THE RNA EXPRESSION LEVEL OF SURVIVIN, OCT 4 AND CYCLIN D1 GENES IN TRIPLE NEGATIVE AND NON-TRIPLE NEGATIVE BREAST CANCER

Background: the purpose of the present study to investigate the RNA expression level of Oct4, Survivin and Cyclin D1 genes in Triple-negative breast cancer (TNBC) and compared to non-triple negative breast cancer (non-TNBC) group. Also, correlate the results of gene expression with clinicopathological features of patients. Method, RNA expression levels of Oct4, Survivin and Cyclin D1 was tested for 100 breast cancer (BC) patients [formalin fixed paraffin embedded tissue (FFPE)] diagnosed as invasive duct carcinoma in Pathology Department, National Cancer Institute (NCI), Cairo University. The qRT-PCR technique is use and the results correlated to clinico-pathological characteristics of patients and survival rates. Result, in (TNBC) patients, oct4, survivin and cyclin D1 showed positive expression in 30 (60%), 32(64%) and 32 (64%) (p < 0.001, p= 0.001 and p= 0.003;respectively). In non-TNBC patients, the positive expression of oct4, survivin and cyclin D1 gene was 11(22%), 15(30%) and 17(34%) (p < 0.001, p= 0.001 and p= 0.003;respectively). All patients in TNBC have negative ER, PR and HER-2 receptor (p=0.001). There was highly statistically significant difference between oct4 gene expression and all the clinico-pathological features except the family history. A significant difference between cyclin D1gene expression and all the clinico-pathological features except the tumor size, tumor grade and lymphnode status. Statistically difference was found between survivin gene expression and all the clinico-pathological features except the menopause state, tumor stage and tumor grade. Triple negative breast cancer patients showed significantly decreased DFS (p < 0.001, log rank) and OS (p= 0.002, log rank) when compared to those with non-TNBC patients. In TNBC group, patients with positive expression of survivin was significantly associated with decreased OS (p= 0.03, log rank). TNBC tumors with positive oct4 and cyclin D1 had reduced OS compared to those negative to oct4 and cyclin D1 but without significant difference (p= 0.8 and p= 0.09, respectively, log rank). In non-TNBC group, with positive oct4, cyclin D1 and survivin did not significantly differ in terms of DFS and OS when compared to those with negative expression.
Conclusion:  Oct4 and survivin expression gene are better marker used for diagnosis in TNBC and for molecular targeting therapy of TNBC treatment. Cyclin D1 expression used as a marker for aggressive TNBC. The TNBC tumor possibly respond to treatment that downregulates cyclin D1 amplifica tion. More studied and large sample size is needed.