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Angius A, Pira G, Cossu-Rocca P, Sotgiu G, Saderi L, Muroni MR, Virdis P, Piras D, Vincenzo R, Carru C, Coradduzza D, Uras MG, Cottu P, Fancellu A, Orrù S, Uva P, De Miglio MR. Deciphering clinical significance of BCL11A isoforms and protein expression roles in triple-negative breast cancer subtype. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04301-w. [DOI: 10.1007/s00432-022-04301-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
Abstract
Purpose
Triple negative breast cancer (TNBC) is an aggressive clinical tumor, accounting for about 25% of breast cancer (BC) related deaths. Chemotherapy is the only therapeutic option to treat TNBC, hence a detailed understanding of the biology and its categorization is required. To investigate the clinical relevance of BCL11A in TNBC subtype, we focused on gene and protein expression and its mutational status in a large cohort of this molecular subtype.
Methods
Gene expression profiling of BCL11A and its isoforms (BCL11A-XL, BCL11A-L and BCL11A-S) has been determined in Luminal A, Luminal B, HER2-enriched and TNBC subtypes. BCL11A protein expression has been analyzed by immunohistochemistry (IHC) and its mutational status by Sanger sequencing.
Results
In our study, BCL11A was significantly overexpressed in TNBC both at transcriptional and translational levels compared to other BC molecular subtypes. A total of 404 TNBCs were selected and examined showing a high prevalence of BCL11A-XL (37.3%) and BCL11A-L (31.4%) isoform expression in TNBC, associated with a 26% of BCL11A protein expression levels. BCL11A protein expression predicts scarce LIV (HR = 0.52; 95% CI, 0.29–0.92, P = 0.03) and AR downregulation (HR = 0.37; 95% CI, 0.16–0.88; P = 0.02), as well as a higher proliferative index in TNBC cells. BCL11A-L expression is associated with more aggressive TNBC histological types, such as medullary and metaplastic carcinoma.
Conclusion
Our finding showed that BCL11A protein expression acts as an unfavorable prognostic factor in TNBC patients, especially in non luminal TNBCs subgroups. These results may yield a better treatment strategy by providing a new parameter for TNBC classification.
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Floris M, Pira G, Castiglia P, Idda M, Steri M, De Miglio M, Piana A, Cossu A, Azara A, Arru C, Deiana G, Putzu C, Sanna V, Carru C, Serra A, Bisail M, Muroni M. Impact on breast cancer susceptibility and clinicopathological traits of common genetic polymorphisms in TP53, MDM2 and ATM genes in Sardinian women. Oncol Lett 2022; 24:331. [PMID: 36039053 PMCID: PMC9404703 DOI: 10.3892/ol.2022.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/22/2022] [Indexed: 11/06/2022] Open
Abstract
Common variants of genes involved in DNA damage correction [tumor protein p53 (TP53), murine double 2 homolog oncoprotein (MDM2) and ataxia-telengiectasia mutated (ATM)] may serve a role in cancer predisposition. The purpose of the present study was to investigate the association of five variants in these genes with breast cancer risk and clinicopathological traits in a cohort of 261 women from northern Sardinia. Polymorphic variants in TP53 (rs17878362, rs1042522 and rs1625895), MDM2 (rs2279744) and ATM (rs1799757) were determined by PCR and TaqMan single nucleotide polymorphism assay in patients with breast cancer (n=136) and healthy controls (n=125). Association with clinicopathological (e.g., age at diagnosis, lymph node involvement, clinical stage) and lifestyle factors (e.g., smoking status, alcohol intake, contraceptive use) was also evaluated. TP53 rs17878362 and rs1625895 polymorphisms were associated with decreased risk of BC diagnosis in patients older than 50 years (codominant and recessive models) and post-menopause (recessive model). Furthermore, there was a significant association between lymph node status (positive vs. negative) and ATM rs1799757-delT in dominant and additive models and between MDM2 rs2279744-allele and use of oral contraceptives. This analysis suggested that TP53 rs17878362 and rs1625895 may affect age of onset of breast cancer and ATM rs1799757 and MDM2 rs2279744 may be associated with lymph node status and prolonged use of oral contraceptives, respectively.
