The Relationship of CDK4 Expression with Histopathological Grade and Metastasis in Luminal Subtype Breast Cancer
Abstract
Background: The luminal (Hormone Receptor-positive/HER2-negative) subtype constitutes the majority of breast cancer cases. Despite a generally favorable prognosis, a significant proportion of patients experience metastasis. Cyclin-dependent kinase 4 (CDK4) is a key regulator of the cell cycle, and its dysregulation is a known driver of uncontrolled proliferation in luminal breast cancer. However, data on its association with adverse pathological features in the Indonesian population are limited. This study aimed to investigate the relationship between CDK4 expression, histopathological grade, and metastatic status in luminal subtype breast cancer patients in Makassar, Indonesia.
Material and methods: This observational study utilized a cross-sectional design involving 74 patients with luminal subtype breast cancer. Formalin-fixed, paraffin-embedded (FFPE) tumor tissues were analyzed for CDK4 expression using immunohistochemistry (IHC). CDK4 expression was categorized as high (overexpression) or low based on staining intensity and the percentage of positive tumor cells. The Chi-square test was used to assess the association between CDK4 expression and tumor grade and metastasis.
Results: Of the 74 patients, 29 (39.2%) had metastatic disease. High CDK4 expression was significantly associated with high-grade tumors (p = 0.019) and with the presence of metastasis (p = 0.044). Patients with high CDK4 expression had 1.86 times higher odds of having metastasis compared to those with low CDK4 expression (OR = 1.862; 95% CI 1.025–3.383).
Conclusion: Overexpression of CDK4 in luminal subtype breast cancer is significantly associated with higher histopathological grade and an increased likelihood of distant metastasis. This suggests CDK4 is a valuable prognostic marker in this patient population.
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