Abstract
Simple SummaryThis prospective study was designed to examine the utility of stromal cell-derived factor 1α (SDF-1α) and selected vasculo-angiogenic parameters—vascular endothelial growth factor A (VEGF-A), the soluble forms of VEGF receptors type 1 and 2, and the number of circulating endothelial progenitor cells (circulating EPCs)—for estimating the probability of disease relapse in invasive breast cancer (IBrC) patients. Kaplan–Meier plots and log-rank and F Cox tests were used to determine the clinical outcomes in terms of disease-free survival (DFS). Patients with a combination of SDF-1α lower than 42 pg/dL and a number of circulating EPCs lower than 9.68 cells/µL had significantly shorter DFS (p = 0.0138); thus, the combination of these two factors shows strong diagnostic power for the prediction of disease relapse.(1) Background: Tumour angiogenesis is critical for the progression of neoplasms. A prospective study was designed to examine the utility of stromal cell-derived factor 1α (SDF-1α) and selected vasculo-angiogenic parameters for estimating the probability of disease relapse in 84 primary, operable invasive breast cancer (IBrC) patients (40 (48%) with stage IA and 44 (52%) with stage IIA and IIB). (2) Methods: We explored the prognostic value of the plasma levels of SDF-1α, vascular endothelial growth factor A (VEGF-A), the soluble forms of VEGF receptors type 1 and 2, and the number of circulating endothelial progenitor cells (circulating EPCs) in breast cancer patients. The median follow-up duration was 58 months, with complete follow-up for the first event. (3) Results: According to ROC curve analysis, the optimal cut-off point for SDF-1α (for discriminating between patients at high and low risk of relapse) was 42 pg/mL, providing 57% sensitivity and 75% specificity. Kaplan–Meier curves for disease-free survival (DFS) showed that concentrations of SDF-1α lower than 42 pg/dL together with a VEGFR1 lower than 29.86 pg/mL were significantly associated with shorter DFS in IBrC patients (p = 0.0381). Patients with both SDF-1α lower than 42 pg/dL and a number of circulating EPCs lower than 9.68 cells/µL had significantly shorter DFS (p = 0.0138). (4) Conclusions: Our results imply the clinical usefulness of SDF-1α, sVEGFR1 and the number of circulating EPCs as prognostic markers for breast cancer in clinical settings.
Highlights
Breast cancer cases and deaths continue to rise worldwide, with invasive breast cancer (IBrC) being commonly diagnosed
We investigated the association of stromal cell-derived factor 1α (SDF-1α) with selected vasculo-angiogenic factors in terms of prognosis
SDF-1α is released by cancer-associated fibroblasts and recruits endothelial progenitor cells and induces the expression of vascular endothelial growth factor (VEGF), which leads to the development of the tumour blood vessel network
Summary
Breast cancer cases and deaths continue to rise worldwide, with invasive breast cancer (IBrC) being commonly diagnosed. Non-invasive breast carcinomas, the ductal type, are not usually lethal and can often be managed by conservative approaches including breast-conserving surgery, but invasive tumours with metastatic spread remain a challenge for contemporary medicine. Breast cancer is a complex disease, which includes different subtypes with specific clinical, histopathologic and molecular features. These subtypes include: luminal A, luminal B, triple-negative (basal-like), HER2-enriched and normal-like IBrC and can be distinguished with the use of immunohistochemical (IHC) markers such as oestrogen receptor (ER), progesterone receptor (PR), expression of human epidermal growth factor receptor 2 (HER2) and expression of the proliferation marker Ki67. Knowledge of the molecular biology of breast cancer invasion and metastasis is crucial; identifying key molecules or signalling pathways involved in these processes should help in the development of new targeted therapy options that more efficiently prevent tumour recurrence [2]
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