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FOSL2 expression in histologically diagnosed breast cancer: first immunohistochemical evidence from Cameroon
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DOI：10.1186/s12885-026-16682-z.png)
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Abstract
En 中文
FOSL2 (Fra-2), a member of the AP-1 transcription factor family, has been implicated in breast cancer progression and metastasis in Asian and Western cohorts, but its expression has never been characterised in sub-Saharan African populations. We aimed to describe FOSL2 immunohistochemical expression in breast cancer patients managed at Douala General Hospital, Cameroon. We conducted a retrospective cross-sectional, descriptive and analytical study from November 2023 to September 2024. Formalin-fixed, paraffin-embedded specimens from women with histologically confirmed breast carcinoma were processed at Douala General Hospital and analysed by immunohistochemistry at Centre Pasteur du Cameroun. FOSL2 staining was assessed for subcellular localisation, intensity (0–3+), percentage of stained cells and H-score (0–300). Associations between FOSL2 expression (positivity, H-score) and clinicopathological variables were evaluated using Fisher’s exact test and Mann–Whitney U test. Fifty-five women (mean age 48.9 ± 13.8 years) were included. Invasive ductal carcinoma predominated (83.6%); 18 patients (32.7%) had metastatic disease at diagnosis. FOSL2 was expressed in 54/55 tumours (98.2%), with predominantly nuclear localisation (74.1%) and moderate intensity (61.8%). All metastatic tumours were FOSL2-positive (18/18), although positivity was similarly high among non-metastatic tumours (36/37, 97.3%). Median H-score was 20 (IQR 10–66) and did not differ significantly by metastatic status (p = 0.64), SBR grade (p = 0.21), histological type (p = 0.78), age group (p = 0.45) or prior neoadjuvant chemotherapy (p = 0.95). The near-universal positivity limited statistical power for detection of associations. To our knowledge, this is the first immunohistochemical study of FOSL2 expression in breast cancer in Cameroon. FOSL2 positivity was nearly universal (98.2%), although quantitative expression levels were generally low. Although all metastatic tumours expressed FOSL2, positivity was similarly high among non-metastatic tumours, precluding discrimination based on metastatic status. These findings justify further investigation of FOSL2 as a potential biomarker through larger studies with survival data and normal tissue controls.
Keywords:
Breast cancer
FOSL2
Fra-2
AP-1
Immunohistochemistry
Biomarker
Cameroon
Sub-Saharan Africa
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