The Prognositic Value Of Cbl-b In Early Breast Cancer

Objective: Casitas B-lineage lymphoma b(Cbl-b)is an E3 ubiquitin-protein ligase and a signal-transducing adaptor protein involved in the development and progression of cancer.The prognostic value of Cbl-b in different tumors is controversial.The aim of this study is to explore the prognostic value of Cbl-b in early breast cancer.Methods: Cbl-b expression was analyzed by immunohistochemistry in 292 early breast cancer patients from the First Hospital of China Medical University between January 1999 and December 2008.Kaplan‐Meier curve and Cox proportional hazards regression were used to analyze the independent prognostic factors for overall survival(OS)and disease free survival(DFS).Nomogram was constructed based on these prognostic factors.Results: Cbl-b expression was detected in 54.1%(158/292)early breast cancer tissue samples.Though Cbl-b expression was not significantly associated with the known clinic-pathological factors in this study.Kaplan-Meier survival analyses indicated that Cbl-b expression was correlated with better OS(P=0.013)and DFS(P=0.016).Multivariate analysis showed that Cbl-b expression was an independent prognostic factor in early breast cancer.The nomograms we built for predicting OS and DFS were integrated with Cbl-b expression,age,tumor size,lymph node metastasis and histological grade.The C-indexes of the nomograms were 0.735 and 0.662,respectively.The novel nomogram was superior to TNM staging.Conclusion: Cbl-b expression independently predicts favorable prognosis in early breast cancer.Cbl-b expression,combined with age,tumor size,lymph node metastasis and histological grade could be a more precise clinical model for predicting OS and DFS in patients with early breast cancer.