Abstract
Estrogen receptor (ER)-positive breast cancers overall have a good prognosis, however, some patients suffer relapses and do not respond to endocrine therapy. The purpose of this study was to determine whether there are any correlations between high-resolution magic angle spinning (HR-MAS) magnetic resonance spectroscopy (MRS) metabolic profiles of core needle biopsy (CNB) specimens and the molecular markers currently used in patients with ER-positive breast cancers. The metabolic profiling of CNB samples from 62 ER-positive cancers was performed by HR-MAS MRS. Metabolic profiles were compared according to human epidermal growth factor receptor 2 (HER2) and Ki-67 status, and luminal type, using the Mann-Whitney test. Multivariate analysis was performed with orthogonal projections to latent structure-discriminant analysis (OPLS-DA). In univariate analysis, the HER2-positive group was shown to have higher levels of glycine and glutamate, compared to the HER2-negative group (P<0.01, and P <0.01, respectively). The high Ki-67 group showed higher levels of glutamate than the low Ki-67 group without statistical significance. Luminal B cancers showed higher levels of glycine (P=0.01) than luminal A cancers. In multivariate analysis, the OPLS-DA models built with HR-MAS MR metabolic profiles showed visible discrimination between the subgroups according to HER2 and Ki-67 status, and luminal type. This study showed that the metabolic profiles of CNB samples assessed by HR-MAS MRS can be used to detect potential prognostic biomarkers as well as to understand the difference in metabolic mechanism among subtypes of ER-positive breast cancer.
Highlights
Since it became known that a large subset of breast cancers depends on estrogen receptor (ER) signaling, leading to the clinical application of endocrine therapies, breast cancers have been classified into Estrogen receptor (ER)-positive and ER-negative cancers [1,2,3,4,5]
The purpose of this study was to determine whether there are any correlations between high-resolution magic angle spinning (HR-MAS) magnetic resonance spectroscopy (MRS) metabolic profiles of core needle biopsy (CNB) specimens and the molecular markers currently used in patients with ER-positive breast cancers
Patients with ER-positive breast cancers are generally thought to have a good prognosis, but some experience recurrence while others have cancers that are unresponsive to endocrine therapy [8, 25]
Summary
Since it became known that a large subset of breast cancers depends on estrogen receptor (ER) signaling, leading to the clinical application of endocrine therapies (e.g., tamoxifen, aromatase inhibitors), breast cancers have been classified into ER-positive and ER-negative cancers [1,2,3,4,5]. Patients with ER-positive cancers have significantly better outcomes than those with ER-negative cancers [1,2,3,4]. Luminal B cancers, high proliferative ER-positive cancers, have a poor prognosis compared to luminal A [9, 10]. This “intrinsic gene” molecular subclassification of ER-positive cancers has been widely used by clinicians to predict prognosis and to select treatment options for patients with these cancers [8, 11]
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