SOX2 Expression and Long-Term Survival in Invasive Breast Carcinoma: A Retrospective Cohort Study

Tülay Koç; Şahande Elagöz

doi:10.5281/zenodo.23008579

Authors

Tülay Koç Sivas Cumhuriyet University https://orcid.org/0000-0001-8612-0238
Şahande Elagöz Memorial Göztepe Hospital https://orcid.org/0000-0001-5897-5642

DOI:

https://doi.org/10.5281/zenodo.23008579

Keywords:

Breast cancer, SOX2, Cancer stem cells, Immunohistochemistry, Prognosis

Abstract

Objective: Sex-determining region Y-box 2 (SOX2) is a stemness-associated transcription factor implicated in tumor progression and treatment resistance. This study aimed to evaluate SOX2 expression in invasive breast carcinoma and investigate its association with clinicopathological parameters and long-term survival outcomes.

Material and Methods: This retrospective cohort study included 100 patients with invasive breast carcinoma diagnosed between 2009 and 2013. SOX2 expression was evaluated immunohistochemically and classified as negative or positive. Associations between SOX2 expression and clinicopathological parameters were analyzed. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier analysis and the log-rank test. Cox proportional hazards regression was used for univariable and multivariable survival analyses.

Results: SOX2 expression was positive in 27 (27.0%) tumors. Median tumor diameter was significantly greater in SOX2-positive than in SOX2-negative tumors (35 vs. 25 mm; p=0.008). SOX2-positive patients had significantly poorer OS (log-rank p=0.013) and PFS (log-rank p=0.014). In univariable Cox analysis, SOX2 positivity was associated with increased hazards of death (HR=2.02; 95% CI: 1.15–3.57; p=0.015) and progression (HR=2.08; 95% CI: 1.14–3.79; p=0.017). However, SOX2 did not retain independent prognostic significance for OS or PFS after multivariable adjustment.

Discussion and Conclusion: SOX2 expression was associated with larger tumors and adverse long-term outcomes, supporting its relationship with a more aggressive breast cancer phenotype. SOX2 may identify invasive breast carcinomas with adverse biological behavior, although its prognostic value was not independent of established clinicopathological factors.

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