Breast Cancer Levels Research Articles

Eukaryotic translation initiation factor 3 subunit B could serve as a potential prognostic predictor for breast cancer

ABSTRACT The EIF3 gene family is essential in controlling translation initiation during the cell cycle. The significance of the EIF3 subunits as prognostic markers and therapeutic targets in breast cancer is not yet clear. We analyzed the expression of EIF3 subunits in breast cancer on the GEPIA and Oncomine databases and compared their expression in breast cancer and normal tissues using BRCA data downloaded from TCGA. Then we performed clinical survival analysis on the Kaplan–Meier Plotter database and clinicopathologic analysis on the bc-genexMiner v4.1 database. And EIF3B was chosen for mutation analysis via the Cancer SEA online tool. Meanwhile, we performed the immunohistochemical assay, real-time RT-PCR, and Western blotting to analyze EIF3B expression levels in breast cancer. An EIF3B knockdown and a negative control cell line were conducted for MTT assay and cell cycle analysis to assess cell growth. Specifically, the results of TCGA and online databases demonstrated that upregulated EIF3B was associated with poorer overall and advanced tumor progression. We also confirmed that EIF3B was more highly expressed in breast cancer cells and tissues than normal and correlated with a worse outcome. And knockdown of EIF3B expression inhibited the cell cycle and proliferation. Furthermore, EIF3B was highly mutated in breast cancer. Collectively, our results suggested EIF3B as a potential prognostic marker and therapeutic target for breast cancer.

LncRNA UCA1 promotes SOX12 expression in breast cancer by regulating m6A modification of miR-375 by METTL14 through DNA methylation.

Breast cancer, a multifactorial disease, represents one of the leading causes of cancer-related morbidity and mortality in women. This study set out to elucidate the underlying mechanism by which lncRNA UCA1 affects the m6A modification of miR-375 by mediating the DNA methylation of METTL14 and then altering SOX12 expression in breast cancer. First, the expression patterns of lncRNA UCA1, miR-375, and apoptosis-related factors were quantitated by means of RT-qPCR and western blot analysis. In addition, the proliferation, invasion, and apoptosis of cells were detected using CCK-8, Transwell, and flow cytometry, respectively. RIP was performed to further uncover the interaction of lncRNA UCA1 and DNA methyltransferases, and MSP was employed for METTL14 promoter region methylation. The DNA methyltransferase enrichment in the METTL14 promoter region was measured by ChIP. The targeting relationship between miR-375 and SOX12 was confirmed by bioinformatics analysis and dual-luciferase report assay. Lastly, the aforementioned mechanism was also verified using tumor xenograft in vivo. It was found the elevated lncRNA UCA1 expression levels serve as a risk factor of poor prognosis in breast cancer. Meanwhile, silencing lncRNA UCA1 could inhibit the proliferation and invasion, but promote apoptosis of breast cancer cells by reducing the DNA methylation of METTL14 and augmenting its expression. Furthermore, METTL14 was observed to mediate the low miR-375 expression through m6A modification, leading to increased SOX12 expression levels in breast cancer. Altogether, findings obtained in our study indicated that silencing lncRNA UCA1 curbed the progression of breast cancer through the METTL14-miR-375-SOX12 axis.

Soluble B7H3 level in breast cancer and its relationship with clinicopathological variables and T cell infiltration.

