Abstract
We studied the association between the presence of 2 or more stemness gene amplifications as well as copy number aberrations (CNAs) of WNT signaling genes in residual breast tumor and metastasis. WNT pathway genes associated with metastasis were identified.Material and Methods. The study included 30 patients with breast cancer, who had 2 or more stemness gene amplifications in the residual tumor after neoadjuvant chemotherapy. Fifteen of the thirty patients developed hematogenous metastases; they constituted a group with metastases, the remaining 15 patients entered the second group without metastases. The tumor DNA was examined using a CytoScanHD Array microarray (Affymetrix, USA).Results. By subtracting amplification and deletion frequencies in 852 cytobands between groups with metastases and without metastases, 21 cytobands were identified with the largest difference in deletion and amplification frequencies. They contain 19/150 of WNT genes (12 activators: SKP1, WNT8A, MAPK9, CCND3, FZD9, WNT8B, CCND1, PLCB2, PRKCB, FZD2, WNT3, WNT9B and 7 negative regulators: GSK3B, APC, CSNK2B, SFRP5, BTRC, TCF7L2, CSNK2A2). A point system was developed: when amplifying WNT-signaling activators or deletion of negative regulators, one point was added to the total score, and vice versa when deleting WNT-signaling activators or amplification of negative regulators, one point was taken from the total amount. It was shown that 93% (14/15) of patients with metastases had a total score higher than 0, while 93% (14/15) of patients without metastases had a total score of zero or less than zero. The differences between the groups were statistically significant according to the two-sided Fisher test with a high level of confidence probability (p=0.000003) and the log-rank test (p=0.00004) when assessing non-metastatic survival by the Kaplan-Mayer method.Conclusion. Nineteen WNT signaling genes were identified. Copy number aberrations of these genes in combination with stemness gene amplifications in residual tumors were associated with metastasis. A new highly effective prognostic factor for breast cancer was identified.
Highlights
We showed the association of amplifications of chromosome regions of stemness genes localization (3q (26.33), 5p (15.33; 13.1), 6p (24.3; 22.3; 21.33; 21.32), 7q (11.23; 21.13; 31.2; 32.1), 8q (11.21; 24), 9p (21.2), 9q (34.3; 21.13; 31.2, 22.33), 10p (15.2; 13; 12.2; 11.22), 10q22.1, 12p (13.31) 13q (34; 32.3; 22.1; 13.3; 12.2), 16p (11.2; 13.3), 18q (21.1; 21.2) 19p (13.3; 13.2; 13.12) with hematogenous metastasis
We studied the association between the presence of 2 or more stemness gene amplifications as well as copy number aberrations (CNAs) of WNT signaling genes in residual breast tumor and metastasis
A point system was developed: when amplifying WNT-signaling activators or deletion of negative regulators, one point was added to the total score, and vice versa when deleting WNT-signaling activators or amplification of negative regulators, one point was taken from the total amount
Summary
We showed the association of amplifications of chromosome regions of stemness genes localization (3q (26.33), 5p (15.33; 13.1), 6p (24.3; 22.3; 21.33; 21.32), 7q (11.23; 21.13; 31.2; 32.1), 8q (11.21; 24), 9p (21.2), 9q (34.3; 21.13; 31.2, 22.33), 10p (15.2; 13; 12.2; 11.22), 10q22.1, 12p (13.31) 13q (34; 32.3; 22.1; 13.3; 12.2), 16p (11.2; 13.3), 18q (21.1; 21.2) 19p (13.3; 13.2; 13.12) with hematogenous metastasis. It was found that in cases when tumor cell clones with 2 or more amplifications of the above chromosomal regions remained in a residual tumor after neoadjuvant chemotherapy, 50 % of the patients developed metastases. The results of this study showed that the presence of 2 or more amplifications at regions of stemness gene localization in residual tumors was a necessary, but not sufficient condition for metastasis development. After cancellation of doxorubicin and tamoxifen, the activity of the WNT signaling pathway significantly increased in tumor cells and the number of stem tumor cells increased
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