Clinical Study Of CDCA8 Expression In HR Positive Breast Cancer And Axillary Lymph Nodes

Breast cancer is one of the most common malignant tumors in the world,it is also one of the main causes of death for the middle-aged and elderly women in the world.In the past few decades,the incidence rate of breast cancer is increasing year by year and there is a trend and tendency towards youth.By 2020,the incidence rate of breast cancer will rank first among female cancers.It has surpassed lung cancer,accounting for about11%of new cancer cases.2022 breast cancer Diagnosis and Treatment Guidelines and Specifications of China Anti-cancer Association,it uses molecular typing methods:Luminal A type,Luminal B type,HER-2overexpression type,triple negative type.The most common type of breast cancer is hormone receptor positive breast cancer.It contains estrogen（ER）or progesterone（PR）receptor positive,or both,which together constitute Luminal type,accounting for about 75%of all types of breast cancer^[1-2].Although the prognosis of HR positive breast cancer patients is relatively good,because this type of breast cancer has a large base.Therefore,the number of patients with long-term recurrence and metastasis is relatively large.It is one of the main causes of death of breast cancer.Therefore,it is of great significance to conduct in-depth research on HR positive breast cancer which guides precise treatment.The primary way of breast cancer metastasis is through axillary lymph nodes,the axillary lymph node metastasis directly affects the treatment decision of the axillary,Whether the axillary lymph nodes are metastatic in current clinical surgery,preoperative evaluation is mainly through imaging.However,there are still some drawbacks in imaging prediction of axillary lymph node metastasis,the evaluation of axillary lymph node metastasis with molecular markers is one of the current research directions.In recent years,many experimental studies at home and abroad have shown that cell division cycle associated protein 8（CDCA8）plays a very important role in the occurrence and development of malignant tumors,the expression level of CDCA8 in breast invasive ductal carcinoma is relatively high^[3].In addition,basic research shows that the m RNA expression level of CDCA8 in breast cancer cells（MCF7 and T47D cell lines）is high,the expression of CDCA8 can also be detected in HR positive breast cancer tissues,suggesting that CDCA8 is a key medium for cell proliferation in HR positive breast cancer^[4].Clinical studies suggest that the expression of CDCA8 in breast cancer is related to ER and PR^[5],it suggests that CDCA8may play a role in the occurrence,development,metastasis and recurrence of HR positive breast cancer.At present,there is no clear report on the expression of CDCA8 in HR positive breast cancer tissues and its correlation with axillary lymph node metastasis in China.The purpose of this study was to investigate the expression of CDCA8 in HR positive breast cancer and axillary lymph node metastasis,evaluating the relationship between the clinicopathological characteristics and axillary lymph node metastasis.It is expected to provide reference value for the precise treatment of HR positive breast cancer.Objective:The expression of CDCA8 in HR positive breast cancer tissues a-nd axillary lymph node metastasis tissues was detected by immunohist-ochemistry,exploring the relationship between the expression of CDCA8in HR positive breast cancer and its clinicopathological characteristics and axillary lymph node metastasis.Further analysis of whether CDCA8has predictive value for axillary lymph node metastasis in HR positive breast cancer patients.Methods:Retrospective analysis and selection of 185 patients with breast cancer who underwent modified radical mastectomy in the breast center of Cangzhou People’s Hospital from January 2019 to December 2022 and were pathologically diagnosed as HR positive breast cancer,The corresponding clinicopathological data were collected from 185 HR positive breast cancer tissues and paracancerous tissues,92 axillary lymph node metastatic carcinoma tissues,and 93 axillary lymph node tissues without metastasis.The corresponding lesions were removed for CDCA8 immunohistochemical detection and the detailed data and results of the experimental study were completely recorded.The difference is statistically significant with P<0.05,using SPSS23.0 to process all data.Multivariate logistic regression analysis was used to test whether CDCA8 was a risk factor for axillary lymph node metastasis in HR positive breast cancer.Results:1.The positive expression rate of CDCA8 in HR positive breast c-ancer tissues was 82.2%（152/185）,the positive expression of CDCA8was higher than that the negative expression of CDCA8 in cancer tiss-ue（33/185,17.8%）,the difference is statistically significant（P<0.05）.2.The expression level of CDCA8 in HR positive breast cancer tissue is correlated with axillary lymph node metastasis,tumor diameter,human epidermal growth factor receptor 2,and vascular tumor thrombus（P<0.05）,There is no significant correlation with age,histological grade,Ki67and molecular typing（P>0.05）.3.The positive expression rate of CDCA8 in axillary lymph node metastatic carcinoma was 92.4%（85/92）,The positive expression of CDCA8in axillary lymph node metastatic carcinoma was higher than that the negative expression of CDCA8 in axillary lymph node metastatic carcinoma（7/92,7.6%）,the difference is statistically significant（P<0.05）.4.The positive expression rate of CDCA8 in axillary lymph node metastatic carcinoma was 92.4%（85/92）,The positive expression of CDCA8in axillary lymph node tissue was higher than that without metastasis（20/93,21.5%）,The difference is statistically significant（P<0.05）.5.The positive expression of CDCA8 in axillary lymph node metastatic carcinoma is correlated with vascular tumor thrombus in primary tumor（P<0.05）.There is no correlation with patient age,primary tumor diameter,HER-2,histological grade,Ki67,molecular typing（P>0.05）.6.Multivariate logistic regression analysis showed that the positive expression of CDCA8 in HR positive breast cancer tissues was a high risk factor for axillary lymph node metastasis in breast cancer（OR=5.684,95%CI:1.928-16.754）.Vascular tumor thrombus is a high risk factor for axillary lymph node metastasis in breast cancer（OR=11.435,95%CI:4.262-30.623）.Conclusions:1.The expression level of CDCA8 in HR positive breast cancer tissue is elevated,which may participate in the occurrence and development of HR positive breast cancer.2.The positive expression of CDCA8 in HR positive breast cancer tissue is associated with axillary lymph node metastasis,tumor diameter,human epidermal growth factor receptor 2 and vascular cancer thrombus;There was no significant correlation with age,histological grade,Ki67 and molecular typing.3.The positive expression of CDCA8 in axillary lymph node metastatic carcinoma is correlated with vascular tumor thrombus in primary tumor;There was no significant correlation with age,primary tumor diameter,human epidermal growth factor receptor 2,histological grade,Ki67 and molecular typing.4.CDCA8 positive expression and vascular tumor thrombus in HR positive breast cancer are high risk factors for axillary lymph node metastasis,The positive expression of CDCA8 may be a molecular marker for predicting axillary lymph node metastasis in HR positive breast cancer.