Aim of the studyAlthough early diagnosis of breast cancer (BC) is often associated with a good prognosis, there is currently no biomarker with high sensitivity serving this purpose. B7H3, a recently identified member of the B7 family, appears to inhibit antitumor immunity. We investigated the soluble B7H3 (sB7H3) level in BC and its relationship with clinicopathological variables and stromal tumor-infiltrating lymphocytes (sTILs).Material and methodsThe study, which was designed as a cross-sectional trial between January 2020 and September 2021, included 93 BC patients, 20 patients with benign breast disease (BBD) and 14 healthy volunteers as the control group. Serum sB7H3 levels were measured using the ELISA (enzyme-linked immunosorbent assay) method and sTILs were measured by immunohistochemistry using Tru-cut biopsy materials.ResultssB7H3 levels in BC patients were significantly higher than those in patients with BBD and healthy volunteers. Receiver operating characteristic curve analysis results showed that sB7H3 level may be a potential biomarker for distinguishing patients with BC from those with BBD (AUC: 0.807; sensitivity: 0.786; specificity: 0.706) and from healthy volunteers (AUC: 0.731; sensitivity: 0.700; specificity: 0.692).ConclusionsTo the best of our knowledge, the present study is the first to investigate the relationship between sB7H3 and disease parameters in BC. We found that sB7H3 may be a clinically practical and meaningful biomarker in differentiating BC from BBD. In order to evaluate the relationship of B7H3 with clinical variables in BC, and especially with sTILs, tissue-based studies with higher numbers of patients are needed.

High Glucose Accelerates Tumor Progression by Regulating MEDAG-Mediated Autophagy Levels in Breast Cancer.

Recent studies have shown that diabetes is a major risk factor for breast cancer (BC), but the mechanism is incompletely understood. Mesenteric estrogen-dependent adipogenesis (MEDAG) plays a significant role in both glucose uptake and BC development. However, the relationship between MEDAG and BC under high glucose (HG) conditions remains unclear. In our study, MEDAG expression was higher in BC tissue from diabetic patients than in BC tissue from nondiabetic patients. HG promoted BC progression in vitro and in vivo by upregulating MEDAG expression. Furthermore, MEDAG deficiency increased the autophagosome number and autophagic flux. Moreover, inhibition of autophagy partially reversed MEDAG knockdown (MEDAGKD)-induced suppression of tumorigenic biological behaviors and epithelial-mesenchymal transition (EMT) progression. Finally, MEDAG significantly suppressed AMPK phosphorylation. Additionally, the AMPK inhibitor Compound C markedly reduced autophagosome accumulation and antitumor effects in MEDAGKD cells. Treatment with the AMPK activator AICAR exhibited similar effects in MEDAG-overexpressing (MEDAGOE) cells. In conclusion, the MEDAG-AMPK-autophagy axis is vital to BC progression in diabetic patients. Our findings provide a novel treatment target for BC in patients with diabetes.

Comprehensive analysis of STAT family members as prognostic markers in human breast cancer

Breast cancer has the highest morbidity and mortality among cancers in women owing to its malignancy, and its incidence increases with age. However, the specific mechanisms underlying breast cancer recurrence and metastasis remain poorly understood. Numerous tumors have shown extensive dependence on janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling. However, the STAT family has not yet been studied systematically in breast cancer. In this study, we investigated the expression differences, prognostic values, molecular functions, and immune infiltration of STAT members in breast cancer. For these analyses, we used The Cancer Genome Atlas (TCGA), cBioPortal, Kaplan-Meier plotter, and the TIMER databases. Significant changes were observed in the STAT expression in breast cancer, and higher expression levels of STAT1/3/4/5A/5B/6 were associated with a longer overall survival in breast cancer. Moreover, significant differences in STAT3, STAT5A, and STAT6 expression were observed at different tumor stages. Members of the STAT family and the associated genes were found to be involved in the regulation of various biological functions, such as “defense response to virus”, “innate immune response”, and “protein binding” in breast cancer. The expression levels of the STAT family members were positively associated with the infiltration of B cells, CD4+T cells, CD8+T cells, macrophages, dendritic cells, and neutrophils in breast cancer. Our results indicate that the expression of the members of the STAT family may be correlated with breast cancer progression and prognosis. Therefore, the STAT family can be used as a prognostic biomarker for confirming disease prognosis and immune infiltration levels in breast cancer.

SERUM LEPTIN LEVEL IN BREAST CANCER.

