Abstract:
Breast cancer is known to be aggressive among Africans including Ghanaian
women with high mortality. Nuclear factor kappa B (NF-kB), a transcription
marker has been linked to malignant tumors including breast cancer. However,
the underlying molecular mechanism remains unclear with no known published
data on NF-kB prognostic significance among breast cancer patients in Ghana
or any other African country. This study aimed to assess the prognostic
significance of NF-kB (p65) expression and its association with various
clinicopathological features in breast cancer patients at Cape Coast Teaching
Hospital (CCTH). A cross-sectional study design and purposive sampling
procedure were used to obtain breast cancer tissues from 90 breast cancer
patients and normal breast tissues from 15 individuals without breast cancer for
NF-kB (p65) examination by immunohistochemical technique and data was
analyzed by SPSS version 25. The study revealed that NF-kB (p65) was
expressed in 86.7% of breast cancer tissues with a significant relationship to
tumor grade, proliferation index (Ki67) and molecular subtype. In terms of highlevel
expression, tumor grade 3 was about 10 times that of grade 1 (54.2% versus
5.1%), and Ki67 > 20 was 79.7% compared to 20.3% for Ki67 ≤ 20. Triplenegative
breast cancer patients had 49.1% overexpression of NF-kB (p65)
compared to 17% and 25.4% for luminal A and luminal B respectively. Only
8.5% high expression of NF-kB (p65) was seen in HER 2-enriched cases. There
was no strong association between NF-kB (p65) expression and other
clinicopathological parameters such as age, hormonal receptors, laterality,
lymphovascular invasion, perineural invasion, pathological lymph node stage,
pathological tumor stage and HER 2. The AUC predictive value of NF-kB (p65)
was 0.919 with a sensitivity of 83% and specificity of 84% (p <0.0001). This
first study in Ghana (Africa) shows that NF-kB (p65) is highly expressed among
breast cancer patients in CCTH-Ghana and has a link to tumor grade, Ki67 and
molecular subtypes. NF-kB (p65) might affect the prognosis of breast cancer
patients. To assess the role and linkage of NF-kB (p65) expression as a potential
prognostic marker and therapeutic target, additional studies with a bigger sample
size and in vitro experiments are required.
