Nuclear SOX9 Expression and Short-Term Survival Outcomes in Early-Stage Luminal Breast Cancer: An Immunohistochemical and Retrospective Cohort Analysis
7 affiliations
- 1Department of Medical Oncology, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey
- 2Department of Medical Oncology, South Tees Hospitals NHS Foundation Trust, Middlesbrough TS4 3BW, UK
- 3Department of Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, 34303 Istanbul, Turkey
- 4Department of Pathology, Kanuni Sultan Suleyman Training and Research Hospital, 34303 Istanbul, Turkey
- 5Department of General Surgery, Kanuni Sultan Suleyman Training and Research Hospital, 34303 Istanbul, Turkey
- 6Department of Pathology, Faculty of Medicine, İstanbul Medipol University, 34214 Istanbul, Turkey
- 7Department of Internal Medicine, Faculty of Medicine, İstanbul Medipol University, 34214 Istanbul, Turkey
Abstract
SOX9 is a transcription factor linked to cellular plasticity and aggressive behavior in breast cancer. We investigated whether nuclear SOX9 expression correlates with short-term (5-year) survival outcomes in luminal breast cancer. In a retrospective cohort of 60 patients with estrogen receptor-positive invasive breast carcinoma, nuclear SOX9 expression was evaluated via immunohistochemical H-scores (0–300). Survival was analyzed continuously, by median-split dichotomy, and using a 1% nuclear-staining threshold via Kaplan–Meier and Cox regression models. Most tumors were luminal B (73.3%), and 45% were node-positive. Nuclear SOX9 was detected in 51.7% of cases (median positive H-score: 30). Over follow-up, 13 disease-free survival (DFS) and 12 overall survival (OS) events occurred. Continuous H-score did not correlate with clinicopathological variables, DFS (p = 0.576), or OS (p = 0.613). A median-split showed higher 5-year DFS for high-expression tumors (89.7% vs. 74.2%, p = 0.048), but this borderline protective trend was unconfirmed by Cox regression (p = 0.063) or the 1% threshold; ROC analysis showed no discrimination (AUC: 0.34–0.36). Standalone nuclear SOX9 expression has no significant impact on short-term (5-year) prognosis in early-stage luminal breast cancer; extended follow-up is warranted to assess potential late recurrence.
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BibTeX
@article{karci2026nuclear,
title = {{Nuclear SOX9 Expression and Short-Term Survival Outcomes in Early-Stage Luminal Breast Cancer: An Immunohistochemical and Retrospective Cohort Analysis}},
author = {Ebru Karci and Sabin Goktas Aydin and Osman Erinc and Taskin Erkin Uresin and Sevinc Dagistanli and Nilay Bakoglu Malinowski and Ahmet Aydın and Onur Tanrikulu},
journal = {International Journal of Molecular Sciences},
year = {2026},
month = sep,
doi = {10.3390/ijms27188337},
url = {https://www.mdpi.com/1422-0067/27/18/8337},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Nuclear SOX9 Expression and Short-Term Survival Outcomes in Early-Stage Luminal Breast Cancer: An Immunohistochemical and Retrospective Cohort Analysis
AU - Ebru Karci
AU - Sabin Goktas Aydin
AU - Osman Erinc
AU - Taskin Erkin Uresin
AU - Sevinc Dagistanli
AU - Nilay Bakoglu Malinowski
AU - Ahmet Aydın
AU - Onur Tanrikulu
PY - 2026
DA - 2026/09/19
JO - International Journal of Molecular Sciences
DO - 10.3390/ijms27188337
UR - https://www.mdpi.com/1422-0067/27/18/8337
AB - SOX9 is a transcription factor linked to cellular plasticity and aggressive behavior in breast cancer. We investigated whether nuclear SOX9 expression correlates with short-term (5-year) survival outcomes in luminal breast cancer. In a retrospective cohort of 60 patients with estrogen receptor-positive invasive breast carcinoma, nuclear SOX9 expression was evaluated via immunohistochemical H-scores (0–300). Survival was analyzed continuously, by median-split dichotomy, and using a 1% nuclear-staining threshold via Kaplan–Meier and Cox regression models. Most tumors were luminal B (73.3%), and 45% were node-positive. Nuclear SOX9 was detected in 51.7% of cases (median positive H-score: 30). Over follow-up, 13 disease-free survival (DFS) and 12 overall survival (OS) events occurred. Continuous H-score did not correlate with clinicopathological variables, DFS (p = 0.576), or OS (p = 0.613). A median-split showed higher 5-year DFS for high-expression tumors (89.7% vs. 74.2%, p = 0.048), but this borderline protective trend was unconfirmed by Cox regression (p = 0.063) or the 1% threshold; ROC analysis showed no discrimination (AUC: 0.34–0.36). Standalone nuclear SOX9 expression has no significant impact on short-term (5-year) prognosis in early-stage luminal breast cancer; extended follow-up is warranted to assess potential late recurrence.
SN - 1422-0067
ER -