Leptin is a polypeptide which is mostly produced in white fat tissue and is an important proinflammatory, proangiogenic, proinvasive and mitotic factor. There is ever more evidence suggesting the key role of leptin in the occurrence of breast cancer. The aim of the study was to investigate serum leptin levels in patients with benign breast tumors, as well as in various breast cancer phenotypes, taking into account leptin levels connected to menopausal status and body mass index (BMI). The study included 97 patients having their breast tumor surgically removed. Serum leptin level was determined by ELISA method in all study patients. Study results showed that significantly more women, regardless of having malignant or benign tumors, were postmenopausal and had a significantly higher level of leptin compared to the premenopausal group. The highest level of leptin was recorded in the group of postmenopausal obese women compared to other postmenopausal women but also compared to premenopausal women. According to BMI alone, obese women had a significantly higher level of leptin regardless of the type of tumor. The most significant differences in leptin levels observed through BMI were found in the Luminal B1 group. In conclusion, serum leptin level was shown to be a good diagnostic parameter suggesting a higher possibility of breast cancer development.

Relationship between SUVmax of 18F-FDG PET/CT and serum YKL-40 levels in breast cancer

Relationship between SUVmax of 18F-FDG PET/CT and serum YKL-40 levels in breast cancer

Hexokinase 2 Is a Pivot for Lovastatin-induced Glycolysis-to-Autophagy Reprogramming in Triple-Negative Breast Cancer Cells.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with limited therapeutic options available. We have recently demonstrated that lovastatin, a 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor, suppresses TNBC cell proliferation and stemness properties in vitro and in vivo. However, the mechanisms through which lovastatin inhibits TNBC cells are not fully understood. Here, we used 1H NMR-based metabolomic profiling to investigate lovastatin-induced metabolic changes in TNBC cell line MDA-MB-231. Among the 46 metabolites identified, lactate demonstrated the highest variable importance in projection (VIP) score. Glycolysis stress test revealed that lovastatin significantly decreased the extracellular acidification rate (ECAR) in MDA-MB-231 cells. Furthermore, lovastatin treatment down-regulated the levels of glycolysis-related proteins including GLUT1, PFK1, and PKM2 in MDA-MB-231 but not non-TNBC MDA-MB-453 cells. In addition, lovastatin induced autophagy as evidenced by increased LC3 puncta formation and LC3-II/I ratio, increased AMPK phosphorylation, and decreased Akt phosphorylation. We also revealed the interaction between the glycolytic enzyme hexokinase 2 (HK2) and the mitochondrial membrane protein voltage-dependent anion channel 1 (VDAC1), an important regulator of autophagy. Further bioinformatics analysis revealed that VDAC1 was expressed at a higher level in breast cancer than normal tissues and higher level of VDAC1 predicted poorer survival outcomes in breast cancer patients. The present study suggests that lovastatin might exert anti-tumor activity by reprogramming glycolysis toward autophagy in TNBC cells through HK2-VDAC1 interaction.

CEMIP as a potential biomarker and therapeutic target for breast cancer patients.

Purpose: We aimed to evaluate whether CEMIP plays any role in the survival outcome of breast cancer (BC) patients, as well as to explore the regulatory mechanism of CEMIP in BC.Methods: We evaluated the expression and prognostic effect of CEMIP in BC patients using the Oncomine, GEPIA, UALCAN, and Kaplan-Meier plotter databases. Additionally, we detected CEMIP mRNA and protein levels in BC and normal tissues via PCR and western blotting analyses. Through immunochemistry analysis, we quantified CEMIP expression in 233 samples from BC patients. We then analyzed the link between the survival outcomes and CEMIP expression based on these clinical samples. Furthermore, we explored the immune-related molecules regulated by CEMIP and its coexpressed genes using the STRING database.Results: CEMIP expression was higher in BC tissues than in normal tissues. Patients with high CEMIP mRNA levels had a worse survival outcome. Similarly, patients expressing CEMIP had significantly shorter overall survival and disease-free survival than those not expressing the protein (P < 0.01). Some lymphocytes, immune inhibitors, immune stimulators, MHC molecules, chemokines, and chemokine receptors can be regulated by CEMIP, and CEMIP and its coexpressed genes can participate in the hyaluronan biosynthetic process, hyaluronan catabolic process, and other related biological processes in the progression of BC.Conclusion: Compared to normal tissues, BC tissues had higher number of CEMIP transcripts. CEMIP expression was associated with an adverse prognosis. CEMIP and its coexpressed genes can participate in the progression of BC. Therefore, CEMIP may be a potential biomarker for the treatment of BC patients.

