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Zhang M, Zhou K, Wang Z, Liu T, Stevens LE, Lynce F, Chen WY, Peng S, Xie Y, Zhai D, Chen Q, Shi Y, Shi H, Yuan Z, Li X, Xu J, Cai Z, Guo J, Shao N, Lin Y. A Subpopulation of Luminal Progenitors Secretes Pleiotrophin to Promote Angiogenesis and Metastasis in Inflammatory Breast Cancer. Cancer Res 2024; 84:1781-1798. [PMID: 38507720 PMCID: PMC11148543 DOI: 10.1158/0008-5472.can-23-2640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/19/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
Inflammatory breast cancer (IBC) is a highly aggressive subtype of breast cancer characterized by rapidly arising diffuse erythema and edema. Genomic studies have not identified consistent alterations and mechanisms that differentiate IBC from non-IBC tumors, suggesting that the microenvironment could be a potential driver of IBC phenotypes. Here, using single-cell RNA sequencing, multiplex staining, and serum analysis in patients with IBC, we identified enrichment of a subgroup of luminal progenitor (LP) cells containing high expression of the neurotropic cytokine pleiotrophin (PTN) in IBC tumors. PTN secreted by the LP cells promoted angiogenesis by directly interacting with the NRP1 receptor on endothelial tip cells located in both IBC tumors and the affected skin. NRP1 activation in tip cells led to recruitment of immature perivascular cells in the affected skin of IBC, which are correlated with increased angiogenesis and IBC metastasis. Together, these findings reveal a role for cross-talk between LPs, endothelial tip cells, and immature perivascular cells via PTN-NRP1 axis in the pathogenesis of IBC, which could lead to improved strategies for treating IBC. SIGNIFICANCE Nonmalignant luminal progenitor cells expressing pleiotrophin promote angiogenesis by activating NRP1 and induce a prometastatic tumor microenvironment in inflammatory breast cancer, providing potential therapeutic targets for this aggressive breast cancer subtype.
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Affiliation(s)
- Mengmeng Zhang
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kaiwen Zhou
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zilin Wang
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ting Liu
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Laura E Stevens
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Filipa Lynce
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Wendy Y Chen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sui Peng
- Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yubin Xie
- Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Duanyang Zhai
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qianjun Chen
- Department of Breast Oncology, Traditional Chinese Medicine Hospital of Guangdong Province, Guangzhou, Guangdong, China
| | - Yawei Shi
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huijuan Shi
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhongyu Yuan
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaoping Li
- Department of Breast Oncology, Jiangmen Central Hospital, Jiangmen, China
| | - Juan Xu
- Department of Breast Oncology, Maternal and Child Health Care Hospital of Guangdong Province, Guangzhou, China
| | - Zhenhai Cai
- Department of Breast Oncology, Jieyang People's Hospital, Jieyang, China
| | - Jianping Guo
- Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Nan Shao
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Kong J, Bandyopadhyay S, Chen W, Al-Mufarrej F, Choi L, Kosir MA. Improved Rate of Negative Margins for Inflammatory Breast Cancer Using Intraoperative Frozen Section Analysis. Cancers (Basel) 2023; 15:4597. [PMID: 37760566 PMCID: PMC10526412 DOI: 10.3390/cancers15184597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer with a poor survival rate. Modified radical mastectomy (MRM) with negative pathologic margins is critical for improved survival. We aim to study the potential benefit of intraoperative frozen section analysis (FSA) to improve disease-free margins. METHODS This prospective, monocentric study included 19 patients who underwent MRM for IBC. For each patient, a 2 mm continuous skin edge was sent for FSA to guide further resection. The rate of tumor-free margins and the concurrence between the FSA and permanent pathological results were analyzed. RESULTS Overall, 15 of the 19 patients achieved negative margins, including four patients who would have had positive margins without FSA. The odds ratio of achieving a negative final margin with FSA was infinity (p = 0.031), and there was a strong agreement between the FSA and permanent pathological results (Kappa-0.83; p < 0.0001). CONCLUSIONS The FSA technique decreased the number of positive margins in IBC patients undergoing MRM, thereby potentially reducing the need for re-operation, allowing immediate wound closure, and preventing delays in the administration of adjuvant radiation therapy. More extensive trials are warranted to establish the use of intraoperative FSA in IBC treatment.
