title: Hedgehog related protein expression in breast cancer: gli-2 is associated with poor overall survival.
abstract: BACKGROUND
  The hedgehog (Hh) signaling pathway is known to play a critical role in various malignancies, but its clinicopathologic role in breast cancer is yet to be established.
  
  
  METHODS
  Tissue microarray blocks from 334 cases of breast cancer were prepared. The expression of six Hh signaling proteins including sonic hedgehog (Shh), patched (Ptch), smoothened (Smo), and the glioma-associated oncogene (Gli)-1, Gli-2, and Gli-3 were analyzed immunohistochemically.
  
  
  RESULTS
  The expression of Hh signaling proteins was significantly correlated with some prognostic factors including the correlation of lymph node metastasis with the expression of Shh (p=0.001) and Ptch (p=0.064), the correlation of the stages with Shh and Gli-3 expression (p=0.007 and p=0.024, respectively), the correlation of the nuclear grade with the Smo (p=0.004) and Gli-3 (p=0.000), and the correlation of the histologic grade with the Ptch (p=0.016), Smo (p=0.007), and Gli-3 (p=0.000). The Shh, Ptch, Smo, Gli-1, and Gli-2 expression was significantly different between the phenotypes (p=0.000, p=0.001, p=0.004, p=0.039, and p=0.031, respectively). Gli-2 expression was correlated with a worse overall survival outcome (p=0.012).
  
  
  CONCLUSIONS
  Hh pathway activation is correlated with a more aggressive clinical behavior in breast carcinomas. The comparison of phenotypes suggested that the Hh pathway may be a useful therapeutic target for breast carcinoma. Patients with Gli-2 expression had a significantly lower overall survival rate and, therefore, it showed promise as a prognostic marker.
authors.affiliation: Department of Hospital Pathology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
authors.forename: Soyoung
authors.initials: S
authors.lastname: Im
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Choi
authors.forename: Changyoung
authors.initials: C
authors.lastname: Yoo
authors.forename: Ji-Han
authors.initials: JH
authors.lastname: Jung
authors.forename: Ye-Won
authors.initials: YW
authors.lastname: Jeon
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Suh
authors.forename: Chang Suk
authors.initials: CS
authors.lastname: Kang
keywords: Breast neoplasms; Gli protein; Gli-2 protein; Hedgehog proteins