Expression And Clinical Significance Of PAX9 And TBX2 In Non-specific Invasive Breast Cancer

Objective: To detect the expression of paired box gene 9(PAX9)and T-box transcription factors 2(TBX2)in non-specific invasive breast cancer(NST-IBC)tissues and their relationship with tumor budding,and to explore their relationship with clinicopathological features of NST-IBC.Methods:(1)100 cases of NST-IBC tissues were selected as the experimental group,and the adjacent tissues of the same section were used as the control group;(2)A total of 100HE-stained sections of NST-IBC tissues were counted for tumor budding by two associate chief pathologists;(3)Immunohistochemistry was used to detect the expression of PAX9 and TBX2 in 100 cases of NST-IBC tissues and 100 cases of adjacent tissues,and the related clinicopathological features were analyzed;(4)Chi-square test was used to analyze the difference of PAX9 and TBX2 expression between cancer tissues and adjacent tissues.The relationship between PAX9,TBX2,tumor budding and clinicopathological features was analyzed;(5)spearman correlation analysis was used to explore the correlation between the expression of PAX9 and TBX2,and the correlation between the expression of PAX9 and TBX2 and tumor budding was analyzed.Results:(1)The high expression rate of PAX9 in cancer tissues was 83.0%(83/100),which was significantly higher than that in adjacent tissues 16.0%(16/100),and the difference was statistically significant(P=0.000);(2)The high expression rates of PAX9 in different molecular subtypes were: Luminal A 81.3%(39/48),Luminal B 84.6%(11/13),Her-2 positive84.2%(16/19),triple negative 85.0%(17/20).There was no significant difference in expression level(P=1.000);(3)The high expression of PAX9 in cancer tissues was associated with lymph node metastasis(P=0.029)and histological grade(P=0.040).It was not related to age(P=0.664),tumor size(P=0.592),distant metastasis(P=0.753),clinical stage(P=0.282),intravascular tumor thrombus(P=0.721),ER expression(P=0.154);(4)The high expression rate of TBX2 in cancer tissues was 74.0%(74/100),which was significantly higher than that in adjacent tissues 34.0%(34/100),and the difference was statistically significant(P=0.000);(5)The high expression rates of TBX2 in different molecular subtypes were: Luminal A75.0%(36/48),Luminal B 84.6%(11/13),Her-2 positive 68.4%(13/19),triple negative70.0%(14/20).There was no significant difference in the expression level(P=0.767);(6)The high expression of TBX2 in tumor tissues was related to tumor size(P=0.018)and lymph node metastasis(P=0.013),but not related to age(P=0.515),distant metastasis(P=0.641),clinical stage(P=0.679),intravascular tumor thrombus(P=0.736),histological grade(P=0.934),ER expression(P=0.147),PR expression(P=0.618),Her-2 positive(P=0.948),Ki-67 expression(P=0.055);(7)High-grade tumor budding was associated with lymph node metastasis(P=0.000),clinical stage(P=0.000)and intravascular tumor thrombus(P=0.028).It was not related to histological grade(P=0.471)and distant metastasis(P=0.317);(8)The expression of PAX9 was positively correlated with TBX2(r=0.339,P=0.000),The expression of PAX9 and TBX2 was positively correlated with the number of tumor budding(r=0.347,P<0.001;r=0.416,P < 0.001).Conclusion:(1)The expression of PAX9 and TBX2 in NST-IBC tissues was significantly higher than that in adjacent tissues,and the expression was positively correlated;(2)High-grade tumor budding in NST-IBC tissues was associated with lymph node metastasis(P=0.000),clinical stage(P=0.000)and intravascular tumor thrombus(P=0.028);(3)The high expression of PAX9 and TBX2 in NST-IBC tissues was positively correlated with the number of tumor buds.The study suggesting that PAX9 and TBX2 may become new biomarkers for breast cancer,providing new strategies for the treatment of breast cancer and evaluating the prognosis of patients.