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Affiliation(s)
- Matteo Floris
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Maria Idda
- Institute for Genetic and Biomedical Research, National Research Council, Monserrato, Cagliari, I-09121 Sardinia, Italy
| | - Maristella Steri
- Institute for Genetic and Biomedical Research, National Research Council, Monserrato, Cagliari, I-09121 Sardinia, Italy
| | - Maria De Miglio
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Andrea Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Andrea Cossu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Antonio Azara
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Caterina Arru
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Giovanna Deiana
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Carlo Putzu
- Division of Medical Oncology, Azienda Ospedaliera Universitaria, Sassari, I-07100 Sardinia, Italy
| | - Valeria Sanna
- Division of Medical Oncology, Azienda Ospedaliera Universitaria, Sassari, I-07100 Sardinia, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Antonello Serra
- Unit of Occupational Medicine, Azienda Ospedaliera Universitaria, Sassari, I-07100 Sardinia, Italy
| | - Marco Bisail
- Lega Italiana per la Lotta contro i Tumori, Sassari, I-07100 Sardinia, Italy
| | - Maria Muroni
- Institute for Genetic and Biomedical Research, National Research Council, Monserrato, Cagliari, I-09121 Sardinia, Italy
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Malune P, Piras G, Monne M, Fiamma M, Asproni R, Fancello T, Manai A, Carta F, Pira G, Fancello P, Rosu V, Uras A, Mereu C, Mameli G, Lo Maglio I, Garau MC, Palmas AD. Molecular Characterization of Severe Acute Respiratory Syndrome Coronavirus 2 Isolates From Central Inner Sardinia. Front Microbiol 2022; 12:827799. [PMID: 35095827 PMCID: PMC8795702 DOI: 10.3389/fmicb.2021.827799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background The SARS-CoV-2 pandemic stimulated an outstanding global sequencing effort, which allowed to monitor viral circulation and evolution. Nuoro province (Sardinia, Italy), characterized by a relatively isolated geographical location and a low population density, was severely hit and displayed a high incidence of infection. Methods Amplicon approach Next Generation Sequencing and subsequent variant calling in 92 respiratory samples from SARS-CoV-2 infected patients involved in infection clusters from March 2020 to May 2021. Results Phylogenetic analysis displayed a coherent distribution of sequences in terms of lineage and temporal evolution of pandemic. Circulating lineage/clade characterization highlighted a growing diversity over time, with an increasingly growing number of mutations and variability of spike and nucleocapsid proteins, while viral RdRp appeared to be more conserved. A total of 384 different mutations were detected, of which 196 were missense and 147 synonymous ones. Mapping mutations along the viral genome showed an irregular distribution in key genes. S gene was the most mutated gene with missense and synonymous variants frequencies of 58.8 and 23.5%, respectively. Mutation rates were similar for the S and N genes with one mutation every ∼788 nucleotides and every ∼712 nucleotides, respectively. Nsp12 gene appeared to be more conserved, with one mutation every ∼1,270 nucleotides. The frequency of variant Y144F in the spike protein deviated from global values with higher prevalence of this mutation in the island. Conclusion The analysis of the 92 viral genome highlighted evolution over time and identified which mutations are more widespread than others. The high number of sequences also permits the identification of subclusters that are characterized by subtle differences, not only in terms of lineage, which may be used to reconstruct transmission clusters. The disclosure of viral genetic diversity and timely identification of new variants is a useful tool to guide public health intervention measures.
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Affiliation(s)
- Paolo Malune
- UOC Ematologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Giovanna Piras
- UOC Ematologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
- *Correspondence: Giovanna Piras,
| | - Maria Monne
- UOC Ematologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Maura Fiamma
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Rosanna Asproni
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Tatiana Fancello
- UOC Cardiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Antonio Manai
- UOC Ematologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Franco Carta
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Giovanna Pira
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Patrizia Fancello
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Valentina Rosu
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Antonella Uras
- UOC Ematologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Caterina Mereu
- UOC Ematologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Giuseppe Mameli
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Iana Lo Maglio
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
| | - Maria Cristina Garau
- UOC Laboratorio Analisi Clinico-Chimiche e Microbiologia, P.O. “San Francesco,” Azienda Tutela Salute, ASSL Nuoro, Nuoro, Italy
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Tanca A, Abbondio M, Fiorito G, Pira G, Sau R, Manca A, Muroni MR, Porcu A, Scanu AM, Cossu-Rocca P, De Miglio MR, Uzzau S. Metaproteomic Profile of the Colonic Luminal Microbiota From Patients With Colon Cancer. Front Microbiol 2022; 13:869523. [PMID: 35495697 PMCID: PMC9048685 DOI: 10.3389/fmicb.2022.869523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Recent studies have provided evidence of interactions among the gut microbiota (GM), local host immune cells, and intestinal tissues in colon carcinogenesis. However, little is known regarding the functions exerted by the GM in colon cancer (CC), particularly with respect to tumor clinical classification and lymphocyte infiltration. In addition, stool, usually employed as a proxy of the GM, cannot fully represent the original complexity of CC microenvironment. Here, we present a pilot study aimed at characterizing the metaproteome of CC-associated colonic luminal contents and identifying its possible associations with CC clinicopathological features. Colonic luminal contents were collected from 24 CC tissue specimens immediately after surgery. Samples were analyzed by shotgun metaproteomics. Almost 30,000 microbial peptides were quantified in the samples, enabling the achievement of the taxonomic and functional profile of the tumor-associated colonic luminal metaproteome. Upon sample aggregation based on tumor stage, grade, or tumor-infiltrating lymphocytes (TILs), peptide sets enabling discrimination of sample groups were identified through discriminant analysis (DA). As a result, Bifidobacterium and Bacteroides fragilis were significantly enriched in high-stage and high-grade CC, respectively. Among metabolic functions, formate-tetrahydrofolate ligase was significantly associated with high-stage CC. Finally, based on the results of this pilot study, we assessed the optimal sample size for differential metaproteomic studies analyzing colonic luminal contents. In conclusion, we provide a detailed picture of the microbial and host components of the colonic luminal proteome and propose promising associations between GM taxonomic/functional features and CC clinicopathological features. Future studies will be needed to verify the prognostic value of these data and to fully exploit the potential of metaproteomics in enhancing our knowledge concerning CC progression.