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Affiliation(s)
- Joshua Kong
- Department of Surgery, Wayne State University, 4160 John R, Suite 400, Detroit, MI 48201, USA
| | - Sudeshna Bandyopadhyay
- Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA (W.C.)
- Department of Pathology, Wayne State University, 540 E. Canfield, Ste. 9374, Detroit, MI 48201, USA
| | - Wei Chen
- Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA (W.C.)
| | - Faisal Al-Mufarrej
- Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA (W.C.)
- Division of Plastic Surgery, Department of Surgery, Wayne State University, 4160 John R, Suite 400, Detroit, MI 48201, USA
| | - Lydia Choi
- Department of Surgery, Wayne State University, 4160 John R, Suite 400, Detroit, MI 48201, USA
- Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA (W.C.)
| | - Mary A. Kosir
- Department of Surgery, Wayne State University, 4160 John R, Suite 400, Detroit, MI 48201, USA
- Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA (W.C.)
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Selvarajan G, Radhakrishnan V, Jayachandran PK, Subramaniam Murali C, Velusamy S, Krishnamurthy A, Iyer P, Ananthi B, Ganesarajah S, Sagar TG. Forecasting factors and outcomes in hawkish inflammatory breast carcinoma - A single center data exploration. Cancer Treat Res Commun 2022; 32:100599. [PMID: 35792427 DOI: 10.1016/j.ctarc.2022.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/11/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Inflammatory breast carcinoma (IBC) is an aggressive clinical syndrome of invasive breast carcinoma. There is paucity of data regarding the outcomes in IBC. OBJECTIVES Analyses of OS and Event-free survival (EFS) in nonmetastatic and metastatic IBC and to find prognostic factors influencing them. METHODOLOGY In this single center, retrospective study the data of patients fulfilling the clinical criteria of IBC were retrieved from 2016 to 2021. The impact of prognostic factors on OS and EFS were analysed by log rank test (univariate analysis). The OS and EFS were depicted as Kaplan Meier survival curves. RESULTS There were 22 patients with IBC. Median follow-up was 17 months. The median OS was significantly better in non-metastatic(M0) compared to metastatic IBC (25 months vs 6 months) with 3year OS rate of 50% vs 0% respectively. The post-menopausal status, grade 2 histology and trimodality treatment showed better outcome while N3 stage at diagnosis had worse outcome in M0 group. The lesser HR expression, lesser pCR rates, higher N3 proportion, liver metastasis and multiple metastatic site involvement contributed to the worse outcome observed in this study. CONCLUSION The aggressive clinicopathological features of IBC in the present study resulted in less favourable outcome compared to literature review. Improved outcome with trimodality highlights the emergent need for additional targeted therapy to improve pCR and operability.
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Affiliation(s)
- Gangothri Selvarajan
- Department of Medical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India.
| | - Venkatraman Radhakrishnan
- Department of Medical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
| | | | | | - Sridevi Velusamy
- Department of Surgical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
| | - Arvind Krishnamurthy
- Department of Surgical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
| | - Priya Iyer
- Department of Radiation Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
| | - Balasubramanian Ananthi
- Department of Radiation Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
| | - Selvaluxmy Ganesarajah
- Department of Radiation Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
| | - Tenali Gnana Sagar
- Department of Medical Oncology, Cancer Institute (WIA), 38, Sardar Patel Road, Chennai, 600036, India
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Remo A, Sina S, Barbi S, Simeone I, Insolda J, Parcesepe P, Giordano G, Cerulo L, Ceccarelli M, Fiorica F, Bonetti A, Pancione M, Manfrin E. Wnt (canonical and non canonical) pathways in breast carcinoma with extensive vascular invasion and inflammatory breast carcinoma. Pathol Res Pract 2021; 219:153347. [PMID: 33550148 DOI: 10.1016/j.prp.2021.153347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Breast carcinoma with extensive peritumoral vascular invasion (ePVI-BC) is a cancer with massive vascular invasion (>10) detected in more than one slide. This neoplasm shows clinic-pathological affinity with inflammatory breast carcinoma (IBC). In this paper we evaluate their biological relationship through the study of surrogate markers (β-catenin and NFAT5) of Canonical (cWnt) and non-canonical (nWnt) Wnt pathways activation. METHODS By immunoistochemistry, we investigate β-catenin and NFAT5 in 39 IBC, 74 ePVI-BC and 84 control cases (CG-BC). RESULTS cWnt was activated in 100 % of ePVI-BC, in 64 % of IBC and 10 % of CG-BC. nWnt was activated in 20 % of ePVI-BC, 50 % of IBC and 1% of CG-BC. The prognosis of carcinomas with nWnt activated was poor similar to IBC. The statistical analysis evidences as both the pathways are synergistic in malignant progression and survival time. β-catenin show an important association with prognostic factors and NFAT5 shows a relevant prognostic role on OS (p = 1.5*10-6) and DFS (P = 1,2*10-4). nWnt is associated with a worse prognosis independently of cWnt. cWnt is associated with adverse prognosis (DFS p = 0.0469; OS p = 0.004891) but its prognostic role is indifferent in carcinoma with nWnt activated. CONCLUSIONS Canonical Wnt pathway is involved in malignant progression with dominant role for vascular invasion whereas non canonical Wnt pathway plays an important role on survival time including the capacity to identify carcinomas with IBC-like prognosis. Furthermore ePVI may represent a "prodromal form of IBC" as demonstrated by its clinicopathological and biological similarity with IBC.
