Identificador: TDX:493
Autors: Blázquez Vilas, Susana
Resum:
Nowadays, breast cancer is the most common cancer in women and it corresponds to 22% of all cancers in females. In the Tarragona area, nearly 280 new cases are diagnosed with an annual increase tax of 2.2%.<br/>During the last decade, mortality due to this cancer was very high, at present it has decreased specially by screening programs and an early detection.<br/>There are some risk factors involved in breast cancer development such as diet factors and some life styles, genetic alterations, mainly in two genes known as BRCA1 and BRCA2, and hormonal factors.<br/>All of them have been widely studied to avoid a cancer progression, however, new breast cancers cases continue appearing and many women died by its fault.<br/>Once the breast cancer has appeared, it is important to know which will be its prognosis which depends on some intrinsic and extrinsic tumour features. From this point of view, some different prognostic factors have been studied in order to predict the course and the evolution of this tumour and to see if we could do any special treatment in each case. In this important aspect is based the present study.<br/>Many publications have proved that breast cancers with a high apoptosis index (programmed cell death) have a better prognosis compared with the same type of cancer with less or any apoptosis. This feature seems to be related to the high proliferation index that breast cancer with high apoptosis have, so consequently, its behaviour is worst. <br/>Many elements take part in the apoptotic process, some of them are the Caspases, cisteine proteases which are activated sequentially and are the main point in the apoptotic process..<br/>In this work two from more than ten caspases have been studied (caspase 3 and caspase 6) to see if they have any paper in breast cancer prognosis. We have evaluated some other factors such as cell proliferation index (ki67) and the average of apoptotic cells done by TUNEL technique.<br/>The study includes 210 cases of Ductal breast cancer in operable stages (pT1 - pT2) which were diagnosed in Joan XXIII Hospital in Tarragona between 1988 - 2001.<br/>We have collected some information from each cases such as tumour size, histological differentiation degree, the presence or absence of lymph node metastasis and the presence or absence of tumoral necrosis in the infiltrating component.<br/>We have evaluated from each case, the number of apoptotic cells or bodies by TUNEL technique and we have done immunohistochemical studies to evaluate the caspases' expression as the proliferation index. The results have been expressed on percentage.<br/>In the multivariate analysis our results show that lymph node status and cell atipism are independent prognostic factors for recurrence and mortality. On the other hand, the tumour size is only independent prognostic factor for recurrence.<br/>Moreover, in this study, the apoptotic index and the immunohistochemical expression of caspases and cell proliferation index have not turned out to be an independent prognostic factors neither recurrence nor mortality.<br/>These results show that classic prognostic factors known until now are the most important factors to predict the evolution of the illness.<br/>More studies will be necessary more studies in this field to know completely the caspases behaviour and to see if changing its functions, the course of the breast cancer could change.
Repositori URV