Micro ribonucleic acid-448 regulates zinc finger e-box binding homeobox 1 to inhibit the growth of breast cancer cells and increase their sensitivity to chemotherapy

ObjectiveThis study aimed to investigate the effect of Zinc Finger E-box Binding Homeobox 1 (ZEB1) regulation by Micro Ribonucleic acid (miR)-448 on Breast Cancer (BC) cells and their sensitivity to chemotherapy. MethodsmiR-448 and ZEB1 mRNA levels in BC and normal tissues were detected by qPCR, and ZEB1 protein was detected by Western Blotting (WB). The correlation between miR-448 and tumor metastasis, clinical staging, and ZEB1 expression was analyzed. MCF-7 cells were transfected or co-transfected with the miR-448 mimic, oe-ZEB1, or their negative controls. Changes in miR-448 and ZEB1 expression were detected by qPCR and WB. Cell proliferation was determined by CCK-8 assays, invasion changes were analyzed by Transwell assays, and apoptosis was detected by flow cytometry. ResultsmiR-448 expression in BC tissues was lower than that in normal tissues, while ZEB1 expression was increased in the former. ZEB1 expression was lower in BC patients with lymph node metastasis than in those without. In patients with clinical stage I–III BC, miR-448 expression decreased with an increase in tumor stage, which was negatively correlated with ZEB1 expression. Upregulation of miR-448 expression can suppress MCF-7 cell proliferation and invasion and promote apoptosis. Upregulation of ZEB1 expression in cells overexpressing miR-448 can partially reverse the inhibition of BC cell growth induced by miR-448. miR-448 can enhance the sensitivity of cells toward paclitaxel and 5-fluorouracil. ConclusionsmiR-448 suppresses cell proliferation and invasion and promotes apoptosis by targeting ZEB1. Moreover, it can increase the sensitivity of cells toward paclitaxel and 5-fluorouracil.

Pyroptosis-Mediated Molecular Subtypes are Characterized by Distinct Tumor Microenvironment Infiltration Characteristics in Breast Cancer.

BackgroundNumerous reports have highlighted that pyroptosis is closely linked to tumorigenesis and drug resistance of tumors. However, the potential role of pyroptosis in regulating immune cell infiltration in tumor microenvironment (TME) remains unclear.MethodsHere, we performed consensus clustering analysis based on the expression of 10 typical pyroptosis-related regulators (PRRs) to construct pyroptosis-mediated tumor pattern clusters and pyroptosis-related gene signature in breast cancer (BC). GSVA combined with ssGSEA methods were applied to evaluate the differences in biological pathway and immune cell infiltration level, respectively. The PCA method was employed to construct the pyro-score to quantify the pyroptosis pattern level of individual BC patient.ResultsWe determined three distinct pyro-clusters among 1852 BC samples, which exhibited different survival outcomes and enriched biological processes. The TME features demonstrated that these three clusters corresponded to three established immune profiles: immune-desert, immune-excluded and immune-inflamed phenotype, respectively. Based on pyroptosis-related signature genes, we constructed the pyro-score and stratified BC patients into high and low pyro-score group. Patients with high pyro-score exhibited favorable outcome and increased infiltration of immune cells. Further investigation revealed that high pyro-score was also related to high expression of immunosuppressive molecules, decreased tumor mutation burden (TMB) and high rate of mutation in significantly mutated genes (SMGs) (eg, PIK3CA and CDH1).ConclusionThis research emphasizes the indispensable role of pyroptosis in TME complexity and diversity. Assessing the pyroptosis pattern level of individual BC patient will assist us in better understanding TME features and directing more effective immunotherapeutic approaches.