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Affiliation(s)
- Alessandro Tanca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Marcello Abbondio
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Fiorito
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Medical Research Council (MRC), Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Rosangela Sau
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Manca
- Department of Pathology, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Antonio Mario Scanu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Paolo Cossu-Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Surgical Pathology Unit, Department of Diagnostic Services, "Giovanni Paolo II" Hospital, Area Socio-Sanitaria Locale (ASSL) Olbia-Azienda per la Tutela della Salute (ATS) Sardegna, Olbia, Italy
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Uzzau
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Angius A, Scanu AM, Arru C, Muroni MR, Rallo V, Deiana G, Ninniri MC, Carru C, Porcu A, Pira G, Uva P, Cossu-Rocca P, De Miglio MR. Portrait of Cancer Stem Cells on Colorectal Cancer: Molecular Biomarkers, Signaling Pathways and miRNAome. Int J Mol Sci 2021; 22:1603. [PMID: 33562604 PMCID: PMC7915330 DOI: 10.3390/ijms22041603] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer death worldwide, and about 20% is metastatic at diagnosis and untreatable. Increasing evidence suggests that the heterogeneous nature of CRC is related to colorectal cancer stem cells (CCSCs), a small cells population with stemness behaviors and responsible for tumor progression, recurrence, and therapy resistance. Growing knowledge of stem cells (SCs) biology has rapidly improved uncovering the molecular mechanisms and possible crosstalk/feedback loops between signaling pathways that directly influence intestinal homeostasis and tumorigenesis. The generation of CCSCs is probably connected to genetic changes in members of signaling pathways, which control self-renewal and pluripotency in SCs and then establish function and phenotype of CCSCs. Particularly, various deregulated CCSC-related miRNAs have been reported to modulate stemness features, controlling CCSCs functions such as regulation of cell cycle genes expression, epithelial-mesenchymal transition, metastasization, and drug-resistance mechanisms. Primarily, CCSC-related miRNAs work by regulating mainly signal pathways known to be involved in CCSCs biology. This review intends to summarize the epigenetic findings linked to miRNAome in the maintenance and regulation of CCSCs, including their relationships with different signaling pathways, which should help to identify specific diagnostic, prognostic, and predictive biomarkers for CRC, but also develop innovative CCSCs-targeted therapies.
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Affiliation(s)
- Andrea Angius
- Institute of Genetic and Biomedical Research (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy;
| | - Antonio Mario Scanu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
| | - Caterina Arru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
| | - Vincenzo Rallo
- Institute of Genetic and Biomedical Research (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy;
| | - Giulia Deiana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
| | - Maria Chiara Ninniri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Paolo Uva
- IRCCS G. Gaslini, 16147 Genoa, Italy;
| | - Paolo Cossu-Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
- Department of Diagnostic Services, “Giovanni Paolo II” Hospital, ASSL Olbia-ATS Sardegna, 07026 Olbia, Italy
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (A.M.S.); (M.R.M.); (G.D.); (M.C.N.); (A.P.); (P.C.-R.)
