title: C4.4A highly expressed in HER2-positive human breast cancers may indicate a good prognosis.
abstract: BACKGROUND
  The aim of our study was to investigate the association of C4.4A expression in breast tumors with both patients' clinicopathological characteristics and outcomes in order to clarify the significance of C4.4A in breast cancer.
  
  
  METHODS
  Primary breast cancer patients (n = 125, stage I-III) who had undergone breast mastectomy or breast-conserving surgery at our hospital between 2005 and 2011 were recruited for this study. Tumor samples were obtained from surgical specimens and expression status of C4.4A, estrogen receptors, progesterone receptors, human epidermal growth factor receptor 2 (HER2) and Ki67 was analyzed immunohistochemically, while HER2 amplification was examined using fluorescence in situ hybridization.
  
  
  RESULTS
  Multivariate analysis showed that HER2 positivity was the only independent predictive factor for C4.4A expression (odds ratio 5.31, 95 % confidence interval 2.04-15.72; P < 0.001). Univariate prognostic analysis of the relationship between C4.4A and disease-free survival showed that survival of patients with C4.4A-positive tumors was longer than that of patients with C4.4A-negative tumors in the HER2-positive subset (P = 0.004) while there was no significant difference in patient outcome according to C4.4A status for total patients (median observation period 37 months, range 1-92 months; P = 0.223).
  
  
  CONCLUSIONS
  We established a positive relationship between C4.4A and HER2 status, suggesting that C4.4A expression may be a prognostic factor for HER2-positive breast cancer patients.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Miyake
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.forename: Ayako
authors.initials: A
authors.lastname: Yanai
authors.forename: Natsuko
authors.initials: N
authors.lastname: Inoue
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Miyagawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Murase
authors.forename: Michiko
authors.initials: M
authors.lastname: Imamura
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Ichii
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takatsuka
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nishizaki
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.forename: Masahisa
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Shinzaburo
authors.initials: S
authors.lastname: Noguchi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miyoshi
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D058851:GPI-Linked Proteins / Q000378:metabolism; D006801:Humans; D008408:Mastectomy; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D015815:Cell Adhesion Molecules; D058851:GPI-Linked Proteins; D018719:Erb-b2 Receptor Tyrosine Kinases; C472589:LYPD3 protein, human; C508053:ERBB2 protein, human