Expression of adrenomedullin and its correlation with apoptotic and mitotic count in breast invasive cancer NST with or without lymph node metastasis

Adrenomedullin is a peptide hormone with many biological activities either in physiological conditions or malignancy. In malignancy, adrenomedullin acts as a factor in stimulating proliferation, inhibiting apoptosis, and induces angiogenesis. Its secretion is influenced by hypoxia condition and cytokine secretion. The purpose of this study was to see the difference of adrenomedullin expression in breast invasive carcinoma NST in metastatic and non-metastatic breast invasive carcinoma NST. The correlation with mitosis count and apoptosis were also analysed. Twenty five cases of non-metastatic (N0) and 25 cases of metastastic breast invasive carcinoma NST (N1) were examined for the expression of adrenomedullin and Caspase-3 by immunohistochemistry method. Mitosis count was done on H&E staining. Results: There is correlation between the high expression of adrenomedullin and metastasis (p = 0.002), and correlation between expression of Caspase-3 with metastasis (p = 0.038). However, there is no correlation between mitosis with metastasis (p=0.906), no correlation between expression of adrenomedullin and expression of Caspase-3 (p = 0.697) nor mitosis (p = 0.711). High expression of adrenomedullin and low apoptotic count was correlated with metastasis to the lymph nodes, although there was no correlation to mitosis and apoptosis.