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6
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Angius A, Cossu-Rocca P, Arru C, Muroni MR, Rallo V, Carru C, Uva P, Pira G, Orrù S, De Miglio MR. Modulatory Role of microRNAs in Triple Negative Breast Cancer with Basal-Like Phenotype. Cancers (Basel) 2020; 12:E3298. [PMID: 33171872 PMCID: PMC7695196 DOI: 10.3390/cancers12113298] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 12/16/2022] Open
Abstract
Development of new research, classification, and therapeutic options are urgently required due to the fact that TNBC is a heterogeneous malignancy. The expression of high molecular weight cytokeratins identifies a biologically and clinically distinct subgroup of TNBCs with a basal-like phenotype, representing about 75% of TNBCs, while the remaining 25% includes all other intrinsic subtypes. The triple negative phenotype in basal-like breast cancer (BLBC) makes it unresponsive to endocrine therapy, i.e., tamoxifen, aromatase inhibitors, and/or anti-HER2-targeted therapies; for this reason, only chemotherapy can be considered an approach available for systemic treatment even if it shows poor prognosis. Therefore, treatment for these subgroups of patients is a strong challenge for oncologists due to disease heterogeneity and the absence of unambiguous molecular targets. Dysregulation of the cellular miRNAome has been related to huge cellular process deregulations underlying human malignancy. Consequently, epigenetics is a field of great promise in cancer research. Increasing evidence suggests that specific miRNA clusters/signatures might be of clinical utility in TNBCs with basal-like phenotype. The epigenetic mechanisms behind tumorigenesis enable progress in the treatment, diagnosis, and prevention of cancer. This review intends to summarize the epigenetic findings related to miRNAome in TNBCs with basal-like phenotype.
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Affiliation(s)
- Andrea Angius
- Institute of Genetic and Biomedical Research (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy;
| | - Paolo Cossu-Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (P.C.-R.); (M.R.M.)
- Department of Diagnostic Services, “Giovanni Paolo II” Hospital, ASSL Olbia-ATS Sardegna, 07026 Olbia, Italy
| | - Caterina Arru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (P.C.-R.); (M.R.M.)
| | - Vincenzo Rallo
- Institute of Genetic and Biomedical Research (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy;
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Paolo Uva
- CRS4, Science and Technology Park Polaris, Piscina Manna, 09010 Pula, CA, Italy;
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (C.A.); (C.C.); (G.P.)
| | - Sandra Orrù
- Department of Pathology, “A. Businco” Oncologic Hospital, ASL Cagliari, 09121 Cagliari, Italy;
| | - Maria Rosaria De Miglio
- Institute of Genetic and Biomedical Research (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy;
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7
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Bibbò S, Abbondio M, Sau R, Tanca A, Pira G, Errigo A, Manetti R, Pes GM, Dore MP, Uzzau S. Fecal Microbiota Signatures in Celiac Disease Patients With Poly-Autoimmunity. Front Cell Infect Microbiol 2020; 10:349. [PMID: 32793511 PMCID: PMC7390951 DOI: 10.3389/fcimb.2020.00349] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
To date, reliable tests enabling the identification of celiac disease (CD) patients at a greater risk of developing poly-autoimmune diseases are not yet available. We therefore aimed to identify non-invasive microbial biomarkers, useful to implement diagnosis of poly-autoimmunity. Twenty CD patients with poly-autoimmunity (cases) and 30 matched subjects affected exclusively by CD (controls) were selected. All patients followed a varied gluten-free diet for at least 1 year. Fecal microbiota composition was characterized using bacterial 16S ribosomal RNA gene sequencing. Significant differences in gut microbiota composition between CD patients with and without poly-autoimmune disease were found using the edgeR algorithm. Spearman correlations between gut microbiota and clinical, demographic, and anthropometric data were also examined. A significant reduction of Bacteroides, Ruminococcus, and Veillonella abundances was found in CD patients with poly-autoimmunity compared to the controls. Bifidobacterium was specifically reduced in CD patients with Hashimoto's thyroiditis and its abundance correlated negatively with abdominal circumference values in patients affected exclusively by CD. In addition, the duration of CD correlated with the abundance of Firmicutes (negatively) and Odoribacter (positively), whereas the abundance of Desulfovibrionaceae correlated positively with the duration of poly-autoimmunity. This study provides supportive evidence that specific variations of gut microbial taxa occur in CD patients with poly-autoimmune diseases. These findings open the way to future validation studies on larger cohorts, which might in turn lead to promising diagnostic applications.
