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Open Access Research article

Gene expression of PMP22 is an independent prognostic factor for disease-free and overall survival in breast cancer patients

Dan Tong1*, Georg Heinze2, Dietmar Pils3, Andrea Wolf1, Christian F Singer1, Nicole Concin4, Gerda Hofstetter4, Ingrid Schiebel1, Margaretha Rudas5 and Robert Zeillinger13

Author Affiliations

1 Department of Obstetrics and Gynaecology, Medical University of Vienna, EBO 5Q, AKH, Währinger Gürtel 18-20, Vienna 1090, Austria

2 Section of Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, Vienna 1090, Austria

3 Ludwig-Boltzmann Cluster Translational Oncology; EBO 5Q, AKH, Waehringer Guertel 18-20, Vienna 1090, Austria

4 Department of Gynaecology and Obstetrics, Innsbruck Medical University, Christoph-Probst-Platz, Innrain 52, Innsbruck 6020, Austria

5 Clinic Institute of Pathology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria

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BMC Cancer 2010, 10:682  doi:10.1186/1471-2407-10-682

Published: 15 December 2010

Abstract

Background

Gene expression of peripheral myelin protein 22 (PMP22) and the epithelial membrane proteins (EMPs) was found to be differentially expressed in invasive and non-invasive breast cell lines in a previous study. We want to evaluate the prognostic impact of the expression of these genes on breast cancer.

Methods

In a retrospective multicenter study, gene expression of PMP22 and the EMPs was measured in 249 primary breast tumors by real-time PCR. Results were statistically analyzed together with clinical data.

Results

In univariable Cox regression analyses PMP22 and the EMPs were not associated with disease-free survival or tumor-related mortality. However, multivariable Cox regression revealed that patients with higher than median PMP22 gene expression have a 3.47 times higher risk to die of cancer compared to patients with equal values on clinical covariables but lower PMP22 expression. They also have a 1.77 times higher risk to relapse than those with lower PMP22 expression. The proportion of explained variation in overall survival due to PMP22 gene expression was 6.5% and thus PMP22 contributes equally to prognosis of overall survival as nodal status and estrogen receptor status. Cross validation demonstrates that 5-years survival rates can be refined by incorporating PMP22 into the prediction model.

Conclusions

PMP22 gene expression is a novel independent prognostic factor for disease-free survival and overall survival for breast cancer patients. Including it into a model with established prognostic factors will increase the accuracy of prognosis.