Upregulation of Plasminogen and Fibronectin in Advanced Breast Carcinoma: An Immunohistochemical Study in Iraqi Women

Abstract

Background: Breast cancer (BC) is by far the most prevalent form of cancer among Iraqi females. Both core extracellular matrix glycoprotein fibronectin (FN) and fibrinolytic system zymogen plasminogen (PLG) are considered to have a role in tumor invasion and metastasis. We investigated the relationship between the progression of a pathological process and the expression of FN and PLG in terms of immunohistochemistry (IHC).

Methods: FN and PLG were stained by a polymer-HRP detection method to stain twenty-five FFPE breast carcinomas. Semi-quantitative values were created with predetermined cut-offs as intensity and percentage positive were combined to produce semi-quantitative values (03). It is Wilcoxon signed-rank that was used to test the differences between pairs (FN vs. PLG).

Results: FN scores were higher than PLG, paired analysis(Wilcoxon two-sided p = 0.0074; one-sided p FN = PLG = 0.0037). PLG in Stage II and Stage III (p = 0.03 and p = 0.04 respectively) were statistically higher, but Stage IV was not significant (p = 0.15). FN had stage specific significant increase in Stage II (p = 0.004) and in Stage III-IV (p = 0.04). No correlation with the age of a patient was observed (p > 0.05).

Conclusions: FN and PLG are both up-regulated as the disease advances in this group, although FN is more important and more common in the Stages III and IV than PLG. These findings support the notion that they might be of use as aggressiveness biomarkers and potential targets in methods that address extracellular matrix (ECM) and fibrinolysis. In order to validate and elaborate on these, there is need to carry out larger, multi-center cohorts through digital image analysis.