Cathepsin D

Cathepsin D, a lysosomal proteolytic enzyme has been identified as an independent prognostic factor in several studies. Cathepsin D protein levels greater than 70 pmol/mg protein were associated with a 4.5-fold increase in relapse rate in patients with node-negative tumors, particularly high cytosolic cathepsin-D values were associated with poor prognosis (44, 45). Furthermore, higher Cathepsin D levels were seen in the cytosol of tumors that were larger and involved lymph nodes. However, Cathepsin D levels were also higher in hormone receptor-positive tumors (46). While Cathepsin D may be an adverse prognostic factor, its role as a predictive factor of anti-hormonal therapy has not been established. However, due to technical challenges in reproducibility of the test, the assessment of Cathepsin D currently remains investigational.

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