Association of 25-hydroxyvitamin D, Cyclooxygenase-2 and Prostaglandin E2 Serum Levels in Breast Cancer Patients

BACKGROUND: Serum levels of 25-hydroxyvitamin D (25(OH)D), prostaglandin E2 (PGE2), and cyclooxygenase 2 (COX2) expression differ between breast cancer stages. Since, previous studies showed mixed results, in this study, we aimed to analyze vitamin D levels related to breast cancer stages and serum levels of COX2 and PGE2 in Indonesia.METHODS: This was a cross sectional study involving 75 breast cancer patients. Subjects were divided into 3 groups, namely operable early stage (K1), locally advanced stage (K2), and advanced stage (K3). Venous blood samples were taken from each subject, then were analyzed for the 25(OH)D, COX2, and PGE2 serum levels by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: There were significant differences in 25(OH)D among groups (p=0.012); between K1 and K2 (p=0.009) and between K1 and K3 (p=0.023). However, there was no significant difference in serum COX2 level (p=0.328). There were significant differences of PGE2 among groups (p=0.002); between K1 and K2 (p=0.036) and between K1 and K3 (p=0.001). Correlation test showed that there were differences between 25(OH)D serum levels and PGE2 serum level (r=0.306, p=0.008) and also between 25(OH)D serum level and breast cancer stage (r=-0.229; p=0.048).CONCLUSION: There were differences in serum Vitamin D and PGE2 levels at various stages of breast cancer. Serum 25(OH)D levels had weak correlation with breast cancer stage and PGE2 serum level. Serum vitamin D level in advanced breast cancer were lower than early stage breast cancer and indicate a poor prognosis.KEYWORDS: breast cancer, 25-hydroxyvitamin D, cyclooxygenase 2, prostaglandin E2

Kinesin family member 23 exerts a protumor function in breast cancer via stimulation of the Wnt/β-catenin pathway

Kinesin family member 23 (KIF23) has been described as one of the main genes that are associated with malignant transformation in numerous cancers. However, the exact significance of KIF23 in breast cancer has not been well-addressed. The present study was dedicated to the comprehensive investigation of KIF23 in breast cancer. Initial expression analysis through The Cancer Genome Atlas (TCGA) demonstrated high KIF23 levels in breast cancer compared with normal controls. These in silico data showing high levels of KIF23 in breast cancer were verified by assessing clinical specimens using real-time quantitative PCR and immunoblot assays. Moreover, a high KIF23 level was correlated with adverse clinical outcomes in breast cancer patients. Cellular functional experiments showed that the down-regulation of KIF23 affected the malignant behaviors of breast cancer cells in vitro, whereas the forced expression of KIF23 stimulated them. Mechanistic studies revealed that KIF23 restraint down-regulated the levels of phosphorylated glycogen synthetase kinase-3β (GSK-3β), β-catenin, cyclin D1 and c-myc in breast cancer cells, showing an inhibitory effect on the Wnt/β-catenin pathway. The suppression of GSK-3β was able to reverse KIF23-silencing-induced inactivation of the Wnt/β-catenin pathway. Inhibition of the Wnt/β-catenin pathway abolished KIF23 overexpression-mediated protumor effects in breast cancer. A xenograft assay confirmed the in vivo antitumor function of KIF23 inhibition. In conclusion, these findings suggest that KIF23 may exert a protumor function in breast cancer by stimulating the Wnt/β-catenin pathway. This work suggests that KIF23 has potential values for targeted therapy and prognosis in breast cancer.

JAM2 predicts a good prognosis and inhibits invasion and migration by suppressing EMT pathway in breast cancer

