Exploring the Integrated Role of AKT۲, CD۴۴v۶, And MT۱-MMP as Predictors of Axillary Lymph Node Metastasis in Invasive Breast Carcinoma of No Special Type

Background & Objective: Invasive breast carcinoma of no special type (IBC-NST) is the most common type of breast cancer, which mainly causes axillary lymph-node metastasis (ALNM). Building on our previous research, we wanted to explore the optimal combination of AKT۲, CD۴۴v۶, and MT۱-MMP for the ALNM prediction.Methods: The presence or absence of ALNM was used to separate ۴۶ paraffin blocks containing IBC-NST primary tumors into two groups. Age, tumor grade, tumor size, receptor status (ER, PR, HER۲, Ki-۶۷, TOP۲A), and test biomarker expression were evaluated. Biomarker expressions were assessed by IHC staining and categorized according to their respective cut-offs from our previous study, while other data were collected from archives. Data was gathered and analyzed using univariate, multivariate, and AUROC models.Results: The expression of CD۴۴v۶ (OR: ۱۲.۷۷, ۹۵% CI: ۲.۱۸-۸۷.۱۲, P=۰.۰۰۵) was identified as the independent variable for ALNM. Meanwhile, AKT۲ expression (OR: ۳.۲۲, ۹۵% CI: ۰.۳۶-۲۲.۴۱, P=۰.۲۳۷) and MT۱-MMP expression (OR: ۵.۳۵, ۹۵% CI: ۰.۸۳-۳۴.۵۴, P=۰.۰۷۸) did not demonstrate a statistically significant independent association in respect to ALNM. Combining AKT۲ and MT۱-MMP on CD۴۴v۶ increased overall accuracy by ۴% compared to CD۴۴v۶ alone (AUROC ۰.۸۹ vs. ۰.۸۵).Conclusion: The combined usage of AKT۲, CD۴۴v۶, and MT۱-MMP revealed no significant change compared to CD۴۴v۶ alone. Due to cost and practicality, we propose using CD۴۴v۶ as a biomarker predictor of ALNM in IBC-NST.

Keywords:

AKT۲ , Breast cancer , CD۴۴v۶ , Immunohistochemistry , Lymph-node , Metastasis , MT۱-MMP