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Affiliation(s)
- Stefano Bibbò
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Marcello Abbondio
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Rosangela Sau
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandro Tanca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Errigo
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Roberto Manetti
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Mario Pes
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Pina Dore
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Baylor College of Medicine, Houston, TX, United States
| | - Sergio Uzzau
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Sanges F, Floris M, Cossu-Rocca P, Muroni MR, Pira G, Urru SAM, Barrocu R, Gallus S, Bosetti C, D'Incalci M, Manca A, Uras MG, Medda R, Sollai E, Murgia A, Palmas D, Atzori F, Zinellu A, Cambosu F, Moi T, Ghiani M, Marras V, Santona MC, Canu L, Valle E, Sarobba MG, Onnis D, Asunis A, Cossu S, Orrù S, De Miglio MR. Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis. BMC Cancer 2020; 20:491. [PMID: 32487046 PMCID: PMC7268380 DOI: 10.1186/s12885-020-06998-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/24/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic variants, comparing "special types" to high-grade invasive breast carcinomas of no special type (IBC-NST). METHODS This study was performed on data obtained from TNBC Database, including pathological features and clinical records of 1009 TNBCs patients diagnosed between 1994 and 2015 in the four most important Oncology Units located in different hospitals in Sardinia, Italy. Kaplan-Meier analysis, log-rank test and multivariate Cox proportional-hazards regression were applied for overall survival (OS) and disease free survival (DFS) according to TNBC histologic types. RESULTS TNBC "special types" showed significant differences for several clinico-pathological features when compared to IBC-NST. We observed that in apocrine carcinomas as tumor size increased, the number of metastatic lymph nodes manifestly increased. Adenoid cystic carcinoma showed the smallest tumor size relative to IBC-NST. At five-year follow-up, OS was 92.1, 100.0, and 94.5% for patients with apocrine, adenoid cystic and medullary carcinoma, respectively; patients with lobular and metaplastic carcinoma showed the worst OS, with 79.7 and 84.3%, respectively. At ten-years, patients with adenoid cystic (100.0%) and medullary (94.5%) carcinoma showed a favourable prognosis, whereas patients with lobular carcinoma showed the worst prognosis (73.8%). TNBC medullary type was an independent prognostic factor for DFS compared to IBC-NST. CONCLUSIONS Our study confirms that an accurate and reliable histopathologic definition of TNBC subtypes has a significant clinical utility and is effective in the therapeutic decision-making process, with the aim to develop innovative and personalized treatments.
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Affiliation(s)
- Francesca Sanges
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Matteo Floris
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia Technology Park Polaris, Cagliari, Italy
| | - Paolo Cossu-Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100, Sassari, Italy.
- Department of Diagnostic Services, "Giovanni Paolo II" Hospital, ASSL Olbia-ATS Sardegna, Olbia, Italy.
| | - Maria R Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100, Sassari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Silvana Anna Maria Urru
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia Technology Park Polaris, Cagliari, Italy
- School of Hospital Pharmacy, University of Sassari, Sassari, Italy
| | - Renata Barrocu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio D'Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Maria Gabriela Uras
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100, Sassari, Italy
| | - Ricardo Medda
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia Technology Park Polaris, Cagliari, Italy
| | - Elisabetta Sollai
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | - Alma Murgia
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | - Dolores Palmas
- Department of Medical Oncology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | | | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesca Cambosu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Tiziana Moi
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | - Massimo Ghiani
- Department of Medical Oncology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | | | | | - Luisa Canu
- Department of Pathology, ASSL Nuoro, Nuoro, Italy
| | - Enrichetta Valle
- Department of Medical Oncology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | | | - Daniela Onnis
- Department of Pathology, Brotzu Hospital, Cagliari, Italy
| | - Anna Asunis
- Department of Pathology, Brotzu Hospital, Cagliari, Italy
| | - Sergio Cossu
- Department of Pathology, ASSL Nuoro, Nuoro, Italy
| | - Sandra Orrù
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100, Sassari, Italy.
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9
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Floris M, Sanna D, Castiglia P, Putzu C, Sanna V, Pazzola A, De Miglio MR, Sanges F, Pira G, Azara A, Lampis E, Serra A, Carru C, Steri M, Costanza F, Bisail M, Muroni MR. MTHFR, XRCC1 and OGG1 genetic polymorphisms in breast cancer: a case-control study in a population from North Sardinia. BMC Cancer 2020; 20:234. [PMID: 32192442 PMCID: PMC7083022 DOI: 10.1186/s12885-020-06749-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite conflicting results, considerable evidence suggests the association between single nucleotide polymorphisms in MTHFR, XRCC1 and OGG1 genes and, risk of developing breast cancer. Here a case-control study is reported, including 135 breat cancer patients and 112 healthy women, all representative of Northern Sardinian population. METHODS Polymerase chain reaction/restriction fragment length polymorphism method was used to determine the genotypes of five polymorphisms: MTHFR C677T (rs1801133) and A1298C (rs1801131), XRCC1 Arg194Trp (rs1799782) and Arg399Gln (rs25487) and OGG1 Ser326Cys (rs1052133). Allelic, genotypic and haplotype association analyses with disease risk and clinicopathological parameters were performed. RESULTS A nominally significant association with breast cancer risk was observed for MTHFR C677T polymorphism heterozygous genotype in the codominant model (OR: 0.57, 95% CI: 0.32-1.00, p = 0.049) and for Cys/Cys genotype of the OGG1 Ser326Cys polymorphism in the recessive model (OR: 0.23, 95% CI: 0.05-1.11, p = 0.0465). No significant differences were found at genotype-level for A1298C polymorphism of the MTHFR gene and Arg194Trp and Arg399Gln of the XRCC1 gene. Furthermore, the OGG1 and XRCC1 rs25487 polymorphisms were nominally associated with PgR, Her2 status and with sporadic breast cancer, respectively. CONCLUSIONS Based on genetic characteristics of individuals included in this study, results suggest that MTHFR CT and OGG1 Cys/Cys genotypes have a protective effect that may have an influence on breast cancer risk in a representative Northern Sardinian population.