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Affiliation(s)
- A Remo
- Pathology Unit, ULSS9 "Scaligera" and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy.
| | - S Sina
- Pathology Unit, ULSS9 "Scaligera" and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - S Barbi
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy
| | - I Simeone
- Center for Genomic Science of IIT@SEMM - Istituto Italiano di Tecnologia, Milan, Italy; Department of Science and Technology, University of Sannio, Benevento, Italy
| | - J Insolda
- Pathology Unit, ULSS9 "Scaligera" and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - P Parcesepe
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy
| | - G Giordano
- U.O.C. Oncologia Medica, Ospedali Riuniti Azienda Ospedaliera Universitaria, 71122, Foggia, Italy
| | - L Cerulo
- Department of Science and Technology, University of Sannio, Benevento, Italy; Bioinformatics Laboratory, BIOGEM, Ariano Irpino, Avellino, Italy
| | - M Ceccarelli
- Department of Science and Technology, University of Sannio, Benevento, Italy; Bioinformatics Laboratory, BIOGEM, Ariano Irpino, Avellino, Italy
| | - F Fiorica
- Radiotherapy Unit, ULSS9 "Scaligera"and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - A Bonetti
- Oncology Unit, ULSS9 "Scaligera"and Breast Unit (Eusoma's Certification n°1030/00), Verona, Italy
| | - M Pancione
- Department of Science and Technology, University of Sannio, Benevento, Italy
| | - E Manfrin
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy.
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Preda M, Ilina R, Potre O, Potre C, Mazilu O. Survival Analysis of Patients with Inflammatory Breast Cancer in Relation to Clinical and Histopathological Characteristics. Cancer Manag Res 2020; 12:12447-12455. [PMID: 33299352 PMCID: PMC7721126 DOI: 10.2147/cmar.s278795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/24/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose To evaluate the survival of patients with inflammatory breast cancer (IBC) and to correlate these survival rates with the histopathological parameters found in the resection specimen of the tumor. Patients and Methods This retrospective study was based on 27 patients that had been diagnosed and had undergone surgery in the 2nd General and Oncological Surgery Clinic of the County Emergency Hospital in Timisoara, Romania. Data about the patient group were collected from archived patient files over a period of eight years starting from January 2008. The collected data regarded age, tumor size and histopathological type and immunohistochemistry (IHC), presence or absence of tumor embolus in lymphatic or blood vessels and the presence or absence of distant metastases at the time of diagnosis. We evaluated the impact of tumor characteristics on the patients’ outcome. Results The 12-month survival rates postsurgery were significantly increased if tumors were <5 cm compared to those >5 cm (p=0.046), if nodal status was N0 vs N1–2 (p=0.039), as well as in cases where distant metastases were absent, compared to patients with distant metastases (p=0.001, α=0.001) and positive-hormone receptors (p=0.043). Survival was influenced neither by histopathological type (p=0.357) nor by the presence of tumor embolus in the resection specimen (p=0.250) and HER2 status (p=0.763). Survival at 12 months after surgery was equal between those with stage IIIB noninflammatory breast cancer (NIBC) and IBC. At 24 months after surgery, IBC cases presented a significantly lower probability of survival. Conclusion The prognosis of patients with IBC is reserved compared to NIBC, increased tumor size, positive lymph node, hormone receptors negative cases and distant metastases drastically decreasing survival rates.