ObjectivesLarge-scale epidemiological surveys have shown that patients with Down syndrome, which is caused by a chromosomal abnormality (an extra chromosome 21), are significantly less likely to develop solid tumors, including breast cancer, than those without. This feature has prompted the search for oncogenes located on chromosome 21. Junctional adhesion molecule 2 (JAM2), which is located on chromosome 21, is expressed at low levels in breast cancer and is associated with a good prognosis. These findings strongly suggest that JAM2 may be a potential oncogene suppressor in breast cancer. However, the role and function of JAM2 in breast cancer are not yet clear. Therefore, this study aimed to explore the biological functions and mechanisms of JAM2 in breast cancer. MethodsSeveral databases were used to explore JAM2 expression in breast cancer and to analyze its diagnostic and prognostic value in breast cancer. Changes in relevant markers were examined at the gene and protein levels using RT-qPCR and Western blot techniques, in addition, cell migration and invasion abilities were identified by scratch assays and transwell assays. Untargeted metabolomics, transcriptome sequencing and Luminex liquid suspension chip detection were performed in combination to study the mechanisms. ResultsJAM2 is expressed at low levels in breast cancer, and patients with high JAM2 expression have a good prognosis, indicating that JAM2 has good clinical diagnostic and prognostic value. Overexpression of JAM2 can block the invasion and migration of breast cancer cells, and the mechanism may be that JAM2 inhibits the EMT pathway. Finally, combined multiomics analysis revealed that JAM2 may affect the immune microenvironment of breast cancer by influencing the secretion of CXCL9/10 from tumor cells.

PTGES3 is a Putative Prognostic Marker in Breast Cancer

The COX/prostaglandin (COX/PG) pathway plays a role in cancer pathogenesis via the production of prostaglandin E2 (PGE2). In breast cancer, the expression patterns of the COX/PG pathway enzymes involved in PGE2 synthesis are not well defined. Using the Cancer Genome Atlas data, we analyzed the expression patterns of cyclooxygenases, COX1 (PTGS1) and COX2 (PTGS2), and four downstream enzymes of the COX/prostaglandin pathway - PTGS3 (PTGDS), PTGES1, PTGES2 and PTGES3 - in invasive breast cancer. The Clinical Proteomic Tumor Analysis Consortium database was used to determine the expression of these six genes at the protein level. Existing single-cell RNA sequencing data were used to evaluate the expression of the six COX/PG genes in luminal and basal epithelial cells from normal breast tissues. Cox regression Kaplan-Meier adjusted survival analyses were performed to evaluate the association of COX/PG pathway genes in overall survival using the TCGA data. Finally, we utilized the Tumor Immune Estimation Resource to correlate the expression of these six COX/PG genes with tumor infiltrating immune cell number. COX1, COX2 and PTGES3 were significantly upregulated at the protein level in breast cancer compared to normal tissues (P < 0.005). However, only PTGES3 expression was elevated at both the mRNA and protein level in breast cancer (P < 0.0005). PTGES3 is the most highly expressed enzymes within the COX/PG pathway in both luminal and basal epithelial cells in normal breast tissues. Using Cox Regression Kaplan-Meier survival analysis, PTGES3 expression had a significant inverse prognostic association with breast cancer survival [HR >1.43, P=0.0057]. Elevated PTGES3 expression within the tumor microenvironment significantly correlated with CD8+ T cell abundance, suggesting a possible immunomodulatory role of PTGES3 in the tumor microenvironment. PTGES3, a terminal synthetase in the COX/prostaglandin pathway, is a putative prognostic marker in breast cancer.

Intratumoral and Peritumoral Analysis of Mammography, Tomosynthesis, and Multiparametric MRI for Predicting Ki-67 Level in Breast Cancer: a Radiomics-Based Study.

To noninvasively evaluate the use of intratumoral and peritumoral regions from full-field digital mammography (DM), digital breast tomosynthesis (DBT), dynamic contrast-enhanced (DCE), and diffusion-weighted (DW) magnetic resonance imaging (MRI) images separately and combined to predict the Ki-67 level based on radiomics. A total of 209 patients with pathologically confirmed breast cancer were consecutively enrolled from September 2017 to March 2021, who underwent DM, DBT, DCE-MRI, and DW MRI scans. Radiomics features were calculated from intratumoral and peritumoral regions in each modality and selected with the least absolute shrinkage and selection operator (LASSO) regression. Radiomics signatures (RSs) were built based on intratumoral, peritumoral, and combined intra- and peritumoral regions. The prediction performance of the RSs was evaluated using the area under the receiver operating characteristic curve (AUC), specificity, and sensitivity as comparison metrics. A nomogram was constructed by integrating the multi-model RS and important clinical predictors and assessed by calibration and decision curve analysis. The combined intra- and peritumoral RSs improved the AUC compared with intra- or peritumoral RSs in each modality. The DCE plus DW MRI yielded higher AUC and specificity but lower sensitivity compared with the DM plus DBT. The nomogram incorporating the multi-model RS, age, and lymph node metastasis status achieved the best prediction performance in the training (AUC, nomogram vs. fusion RS vs. clinical model, 0.922 vs. 0.917 vs. 0.672) and validation (AUCs, nomogram vs. fusion RS vs. clinical model, 0.866 vs. 0.838 vs. 0.661) cohorts. DCA analysis confirmed the potential clinical utility of the nomogram. Peritumoral regions can provide complementary information to intratumoral regions in mammography and MRI for the prediction of Ki-67 levels. The MRI performed better than mammography in terms of AUC and specificity but weaker in sensitivity. The nomogram has a predictive advantage over each modality and could be a potential tool for predicting Ki-67 levels in breast cancer.