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Affiliation(s)
- Matteo Floris
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Daria Sanna
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Paolo Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Carlo Putzu
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | | | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Francesca Sanges
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Antonio Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Emanuele Lampis
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Maristella Steri
- Institute for Genetic and Biomedical Research, National Research Council (CNR), Monserrato, Cagliari, Italy
| | - Flavia Costanza
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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10
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Angius A, Uva P, Pira G, Muroni MR, Sotgiu G, Saderi L, Uleri E, Caocci M, Ibba G, Cesaraccio MR, Serra C, Carru C, Manca A, Sanges F, Porcu A, Dolei A, Scanu AM, Rocca PC, De Miglio MR. Integrated Analysis of miRNA and mRNA Endorses a Twenty miRNAs Signature for Colorectal Carcinoma. Int J Mol Sci 2019; 20:E4067. [PMID: 31434359 PMCID: PMC6720928 DOI: 10.3390/ijms20164067] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 12/17/2022] Open
Abstract
Colorectal cancer (CRC) ranks as the most frequent carcinoma worldwide. CRC patients show strong prognostic differences and responses to treatment, and 20% have incurable metastatic disease at diagnosis. We considered it essential to investigate mechanisms that control cellular regulatory networks, such as the miRNA-mRNA interaction, known to be involved in cancer pathogenesis. We conducted a human miRNome analysis by TaqMan low density array, comparing CRC to normal colon tissue (NCT, and experimentally identified gene targets of miRNAs deregulated, by anti-correlation analysis, with the CRC whole-transcriptome profile obtained from RNASeq experiments. We identified an integrated signature of 20 deregulated miRNAs in CRC. Enrichment analyses of the gene targets controlled by these miRNAs brought to light 25 genes, members of pathways known to lead to cell growth and death (CCND1, NKD1, FZD3, MAD2L1, etc.), such as cell metabolism (ACSL6, PRPS1-2). A screening of prognosis-mediated miRNAs underlined that the overexpression of miR-224 promotes CRC metastasis, and is associated with high stage and poor survival. These findings suggest that the biology and progression of CRC depend on deregulation of multiple miRNAs that cause a complex dysfunction of cellular molecular networks. Our results have further established miRNA-mRNA interactions and defined multiple pathways involved in CRC pathogenesis.
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Affiliation(s)
- Andrea Angius
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato (CA), Italy
| | - Paolo Uva
- CRS4, Science and Technology Park Polaris, Piscina Manna, 09050 Pula (CA), Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Elena Uleri
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Maurizio Caocci
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Gabriele Ibba
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Maria Rosaria Cesaraccio
- Department of Prevention, Registro Tumori Provincia di Sassari, ASSL Sassari-ATS Sardegna, Via Rizzeddu 21, Sassari, Italy
| | - Caterina Serra
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Alessandra Manca
- Department of Pathology, AOU Sassari, Via Matteotti 60, 07100 Sassari, Italy
| | - Francesca Sanges
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Antonia Dolei
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Antonio Mario Scanu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy.
| | - Paolo Cossu Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy.
- Department of Diagnostic Services, "Giovanni Paolo II" Hospital, ASSL Olbia-ATS Sardegna, Via Bazzoni-Sircana, 07026 Olbia, Italy.
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
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11
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Castiglia P, Sanna V, Azara A, De Miglio MR, Murgia L, Pira G, Sanges F, Fancellu A, Carru C, Bisail M, Muroni MR. Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms in breast cancer: a Sardinian preliminary case-control study. Int J Med Sci 2019; 16:1089-1095. [PMID: 31523170 PMCID: PMC6743281 DOI: 10.7150/ijms.32162] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/12/2019] [Indexed: 02/05/2023] Open
Abstract
Two common polymorphisms in the MTHFR gene, C677T and A1298C, are associated with reduced enzyme activity and may be associated with breast cancer susceptibility. We performed a case-control study to investigate the association between the two SNPs in the MTHFR gene and risk of breast cancer. In total, 58 breast cancer patients and 58 unaffected controls were enrolled in the study. Polymerase chain reaction/restriction fragment length polymorphism technique (PCR-RFLP) was conducted to determine the genotypes. No significant differences were found in the genotypes of the two polymorphisms of the MTHFR gene between cases and controls. The OR and 95% CI for the 677CC, 677CT and 677TT genotypes were 1.00, 0.95 (0.39-2.31) and 0.87 (0.27-2.80), respectively; those of the 1298AA, 1298AC and 1298CC genotypes were 1.00, 0.59 (0.26-1.36) and 0.78 (1.32-4.66) respectively. Furthermore, it has been shown in patients with breast cancer a risk of presenting with an aggressive biophenotype about twice or three times higher in the presence of the C677T and A1298C polymorphisms, respectively. Finally, the A1298Cpolymorphism is significantly associated with increased recurrence risk of lymph node-positive breast cancer. Our study has not shown a significant association between MTHFR gene polymorphisms and breast cancer risk. However, it highlighted the key-role played by the presence of mutant alleles for both polymorphisms in increasing the risk of developing more aggressive phenotypes; moreover, specifically in A1298C, it might also lead to a higher risk of developing lymph node metastasis.