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Affiliation(s)
- Marius Preda
- 1st Department of Surgery, Discipline of Surgical Semiology II, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.,2nd General and Oncological Surgery Clinic, Timisoara's Emergency City Hospital, Timisoara, Romania
| | - Răzvan Ilina
- 1st Department of Surgery, Discipline of Surgical Semiology II, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.,2nd General and Oncological Surgery Clinic, Timisoara's Emergency City Hospital, Timisoara, Romania
| | - Ovidiu Potre
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.,Hematology Clinic, Timisoara's Emergency City Hospital, Timisoara, Romania
| | - Cristina Potre
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.,Hematology Clinic, Timisoara's Emergency City Hospital, Timisoara, Romania
| | - Octavian Mazilu
- 1st Department of Surgery, Discipline of Surgical Semiology II, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.,2nd General and Oncological Surgery Clinic, Timisoara's Emergency City Hospital, Timisoara, Romania
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Dobiasova B, Mego M. Biomarkers for Inflammatory Breast Cancer: Diagnostic and Therapeutic Utility. BREAST CANCER-TARGETS AND THERAPY 2020; 12:153-163. [PMID: 33116817 PMCID: PMC7569067 DOI: 10.2147/bctt.s231502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/03/2020] [Indexed: 12/11/2022]
Abstract
Inflammatory breast cancer (IBC) is a rare and highly aggressive subtype of advanced breast cancer. The aggressive behavior, resistance to chemotherapy, angiogenesis, and high metastatic potential are key intrinsic characteristics of IBC caused by many specific factors. Pathogenesis and behavior of IBC are closely related to tumor surrounding inflammatory and immune cells, blood vessels, and extracellular matrix, which are all components of the tumor microenvironment (TME). The tumor microenvironment has a crucial role in the local immune r09esponse. The communication between intrinsic and extrinsic components of IBC and the abundance of cytokines and chemokines in the TME strongly contribute to the aggressiveness and high angiogenic potential of this tumor. Critical modes of interaction are cytokine-mediated communication and direct intercellular contact between cancer cells and tumor microenvironment with a variety of pathway crosstalk. This review aimed to summarize current knowledge of predictive and prognostic biomarkers in IBC.
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Affiliation(s)
- Barbora Dobiasova
- 2 Department of Oncology, Comenius University, Faculty of Medicine, National Cancer Institute, Bratislava, Slovak Republic
| | - Michal Mego
- 2 Department of Oncology, Comenius University, Faculty of Medicine, National Cancer Institute, Bratislava, Slovak Republic
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Cserni G, Charafe-Jauffret E, van Diest P. Inflammatory breast cancer: The pathologists' perspective. Eur J Surg Oncol 2018; 44:1128-1134. [DOI: 10.1016/j.ejso.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/30/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022] Open
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Menta A, Fouad TM, Lucci A, Le-Petross H, Stauder MC, Woodward WA, Ueno NT, Lim B. Inflammatory Breast Cancer: What to Know About This Unique, Aggressive Breast Cancer. Surg Clin North Am 2018; 98:787-800. [PMID: 30005774 DOI: 10.1016/j.suc.2018.03.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Inflammatory breast cancer (IBC) is a rare form of breast cancer that accounts for only 2% to 4% of all breast cancer cases. Despite its low incidence, IBC contributes to 7% to 10% of breast cancer caused mortality. Despite ongoing international efforts to formulate better diagnosis, treatment, and research, the survival of patients with IBC has not been significantly improved, and there are no therapeutic agents that specifically target IBC to date. The authors present a comprehensive overview that aims to assess the present and new management strategies of IBC.