Intratumoral analysis of digital breast tomosynthesis for predicting the Ki-67 level in breast cancer: A multi-center radiomics study.

To non-invasively evaluate the Ki-67 level in digital breast tomosynthesis (DBT) images of breast cancer (BC) patients based on subregional radiomics. A total of 266 patients who underwent DBT scans were consecutively enrolled at two centers, between September 2017 and September 2021. The whole tumor region was partitioned into various intratumoral subregions, based on individual- and population-level clustering. Handcrafted radiomics and deep learning-based features were extracted from the subregions and from the whole tumor region, and were selected by least absolute shrinkage and selection operator (LASSO) regression, yielding radiomics signatures (RSs). The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were calculated to assess the developed RSs. Each breast tumor region was partitioned into an inner subregion (S1) and a marginal subregion (S2). The RSs derived from S1 always generated higher AUCs compared with those from S2 or from the whole tumor region (W), for the external validation cohort (AUCs, S1 vs. W, handcrafted RSs: 0.583 [95% CI, 0.429-0.727] vs. 0.559 [95% CI, 0.405-0.705], p-value: 0.920; deep RSs: 0.670 [95% CI, 0.516-0.802] vs. 0.551 [95% CI, 0.397-0.698], p-value: 0.776). The fusion RSs, combining handcrafted and deep learning-based features derived from S1, yielded the highest AUCs of 0.820 (95% CI, 0.714-0.900) and 0.792 (95% CI, 0.647-0.897) for the internal and external validation cohorts, respectively. The subregional radiomics approach can accurately predict the Ki-67 level based on DBT data; thus, it may be used as a potential non-invasive tool for preoperative treatment planning in BC.

A Novel Gene Prognostic Signature Based on Differential DNA Methylation in Breast Cancer.

Background: DNA methylation played essential roles in regulating gene expression. The impact of DNA methylation status on the occurrence and development of cancers has been well demonstrated. However, little is known about its prognostic role in breast cancer (BC). Materials: The Illumina Human Methylation450 array (450k array) data of BC was downloaded from the UCSC xena database. Transcriptomic data of BC was downloaded from the Cancer Genome Atlas (TCGA) database. Firstly, we used univariate and multivariate Cox regression analysis to screen out independent prognostic CpGs, and then we identified methylation-associated prognosis subgroups by consensus clustering. Next, a methylation prognostic model was developed using multivariate Cox analysis and was validated with the Illumina Human Methylation27 array (27k array) dataset of BC. We then screened out differentially expressed genes (DEGs) between methylation high-risk and low-risk groups and constructed a methylation-based gene prognostic signature. Further, we validated the gene signature with three subgroups of the TCGA-BRCA dataset and an external dataset GSE146558 from the Gene Expression Omnibus (GEO) database. Results: We established a methylation prognostic signature and a methylation-based gene prognostic signature, and there was a close positive correlation between them. The gene prognostic signature involved six genes: IRF2, KCNJ11, ZDHHC9, LRP11, PCMT1, and TMEM70. We verified their expression in mRNA and protein levels in BC. Both methylation and methylation-based gene prognostic signatures showed good prognostic stratification ability. The AUC values of 3-years, 5-years overall survival (OS) were 0.737, 0.744 in the methylation signature and 0.725, 0.715 in the gene signature, respectively. In the validation groups, high-risk patients were confirmed to have poorer OS. The AUC values of 3 years were 0.757, 0.735, 0.733 in the three subgroups of TCGA dataset and 0.635 in GSE146558 dataset. Conclusion: This study revealed the DNA methylation landscape and established promising methylation and methylation-based gene prognostic signatures that could serve as potential prognostic biomarkers and therapeutic targets.

