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Expression of proliferation genes in formalin-fixed paraffin-embedded (FFPE) tissue from breast carcinomas. Feasibility and relevance for a routine histopathology laboratory
  1. Carla Thomas1,2,
  2. Cleo Robinson1,2,3,
  3. Ben Dessauvagie1,2,
  4. Benjamin Wood1,2,
  5. Greg Sterrett1,2,
  6. Jennet Harvey1,2,
  7. Benhur Amanuel1,2
  1. 1Molecular Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, Western Australia, Australia
  2. 2School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
  3. 3School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
  1. Correspondence to Dr Carla Thomas, Molecular Anatomical Pathology, PathWest, QEII Medical Centre, J Block, QEII Medical Centre, Nedlands, WA 6909, Australia; carla.thomas{at}


Aim Breast carcinoma proliferative activity, histological grade and commercial molecular tests are all important in prognostication and treatment. There is a particular need for improved, standardised techniques for subclassification of grade 2 breast cancers into low-risk and high-risk prognostic groups. In this study we investigated whether gene expression profiling of five proliferation genes was feasible using breast cancer tissue in a clinical setting and whether these profiles could enhance pathological assessment.

Methods Expression of five proliferation gene mRNAs; Ki-67, STK 15, CCNB1, CCND1 and MYBL2, was quantified in 27 breast carcinomas and compared with Ki-67 proliferation index (PI) and Nottingham mitotic score.

Results Expression of Ki-67, STK15 and MYBL2 mRNA showed moderate Spearman's correlation with Ki-67 PI (p<0.01), but CCND1 and CCNB1 showed weak, non-significant correlation. Individual gene expression did not associate with mitotic score but combined mRNA expression correlated with both Ki-67 PI (p=0.018) and mitotic score (p=0.03; 0.007).

Conclusions This study confirms mRNA analysis in breast carcinoma formalin-fixed, paraffin-embedded samples is feasible and suggests gene expression profiling, using a small set of five proliferation genes, has potential in aiding histological grading or assessment of proliferative activity of breast cancers. To fully evaluate the clinical applicability of this approach, a larger cohort study with long-term follow-up data is required.

  • KI 67

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  • Handling editor Runjan Chetty

  • Contributors CT, laboratory work, data analysis and interpretation, drafting and finalisation of manuscript; GS, JH, BD and CR, conception, interpretation of data and amendments and finalisation of manuscript; BW: conception and finalisation of manuscript; BA, amendments and finalisation of manuscript.

  • Competing interests None declared.

  • Ethics approval Department of Health of WA.

  • Provenance and peer review Not commissioned; externally peer reviewed.