Open Access Research article

Low expression of TFPI-2 associated with poor survival outcome in patients with breast cancer

Cheng Xu1, Huijun Wang2, Hongyu He3, Fengyun Zheng4, Yating Chen4, Jin Zhang4, Xiaoyan Lin1, Duan Ma4* and Hongwei Zhang3*

Author Affiliations

1 Department of Breast Surgery, Yangpu Hospital, Tongji University, Shanghai, 200090, China

2 Children’s Hospital of Fudan University, Shanghai, 201102, China

3 Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

4 Key Laboratory of Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Institute of Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China

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BMC Cancer 2013, 13:118  doi:10.1186/1471-2407-13-118

Published: 15 March 2013



The purpose of this study is to evaluate the prognostic value of TFPI-2 expression in breast cancer patients through examining the correlation between TFPI-2 expression and breast cancer clinicopathologic features.


Immunohistochemical staining combined with digital image analysis was used to quantify the expression of TFPI-2 protein in breast tumor tissues. For evaluation of the prognostic value of TFPI-2 expression to each clinicopathologic factor, Kaplan-Meier method and COX’s Proportional Hazard Model were employed.


TFPI-2 expression was significantly correlated with tumor size, lymph node metastasis, histologic grade, clinical stage, and vessel invasion. More importantly, TFPI-2 expression was also associated with disease-free survival (DFS) of breast cancer patients. We found that patients with high TFPI-2 expression had longer DFS compared with those with low or negative expression of TFPI-2 (P <0.05, log-rank test). Cox’s regression analysis indicated that TFPI-2 expression, histologic grade, and vessel invasion might be significant prognostic factors for DFS, while TFPI-2 expression and histologic grade were the most significant independent predictors for tumor recurrence. Compared with the group with low/high TFPI-2 expression, the TFPI-2 negative group was more likely to have tumor relapse. The hazard ratio of DFS is 0.316 (P <0.01).


Low or negative expression of TFPI-2 is associated with breast cancer progression, recurrence and poor survival outcome after breast cancer surgery. TFPI-2 expression in breast tumors is a potential prognostic tool for breast cancer patients.

Breast cancer; TFPI-2; Prognosis; Immunohistochemical staining; Survival analysis