High Visfatin Expression in Breast Cancer Tissue Is Associated with Poor Survival

DOI: 10.1158/1055-9965.EPI-11-0399 Published September 2011

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Figure 1.
A, the expression of visfatin in breast cancer tissues. The expression of visfatin in breast cancer tissues, as determined by immunohistochemistry, was divided into 4 categories according to positive staining of tumor cells: score 1, 25% or less; score 2, 26% to 50%; score 3, 51% to 75%; and score 4, 76% or more. The expression of visfatin in the matched adjacent normal breast tissues/noncancerous tissues is also shown. B, representative immunohistochemistry images for the localization of visfatin, ER, PR, and Her2/neu in 2 cancer tissues (#1 and #2).
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Figure 2.
Kaplan–Meier survival curves generated for disease-free and overall survival according to 4 staining intensities of visfatin (A), low and high visfatin expression groups alone (B) or in combination with ER status (C) and PR status (D).
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Figure 3.
Kaplan–Meier survival curves for disease-free and overall survival for the low and high visfatin expression groups regarding the administration of adjuvant radiotherapy (A and B), chemotherapy (C and D), and hormone therapy (E and F).

Table 1.

Correlation of visfatin expression with clinicopathologic characteristics of breast cancer patients

Variables	Item	Visfatin				P^a
		Low		High
		n	%	n	%
Stage	I/II	47	56.6	36	43.4	0.091
	III/IV	8	36.4	14	63.6
Grade	I/II	41	55.4	33	44.6	0.338
	III	14	45.2	17	54.8
Age, y	≤50	32	57.1	24	42.9	0.296
	50	23	46.9	26	53.1
BMI, kg/m²	<24	31	49.2	32	50.8	0.425
	≥24	24	57.1	18	42.9
Tumor size, cm	<2	31	64.6	17	35.4	0.022
	≥2	24	42.1	33	57.9
LN metastasis	0–1	46	57.5	34	42.5	0.060
	≥2	9	36.0	16	64.0
ER	Negative	12	33.3	24	66.7	0.005
	Positive	43	62.3	26	37.7
PR	Negative	17	37.8	28	62.2	0.009
	Positive	38	63.3	22	36.7
Her2/neu	Negative	31	46.3	36	53.7	0.096
	Positive	24	63.2	14	36.8

Table 2.

Correlation of visfatin expression with disease recurrence with/without radiotherapy, chemotherapy, or hormone therapy

	Low visfatin expression				P	High visfatin expression				P
	Recurrence					Recurrence
	No		Yes			No		Yes
	n	%	n	%		n	%	n	%
Radiotherapy
No	18	85.7	3	14.3	0.359^a	15	68.2	7	31.8	0.981^b
Yes	32	94.1	2	5.9		19	67.9	9	32.1
Chemotherapy
No	12	100.0	0	0.0	0.574^a	6	66.7	3	33.3	0.100^a
Yes	38	88.4	5	11.6		28	68.3	13	31.7
Hormone therapy
No	10	100.0	0	0.0	0.572^a	15	51.7	14	48.3	0.005^a
Yes	40	88.9	5	11.1		19	90.5	2	9.5

Table 3.

Univariate and multivariate analyses of disease-free survival for breast cancer

Variables	Item	Univariate			Multivariate
		Hazard rate ratio	95% CI	P	Hazard rate ratio	95% CI	P
Stage	III/IV	5.33	2.25–12.62	<0.001	6.08	1.83–20.18	0.003
	I/II	1.00			1.00
Grade	III	1.38	0.55–3.42	0.491	1.10	0.39–3.05	0.862
	I/II	1.00			1.00
Age, y	50	4.27	1.56–11.66	0.005	2.19	0.73–6.56	0.163
	≤50	1.00			1.00
BMI, kg/m²	<24	1.79	0.76–4.22	0.183	1.54	0.59–4.04	0.377
	≥24	1.00			1.00
ER	Negative	2.45	1.04–5.77	0.041	0.69	0.12–3.94	0.674
	Positive	1.00			1.00
PR	Negative	1.99	0.84–4.72	0.120	3.76	0.74–19.15	0.111
	Positive	1.00			1.00
Her2/neu	Positive	0.70	0.27–1.80	0.455	0.64	0.22–1.87	0.413
	Negative	1.00			1.00
Radiotherapy	Yes	0.69	0.29–1.62	0.393	1.03	0.37–2.92	0.951
	No	1.00			1.00
Chemotherapy	Yes	1.45	0.43–4.91	0.555	0.88	0.23–3.41	0.848
	No	1.00			1.00
Hormone therapy	Yes	0.18	0.07–0.47	<0.001	0.44	0.11–1.76	0.247
	No	1.00			1.00
Visfatin	High	5.73	1.92–17.14	0.002	4.11	1.15–14.70	0.030
	Low	1.00			1.00

Table 4.

Univariate and multivariate analyses of overall survival for breast cancer

Variables	Item	Univariate			Multivariate
		Hazard rate ratio	95% CI	P	Hazard rate ratio	95% CI	P
Stage	III/IV	5.00	1.81–18.83	0.002	10.17	2.41–42.94	0.002
	I/II	1.00			1.00
Grade	III	1.85	0.65–5.23	0.247	1.29	0.38–4.38	0.686
	I/II	1.00			1.00
Age, y	50	8.22	1.85–36.43	0.006	4.11	0.86–19.53	0.076
	≤50	1.00			1.00
BMI, kg/m²	<24	2.31	0.82–6.49	0.113	3.55	0.98–12.84	0.054
	≥24	1.00			1.00
ER	Negative	4.34	1.48–12.70	0.007	2.13	0.18–25.15	0.549
	Positive	1.00			1.00
PR	Negative	3.97	1.26–12.46	0.018	7.10	0.71–70.59	0.095
	Positive	1.00			1.00
Her2/neu	Positive	1.14	0.40–3.20	0.808	1.05	0.29–3.84	0.940
	Negative	1.00			1.00
Radiotherapy	Yes	0.52	0.19–1.43	0.205	0.43	0.11–1.65	0.220
	No	1.00			1.00
Chemotherapy	Yes	1.51	0.34–6.72	0.585	0.45	0.08–2.56	0.364
	No	1.00			1.00
Hormone Therapy	Yes	0.18	0.06–0.57	0.003	1.57	0.26–9.58	0.627
	No	1.00			1.00
Visfatin	High	5.05	1.42–17.98	0.012	6.20	1.18–32.50	0.031
	Low	1.00			1.00