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Affiliation(s)
- Arjun Menta
- The University of Texas at Austin, 110 Inner Campus Drive, Austin, TX 78705, USA
| | - Tamer M Fouad
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Medical Oncology, The National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Anthony Lucci
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Huong Le-Petross
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Breast Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Michael C Stauder
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Wendy A Woodward
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Naoto T Ueno
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Bora Lim
- Morgan Welch Inflammatory Breast Cancer Research and Clinic Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
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9
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Remo A, Simeone I, Pancione M, Parcesepe P, Finetti P, Cerulo L, Bensmail H, Birnbaum D, Van Laere SJ, Colantuoni V, Bonetti F, Bertucci F, Manfrin E, Ceccarelli M. Systems biology analysis reveals NFAT5 as a novel biomarker and master regulator of inflammatory breast cancer. J Transl Med 2015; 13:138. [PMID: 25928084 PMCID: PMC4438533 DOI: 10.1186/s12967-015-0492-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 04/14/2015] [Indexed: 01/30/2023] Open
Abstract
Background Inflammatory breast cancer (IBC) is the most rare and aggressive variant of breast cancer (BC); however, only a limited number of specific gene signatures with low generalization abilities are available and few reliable biomarkers are helpful to improve IBC classification into a molecularly distinct phenotype. We applied a network-based strategy to gain insight into master regulators (MRs) linked to IBC pathogenesis. Methods In-silico modeling and Algorithm for the Reconstruction of Accurate Cellular Networks (ARACNe) on IBC/non-IBC (nIBC) gene expression data (n = 197) was employed to identify novel master regulators connected to the IBC phenotype. Pathway enrichment analysis was used to characterize predicted targets of candidate genes. The expression pattern of the most significant MRs was then evaluated by immunohistochemistry (IHC) in two independent cohorts of IBCs (n = 39) and nIBCs (n = 82) and normal breast tissues (n = 15) spotted on tissue microarrays. The staining pattern of non-neoplastic mammary epithelial cells was used as a normal control. Results Using in-silico modeling of network-based strategy, we identified three top enriched MRs (NFAT5, CTNNB1 or β-catenin, and MGA) strongly linked to the IBC phenotype. By IHC assays, we found that IBC patients displayed a higher number of NFAT5-positive cases than nIBC (69.2% vs. 19.5%; p-value = 2.79 10-7). Accordingly, the majority of NFAT5-positive IBC samples revealed an aberrant nuclear expression in comparison with nIBC samples (70% vs. 12.5%; p-value = 0.000797). NFAT5 nuclear accumulation occurs regardless of WNT/β-catenin activated signaling in a substantial portion of IBCs, suggesting that NFAT5 pathway activation may have a relevant role in IBC pathogenesis. Accordingly, cytoplasmic NFAT5 and membranous β-catenin expression were preferentially linked to nIBC, accounting for the better prognosis of this phenotype. Conclusions We provide evidence that NFAT-signaling pathway activation could help to identify aggressive forms of BC and potentially be a guide to assignment of phenotype-specific therapeutic agents. The NFAT5 transcription factor might be developed into routine clinical practice as a putative biomarker of IBC phenotype. Electronic supplementary material The online version of this article (doi:10.1186/s12967-015-0492-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea Remo
- Department of Pathology, Mater Salutis Hospital, Legnago, Italy.
| | - Ines Simeone
- Department of Science and Technology, University of Sannio, Benevento, Italy. .,Qatar Computing Research Institute (QCRI), Qatar Foundation, Doha, Qatar.
| | - Massimo Pancione
- Department of Science and Technology, University of Sannio, Benevento, Italy.
| | - Pietro Parcesepe
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy.
| | - Pascal Finetti
- Department of Molecular Oncology, Institut Paoli-Calmettes, U1068 Inserm, Marseille, France.
| | - Luigi Cerulo
- Department of Science and Technology, University of Sannio, Benevento, Italy. .,Bioinformatics Laboratory, BIOGEM, Ariano Irpino, Avellino, Italy.
| | - Halima Bensmail
- Qatar Computing Research Institute (QCRI), Qatar Foundation, Doha, Qatar.
| | - Daniel Birnbaum
- Department of Molecular Oncology, Institut Paoli-Calmettes, U1068 Inserm, Marseille, France.
| | | | - Vittorio Colantuoni
- Department of Science and Technology, University of Sannio, Benevento, Italy.
| | - Franco Bonetti
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy.
| | - François Bertucci
- Department of Molecular Oncology, Institut Paoli-Calmettes, U1068 Inserm, Marseille, France.
| | - Erminia Manfrin
- Department of Pathology and Diagnosis, University of Verona, Verona, Italy.
| | - Michele Ceccarelli
- Department of Science and Technology, University of Sannio, Benevento, Italy. .,Qatar Computing Research Institute (QCRI), Qatar Foundation, Doha, Qatar.
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Systems biology analysis of gene expression data and gene network reverse-engineering approaches reveal NFAT5 as a candidate biomarker in Inflammatory Breast Cancer. J Immunother Cancer 2015. [PMCID: PMC4547160 DOI: 10.1186/2051-1426-3-s1-p6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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