الفهرس 
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Abstract
The present study comprised 70 formalin fixed- paraffin-embedded tissue specimens of invasive duct carcinoma of the breast and 54 paraffin blocks of lymph node metastasis corresponding to the primary tumor which were chosen from the Minia Oncology Center archives in the period between January 2012 to December 2016.
High HAX1 expression was detected in 47.1% of cases. HAX1 expression showed statistically significant association with tumor size (p=0.004), tumor grade (p= 0.029), lymph node status (p= 0.028), tumor stage (p=0.001), poor NPI (p=0.008), PR negativity (p=0.031), HER negativity (p=0.024), high Ki67 index (p=0.029) and distant metastasis (p=0.002).
High TPX2 expression was detected in 45.7% of cases. A significant association was found between TPX2 expression and tumor grade (p= 0.020), lymph node status (p= 0.001), LNR (p=0.005) and tumor stage (p<0.001), NPI (p=0.001) and distant metastasis (p<0.001).
Statistically significant positive correlation was found between expression of HAX1 and TPX2 (p<0.001).
As regard HAX1 expression in the tumor and corresponding metastatic node in 54 pairs; 47 pairs (87%) revealed a concordance rate between the primary tumor and corresponding lymph node metastasis. However, 7 cases (13%) showed different expression of HAX1 between tumor and corresponding node metastasis. Four cases of them (7.4%) showed high expression in primary tumor and low expression in corresponding node metastasis. On the other hand, 5.6% (3 cases) showed low expression in primary tumor and high expression in corresponding node metastasis. The results were statistically significant (p<0.001).
As regard TPX2 expression in the primary tumor and corresponding metastatic lymph node in 54 pairs; 51 pairs (94.4%) revealed a concordance rate between the primary tumor and corresponding lymph node metastasis. However, 3 cases (5.6%) showed different expression of TPX2 between primary tumor and corresponding lymph node metastasis. Only one case (1.9%) showed high expression in primary tumor and low expression in corresponding node metastasis. Two cases (3.7%) showed low expression in primary tumor and high expression in corresponding lymph node metastasis. The results were statistically significant (p<0.001).
Regarding markers expression and DFS, patients expressed high HAX1 expression had significantly shorter DFS or RFS than those patients with low HAX1 expression (p= 0.003). Moreover, patients expressed high expression of TPX2 had significantly shorter DFS or RFS than those with low expression (p=0.002).
In the multivariate analysis, molecular subtypes, distant metastasis and local recurrence at the site of the operation were independent prognostic factors (p=0.020, p=0.001 and p=0.002 respectively). In addition, TPX2 expression had independent prognostic impact in patients studied (p= 0.045), while the other variables were not statistically significant.