الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Breast carcinoma (BC) is a major public health problem worldwide. Claudins are important tight junction proteins. They came into focus for their suggested role in carcinogenesis and possible role in cancer therapy. To date, few studies have addressed the role of claudins in BC. Claudin-4 has been found to be overexpressed in a wide variety of cancers including BC, its role in BC progression and spread constitutes an active research focus.
Aim of the work: The present work was conducted to study the immunohistochemical expression of claudin-4 in invasive ductal carcinoma of the breast of no special type (IDC-NST) and analyze its association with various clinicopathological features. In addition, the current study aimed at comparing the claudin-4 expression between the primary tumors and their corresponding lymph node metastasis (LNM).
Methods: Immunohistochemical staining of claudin-4 was conducted on 50 tissue specimens of IDC-NST by using the avidin biotin-peroxidase complex method with diaminobenizidine (DAB) chromagen detection system.
Results: High claudin-4 expression was detected in 52% of cases. Claudin-4 expression showed statistically significant association with tumor laterality, tumor grade, stage, nodal status, lymph node ratio, Nottingham prognostic index, Ki67 Proliferation index, ER & PR status and triple negative phenotype (p.= 0.008, 0.027, 0.016, 0.043, 0.006, 0.006, <0.001, 0.014, 0.019 and 0.047 respectively). On comparing claudin-4 expression in 12 pairs of primary IDC-NST and their corresponding LNM, a concordance rate of 75% was found between primary tumors and their metastatic LNs where 9/12 cases maintained the same expression score. Three cases (25%) changed claudin-4 expression score from high in primary tumor into –ve/low score in LNM. However, no significant difference was found between primary tumors and their corresponding LNs regarding claudin-4 expression (P= 0.083).
Conclusions: Claudin-4 expression is suggested to be a molecular protein with an oncogenic function and biological value. Its over expression in IDC-NST and its association with many poor prognostic features highlight its role in progression and spread of invasive ductal breast carcinoma.