Background: Eukaryotic initiation factor 4E (eIF-4E) is a 25-kilodalton phosphoprotein that binds specifically to mRNA as the initial step for mRNA translation. An elevated level of eIF4E has been associated with the up-regulation of various protooncogene products. Transfection of cell lines by viral vectors with eIF4E overexpression has resulted in malignant transformation. The objective in this study was twofold: to examine benign and malignant breast specimens for eIF4E expression, and to determine whether eIF4E overexpression may have prognostic potential.
Methods: Western blot analysis was performed on benign and malignant breast specimens using anti-eIF4E rabbit antiserum. Quantification was accomplished by developing blots with nitroblue tetrazolium and 5-bromo-4-chloro-3-indolyl phosphate and densitometry. Confirmation of eIF4E overexpression at the cellular level was performed using immunohistologic staining in situ.
Results: The authors examined 112 breast specimens for eIF4E protein expression. Of the 52 benign breast specimens examined, none showed eIF4E overexpression. All 12 ductal carcinoma in situ specimens were found to overexpress eIF4E in the intermediate range (mean elevation: 2.5-fold). Of the 48 breast carcinoma specimens examined, all had eIF4E elevation at levels of 3-30-fold (mean: 10.5 +/- 0.9-fold). Charts from 39 patients with Stage I, II, and III breast carcinoma were reviewed. In ten patients with eIF4E overexpression of < sevenfold, there was no recurrence or death from breast carcinoma. In the 29 breast carcinoma patients with > or = 7-fold eIF4E overexpression, 9 patients had breast carcinoma recurrences and 5 had died from disease at last follow-up. The median follow-up in this study was 34.5 months.
Conclusions: Overexpression of eIF4E was observed in malignant breast specimens but not in normal or benign breast tissues. In patients with breast carcinoma, the group with high eIF4E overexpression (> or = 7-fold) experienced a worse clinical outcome (higher recurrences and death) compared with the group with low eIF4E overexpression (< 7-fold).