; D006801:Humans; D007124:Immunoenzyme Techniques; D036341:Intercellular Signaling Peptides and Proteins; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D036341:Intercellular Signaling Peptides and Proteins; D008562:Membrane Glycoproteins; D009363:Neoplasm Proteins; C070636:TDGF1 protein, human; D004815:Epidermal Growth Factor