title: Podoplanin expression by cancer-associated fibroblasts predicts poor outcome in invasive ductal breast carcinoma.
abstract: OBJECTIVE
  It has recently been shown that podoplanin, a mucin-type glycoprotein, is expressed by cancer cells and cancer-associated fibroblasts (CAFs), and promotes cancer cell migration and invasiveness. The biological role of podoplanin expression in tumour stroma of invasive ductal carcinoma of the breast (IDC) has not been determined.
  
  
  RESULTS
  Podoplanin expression was analysed in 117 cases of IDC and 27 cases of fibrocystic change, as well as in breast cancer cell lines, with the use of immunohistochemistry and real-time polymerase chain reaction. In 82.1% of analysed tumours, podoplanin was found only in CAFs. Only two of 117 IDC cases (1.7%) were characterized by expression of this glycoprotein in cancer cells. None of the fibrocystic changes or stroma surrounding normal ducts showed podoplanin expression. Podoplanin-positive CAFs correlated with tumour size (P = 0.0125), grade of malignancy (P = 0.0058), lymph node metastasis (P = 0.0149), lymphovascular invasion (LVI) (P = 0.0486) and Ki67 expression in cancer cells (P = 0.0128). High-level podoplanin expression (>50% of positive stroma) in the tumour stroma was significantly associated with a negative oestrogen status (P = 0.0201). Univariate, but not multivariate, analysis showed that podoplanin expression by CAFs was associated with poor patient outcome (P = 0.0202).
  
  
  CONCLUSIONS
  Our results suggest that podoplanin expression by CAFs could be an unfavourable prognostic marker for IDC.
authors.affiliation: Department of Histology and Embryology, Medical University, Poznan, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Pula
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jethon
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Piotrowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Gomulkiewicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Owczarek
authors.forename: Jacek
authors.initials: J
authors.lastname: Calik
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wojnar
authors.forename: Wojciech
authors.initials: W
authors.lastname: Witkiewicz
authors.forename: Janusz
authors.initials: J
authors.lastname: Rys
authors.forename: Maciej
authors.initials: M
authors.lastname: Ugorski
authors.forename: Piotr
authors.initials: P
authors.lastname: Dziegiel
authors.forename: Marzena
authors.initials: M
authors.lastname: Podhorska-Okolow
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D005260:Female; D005347:Fibroblasts / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008562:Membrane Glycoproteins / Q000032:analysis / Q000096:biosynthesis*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D000098853:Podoplanin
chemical_list: D014408:Biomarkers, Tumor; D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin