EXPRESSION OF OESTROGEN AND PROGESTERONE RECEPI ORS, Ki-67, p53 AND BCL-2 PROTEINS, CATHEPSIN D, UROKINASE PLASMINOGEN ACT1 VATOR AND UROKINASE PLASMINOGEN ACTIVATOR-RECEPTORS IN CARCINOMAS OF THE FEMALE BREAST IN AN AFRICAN POPULATION

Objective: To determine the expression of oestrogen (ER) and proj ;esterone receptor (PgR),Ki-67, p53, bcl-2 proteins and the proteolytic enzymes cathe~lsin D (CD), urokinaseplasminogenactivator (uPA) and its receptor (uPA-R) in primary carcinomas of the breastfrom indigenous Tanzanian female patients by immunohistochenristry.Design: i'rospective cross-sectional study.Setting: Muhimbili Medical Centre, Dar es Salaam, Tanzania.Subjects: Sixty patients admited between 1995 and 1997.Results: Markers were found to be expressed as follows: ER (3: .3%), PgR (18.3%), p53(30%), bcl-2 (43.5%) and the median proliferation rate of Ki-67 was 15%. Proportion oftumours positive for ER, PgR and bcl-2 initially decreased to 12 nonths disease duration,after which it increased. The observed proliferation rate approaches that reported indeveloped countries. p53 expression did not influence the prolife ration rate nor did bcl-2expression. ER, PgR and bcl-2 were strongly co-expressed. CD was wedominantly expressedin stromal macrophages than in cancer cells.Conclusion: The low expression of ER and PgR and their strong co-expression with bcl-2might negatively influence response to hormonal therapy. The influence of bcl-2 on tumourresponse to anti-cancer therapy in patients with long disease duration requires urgentclarification. Determination of CD in stromal macrophages rathe~ than in cancer cells mayhave greatel- prognostic significance in patients of this region