Expression of ghrelin is correlated to a favorable outcome in invasive breast cancer

Figures & data

Table I. Patients’ characteristics.

	No. of cases (%)
Tumor histology
Ductal	104 (72.2)
Lobular	27 (18.7)
Tubular	7 (4.9)
Medullary	3 (2.1)
Mixed (ductal and lobular)	3 (2.1)
Histologic grade
I	22 (15.3)
II	64 (44.4)
III	58 (40.3)
ER
Positive	125 (86.8)
Negative	19 (13.2)
PgR
Positive	100 (69.4)
Negative	44 (30.6)
HER2 (IHC)
0	88 (61.1)
1	30 (20.8)
2	12 (8.3)
3	9 (6.3)
Missing	5 (3.5)
Node status
1–3	35 (24.3)
≥ 4	21 (14.6)
0	73 (50.7)
Unknown	15 (10.4)
Recurrence
Yes	29 (20.1)
No	115 (79.9)
Vital status
Alive	103 (71.5)
Dead	41 (28.5)
Dead from breast cancer	22 (15.3)
Menopausal status
Pre	20 (13.9)
Peri	3 (2.1)
Post	118 (81.9)
Missing	3 (2.1)
Chemotherapy
Yes	30 (20.8)
No	113 (78.5)
Missing	1 (0.7)
Endocrine therapy
Yes	96 (66.7)
No	47 (32.6)
Missing	1 (0.7)
Type of surgery
Breast conserving	63 (43.8)
Mastectomy	81 (56.2)

Figure 1. Ghrelin expression in invasive breast cancer tissue was analyzed by immunohistochemistry. Representative images of ghrelin with A (non-immunoreactive), B (weak), C (moderate) and D (strong) immunostaining. Scale bar = 100 μm.

Table II. Results from the immunohistochemical scorings.

	Ghrelin IR cases (%)	Obestatin IR cases (%)
Strong (D)	33 (22.9)	63 (43.8)
Moderate (C)	70 (48.6)	48 (33.3)
Weak (B)	24 (16.7)	23 (16)
Non-IR (A)	10 (6.9)	3 (2.1)
Missing	7 (4.9)	7 (4.9)
Total	144	144

IR, immunoreactive.

Table III. Ghrelin and obestatin expression in breast cancer in relation to clinicopathologic variables.

	Ghrelin	Obestatin
Node status
ρ	0.1	0.09
p-value	0.1	0.3
n	124	137
Tumor size
ρ	−0.2	−0.2
p-value	0.05*	0.04*
n	137	137
Age
ρ	0.1	−0.05
p-value	0.7	0.6
n	137	137
ER
ρ	0.2	0.3
p-value	0.03**	0.002**
n	137	137
PgR
ρ	0.1	0.1
p-value	0.2	0.1
n	137	137
HER2
ρ	0.08	−0.04
p-value	0.4	0.6
n	135	133
NHG
ρ	−0,2	−0,3
p-value	0.02*	< 0.00001**
n	137	137
Ki67
ρ	−0.2	−0.3
p-value	0.05*	0.001**
n	118	117
Menopausal status
ρ	−0.03	−0.05
p-value	0.7	0.6
n	137	137
Ghrelin
ρ	1	0.2
p-value		0.02**
n	137	135

Spearman's correlation coefficient −0.2 > ρ > 0.2 in bold.

p-value < 0.05 in bold.

n, number of specimens.

Correlation is significant at the 0.05 level.

**Correlation is significant at the 0.01 level.

Table IV. Univariate analysis of prognostic parameters.

	Recurrence				BC death
		95% CI				95% CI
	HR	Lower	Upper	p-value	HR	Lower	Upper	p-value
Tumor size				0.01**				0.03*
≤ 20	1.0 (ref)				1.0 (ref)
> 20	3.0	1.3	7.0		3.1	1.2	8.5
Node status				< 0.00001**				0.002**
N0	1.0 (ref)				1.0 (ref)
N +	6.7	2.5	17.8		5.6	1.8	16.8
NHG				0.002**				< 0.00001**
I + II	1.0 (ref)				1.0 (ref)
III	3.4	1.6	7.2		6.0	2.2	16.3
Age				0.001**				0.004**
50–69	1.0 (ref)				1.0 (ref)
< 50 or ≥ 70	4.5	1.8	11.1		4.8	1.6	14.3
Ghrelin				0.02*				0.03*
0	1.0 (ref)				1.0 (ref)
1+2+3	0.3	0.1	0.9		0.3	0.1	0.9
Obestatin				0.5				0.3
0	1.0 (ref)				1.0 (ref)
1+2+3	0.5	0.1	3.7		0.3	0.1	2.6

*Correlation is significant at the 0.05 level.

*Correlation is significant at the 0.01 level.

Table V. Multivariate analysis of prognostic markers.

	Recurrence				BC death
		95% CI				95% CI
	HR	Lower	Upper	p-value	HR	Lower	Upper	p-value
Tumor size				0.9				0.9
≤ 20	1.0 (ref)				1.0 (ref)
> 20	1.1	0.4	3.0		0.9	0.3	3.1
Node status				0.001				0.02
N0	1.0 (ref)				1.0 (ref)
N+	5.4	2.0	14.9		4.1	1.3	13.1
NHG				0.1				0.02
I+II	1.0 (ref)				1.0 (ref)
III	2.0	0.8	4.7		3.8	1.2	12.3
Age				0.01*				0.04
50–69	1.0 (ref)				1.0 (ref)
< 50 or ≥ 70	3.6	1.3	9.7		3.6	1.3	12.7
Ghrelin				0.04
0	1.0 (ref)				1.0 (ref)
1+2+3	0.4	0.1	0.9		0.3	0.1	1.0	0.05

*Correlation is significant at the 0.05 level.

Correlation is significant at the 0.01 level.

Figure 2. Survival among breast cancer patients by ghrelin expression. Ghrelin immunoreactive, scores 1–3; ghrelin non-immunoreactive, score 0. A, RFS according to ghrelin. B, BCSS according to ghrelin.