Tumor expression of Nectin-4 as a prognostic marker in breast cancer


Hisham Al-Torky, Galal Aboul-Nagah, Tarek El-Fayomi, Hytham Fayed, Hanan Tayel, Mahmoud Sakr

Background: Identification of new molecular tumor associated biomarkers is the most important current challenge in cancer research. Nectin-4 is one of the Nectin glycoproteins, which are cell adhesion molecules have been involved in tumor biology. Objectives: The objective was to evaluate Nectin-4 expression by immunohistochemistry (IHC) as a prognostic tumor marker in breast cancer (BC). Patients and Methods: This study was carried out on 100 female patients with BC. Their ages ranged between 29 and 67 years, with a mean of 41.3 years. Fifty other age-matched patients, subjected to reduction mammoplasty, served as controls. Data collected prospectively included patient demographics and tumor characteristics, including histopathological type and grade, IHC for Nectin-4 expression, estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2-Neu). Patients were regularly followed-up for 2 years, recording loco-regional recurrence, distant metastasis, and mortality. Results: Nectin-4 expression by IHC was detected in 62% of BC patients, but in none of the tumor-free controls (P = 0.0001). Nectin-4 expression showed a statistically significant positive correlation with higher tumor grade (P = 0.003) and axillary lymph node involvement (P = 0.0001), but not with increasing tumor size (P = 0.273). It had a significant inverse correlation with ER and PR, and a significant positive correlation with HER2-Neu (P = 0.0001). Furthermore, there was a significant correlation between Nectin-4 expression and the development of distant metastases (P = 0.014), local recurrence (P = 0.046), and mortality (P = 0.049). Conclusions: Nectin-4 is a highly recommended biomarker for predicting progression and prognosis of BC.