NOTTINGHAM PROGNOSTIC INDEX IN DIFFERENT AGE GROUPS OF NEWLY DIAGNOSED BREAST CARCINOMA PATIENTS AND ITS ASSOCIATION WITH ER, PR AND HER-2-NEU RECEPTOR STATUS
Keywords:Breast cancer, Estrogen receptor, Immunohistochemistry, Notingham prognostic index, Progesterone receptor
Objective: To calculate Notingham Prognostic Index in all newly diagnosed patients of breast carcinoma from histopathological analysis, to compare the mean Notingham Prognostic Index between different age groups and to determine the association between Notingham Prognostic Index and ER, PR, HER2 expression.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Pathology, Army Medical College, Rawalpindi, Jan to Sep 2018. Methodology: A total of 138 diagnosed cases of breast cancer with age >20 years were enrolled. Notingham Prognostic Index was calculated from histopathology report and Immunohistochemistry was performed for ER, PR and HER-2-neu status. Mean Notingham Prognostic Index was measured and compared within different age groups. Association of NPI with receptor status was assessed.
Results: Mean age of the study participants was 52.2 ± 12.2. Family history was positive in 40 (29%) of cases. ER expression was positive in 67 (48.6%) of patients, PR expression was positive in 44.9% 62 of patients and HER-2-neu expression was positive in 78 (56.5%) of cases. In overall study sample, mean Notingham Prognostic Index was found to be 5.53 ± 1.29 SD (95% CI; 5.32-5.75). In age group 21-30 years it was 7.56 ± 0.83 (95% CI; 6.53-8.59) and showed decreasing trend with increasing age (p=0.04). No significant difference was observed in mean Notingham Prognostic Index between receptor positive and negative cases (p>0.05).
Conclusion: A statistically significant difference was found in mean Notingham Prognostic Index values across age groups.