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Affiliation(s)
- Paolo Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Via E. De Nicola - 07100 Sassari, Italy; Sassari, Italy
| | - Antonio Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Maria R De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Luciano Murgia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Giovanna Pira
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Francesca Sanges
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Alessandro Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43 - 07100 Sassari, Italy
| | - Marco Bisail
- LILT, Sassari, Via Amendola, 40/L - 07100 Sassari, Italy
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
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12
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Angius A, Pira G, Scanu AM, Uva P, Sotgiu G, Saderi L, Manca A, Serra C, Uleri E, Piu C, Caocci M, Ibba G, Zinellu A, Cesaraccio MR, Sanges F, Muroni MR, Dolei A, Cossu-Rocca P, De Miglio MR. MicroRNA-425-5p Expression Affects BRAF/RAS/MAPK Pathways In Colorectal Cancers. Int J Med Sci 2019; 16:1480-1491. [PMID: 31673240 PMCID: PMC6818206 DOI: 10.7150/ijms.35269] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/18/2019] [Indexed: 12/16/2022] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer death worldwide and about 20% is metastatic at diagnosis and untreatable. The anti-EGFR therapy in metastatic patients is led by the presence of KRAS-mutations in tumor tissue. KRAS-wild-type CRC patients showed a positive response rate of about 70% to cetuximab or panitumumab combined with chemotherapy. MiRNAs are promising markers in oncology and could improve our knowledge on pathogenesis and drug resistance in CRC patients. This class of molecules represents an opportunity for the development of miRNA-based strategies to overcome the ineffectiveness of anti-EGFR therapy. We performed an integrative analysis of miRNA expression profile between KRAS-mutated CRC and KRAS-wildtype CRC and paired normal colic tissue (NCT). We revealed an overexpression of miR-425-5p in KRAS-mutated CRC compared to KRAS-wild type CRC and NCT and demonstrated that miR-425-5p exerts regulatory effects on target genes involved in cellular proliferation, migration, invasion, apoptosis molecular networks. These epigenetic mechanisms could be responsible of the strong aggressiveness of KRAS-mutated CRC compared to KRAS-wildtype CRC. We proved that some miR-425-5p targeted genes are involved in EGFR tyrosine kinase inhibitor resistance pathway, suggesting that therapies based on miR-425-5p may have strong potential in targeting KRAS-driven CRC. Moreover, we demonstrated a role in the oncogenesis of miR-31-5p, miR-625-5p and miR-579 by comparing CRC versus NCT. Our results underlined that miR-425-5p might act as an oncogene to participate in the pathogenesis of KRAS-mutated CRC and contribute to increase the aggressiveness of this subcategory of CRC, controlling a complex molecular network.