Upregulation of Interleukin-6 in HPV-Positive Breast Cancer Patients.

Interleukin-6 (IL-6) is a well-known proinflammatory cytokine with tumor promoting capacity in various forms of malignancies including breast cancer (BC). Data highlighted the substantial role of HPV in the pathogenesis of BC. Compelling evidence suggests the contribution of HPV in carcinogenesis through triggering inflammatory cytokines such as IL-6. Here, we assessed the correlation between the presence of HPV infection and the status of IL-6 expression and serum level in BC. 72 tissue specimens including tumoral (Case; n=36) and their adjacent normal tissues (Control; n=36) were used. Nested-PCR and Real-Time PCR were employed to identify HPV DNA and assess the expression of IL-6, respectively. In addition, 72 sera samples from BC patients (n=36) and an age-matched healthy control group (n=36) were taken to measure the IL-6 serum level by ELISA. Overall, the HPV DNA was detected in 19.4% (14/72) of samples. 33.33% (12/36) of cases and 5.5% (2/36) of the controls were found to be positive for HPV (P=0.003). The overexpression of IL-6 was observed in HPV+ samples compared to HPV- samples (P=0.05). However, the concentration of IL-6 serum level was remarkably different between patients and normal controls (P=0.0001. Intriguingly, IL-6 serum level was connected to the advanced clinical stage (III/IV), high grade (II/III), metastasis and, ER+ status of patients. Our finding indicated that the overexpression of the IL-6 may be connected to HPV infection in BC. Furthermore, the results reinforced the clinical significance and prognostic value of the serum IL-6 in BC patients.

Gut Microbiota in Breast Cancer Patients Differs From That of Colon Cancer Patients and Healthy Individuals: A Gut-Tumor Axis

Background: The gut microbiota influences human health and disease. Alterations in gut microbiota may have pathological consequences. Scientific knowledge about gut microbiota can facilitate predicting the likelihood of certain intestinal and/or extra-intestinal diseases. There are six main phyla in gut including Bacteroidetes, Firmicutes, Actinobacteria, Proteobacteria, Verrucomicrobia, and Fusobacteria, among which Proteobacteria and Fusobacteria are associated with colon cancer. Association of the gut microbiota pattern with colon cancer is conceivable because of their close proximity. Accordingly, breast tissue microbiota has been associated with breast tumor. Objective: This study aimed to identify the gut microbiota pattern in breast cancer, therefore, the six phyla in fecal sample from patients with breast cancer were investigated and compared with those from healthy individuals and colon cancer patients. Methods: Real-time polymerase chain reaction (PCR) was performed on DNA extracted from fecal samples based on variable region of 16S ribosomal DNA gene of the six main phyla in the gut. Results: Bacteroidetes and Firmicutes levels in breast cancer patients were higher than those in colon cancer patients and healthy individuals. Inversely, Actinobacteria, Verrucomicrobia, Proteobacteria, and Fusobacteria levels in breast cancer were lower than those in colon cancer patients and healthy individuals. Conclusion: Taking into account the decreased level of oncogenic microbiota in fecal sample from breast cancer patients compared to the level of that from colon cancer or healthy cases as well as the presence of oncogenic microbiota in breast tumor, some bacteria may have translocated from gut to breast tissue in some circumstances which likely contribute to the breast tumorigenesis (gut-tumor axis). Migration of the bacteria from gastrointestinal tract to tumor may have occurred in a similar fashion to that of the bacteria from gastrointestinal to fetus. It is worth mentioning that tumor and fetus are immune privileged sites.