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Affiliation(s)
- Andrea Angius
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato (CA), Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Antonio Mario Scanu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Paolo Uva
- CRS4, Science and Technology Park Polaris, Piscina Manna, 09010 Pula, CA, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Alessandra Manca
- Department of Pathology, AOU Sassari, Via Matteotti 60, 07100 Sassari, Italy
| | - Caterina Serra
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Elena Uleri
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Claudia Piu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Maurizio Caocci
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Gabriele Ibba
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Maria Rosaria Cesaraccio
- Department of Prevention, Registro Tumori Provincia di Sassari, ASSL Sassari-ATS Sardegna, Via Rizzeddu 21, Sassari, Italy
| | - Francesca Sanges
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
| | - Antonina Dolei
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43-b, 07100 Sassari, Italy
| | - Paolo Cossu-Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy.,Department of Diagnostic Services, "Giovanni Paolo II" Hospital, ASSL Olbia-ATS Sardegna, Via Bazzoni-Sircana, 07026 Olbia, Italy
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy
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13
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Urru SAM, Gallus S, Bosetti C, Moi T, Medda R, Sollai E, Murgia A, Sanges F, Pira G, Manca A, Palmas D, Floris M, Asunis AM, Atzori F, Carru C, D'Incalci M, Ghiani M, Marras V, Onnis D, Santona MC, Sarobba G, Valle E, Canu L, Cossu S, Bulfone A, Rocca PC, De Miglio MR, Orrù S. Clinical and pathological factors influencing survival in a large cohort of triple-negative breast cancer patients. BMC Cancer 2018; 18:56. [PMID: 29310602 PMCID: PMC5759886 DOI: 10.1186/s12885-017-3969-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 12/21/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To provide further information on the clinical and pathological prognostic factors in triple-negative breast cancer (TNBC), for which limited and inconsistent data are available. METHODS Pathological characteristics and clinical records of 841 TNBCs diagnosed between 1994 and 2015 in four major oncologic centers from Sardinia, Italy, were reviewed. Multivariate hazard ratios (HRs) for mortality and recurrence according to various clinicopathological factors were estimated using Cox proportional hazards models. RESULTS After a mean follow-up of 4.3 years, 275 (33.3%) TNBC patients had a progression of the disease and 170 (20.2%) died. After allowance for study center, age at diagnosis, and various clinicopathological factors, all components of the TNM staging system were identified as significant independent prognostic factors for TNBC mortality. The HRs were 3.13, 9.65, and 29.0, for stage II, III and IV, respectively, vs stage I. Necrosis and Ki-67 > 16% were also associated with increased mortality (HR: 1.61 and 1.99, respectively). Patients with tumor histotypes other than ductal invasive/lobular carcinomas had a more favorable prognosis (HR: 0.40 vs ductal invasive carcinoma). No significant associations with mortality were found for histologic grade, tumor infiltrating lymphocytes, and lymphovascular invasion. Among lymph node positive TNBCs, lymph node ratio appeared to be a stronger predictor of mortality than pathological lymph nodes stage (HR: 0.80 for pN3 vs pN1, and 3.05 for >0.65 vs <0.21 lymph node ratio), respectively. Consistent results were observed for cancer recurrence, except for Ki-67 and necrosis that were not found to be significant predictors for recurrence. CONCLUSIONS This uniquely large study of TNBC patients provides further evidence that, besides tumor stage at diagnosis, lymph node ratio among lymph node positive tumors is an additional relevant predictor of survival and tumor recurrence, while Ki-67 seems to be predictive of mortality, but not of recurrence.
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Affiliation(s)
- Silvana Anna Maria Urru
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia (CRS4), Technology Park Polaris, Cagliari, Italy
| | - Silvano Gallus
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via G. La Masa 19, 20156, Milan, Italy
| | - Cristina Bosetti
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
| | - Tiziana Moi
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
| | - Ricardo Medda
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia (CRS4), Technology Park Polaris, Cagliari, Italy
| | - Elisabetta Sollai
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
| | - Alma Murgia
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
| | - Francesca Sanges
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Dolores Palmas
- Department of Medical Oncology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
| | - Matteo Floris
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia (CRS4), Technology Park Polaris, Cagliari, Italy
| | | | | | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Maurizio D'Incalci
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Massimo Ghiani
- Department of Medical Oncology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
| | | | - Daniela Onnis
- Department of Pathology, Brotzu Hospital, Cagliari, Italy
| | | | | | - Enrichetta Valle
- Department of Medical Oncology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
| | - Luisa Canu
- Department of Pathology, ASL Nuoro, Nuoro, Italy
| | - Sergio Cossu
- Department of Pathology, ASL Nuoro, Nuoro, Italy
| | - Alessandro Bulfone
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia (CRS4), Technology Park Polaris, Cagliari, Italy
| | - Paolo Cossu Rocca
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | | | - Sandra Orrù
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL, Cagliari, Cagliari, Italy
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14
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Uva P, Cossu-Rocca P, Loi F, Pira G, Murgia L, Orrù S, Floris M, Muroni MR, Sanges F, Carru C, Angius A, De Miglio MR. miRNA-135b Contributes to Triple Negative Breast Cancer Molecular Heterogeneity: Different Expression Profile in Basal-like Versus non-Basal-like Phenotypes. Int J Med Sci 2018; 15:536-548. [PMID: 29725243 PMCID: PMC5930454 DOI: 10.7150/ijms.23402] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 01/05/2018] [Indexed: 01/03/2023] Open
Abstract
The clinical and genetic heterogeneity of Triple Negative Breast Cancer (TNBC) and the lack of unambiguous molecular targets contribute to the inadequacy of current therapeutic options for these variants. MicroRNAs (miRNA) are a class of small highly conserved regulatory endogenous non-coding RNA, which can alter the expression of genes encoding proteins and may play a role in the dysregulation of cellular pathways. Our goal was to improve the knowledge of the molecular pathogenesis of TNBC subgroups analyzing the miRNA expression profile, and to identify new prognostic and predictive biomarkers. We conducted a human miRNome analysis by TaqMan Low Density Array comparing different TNBC subtypes, defined by immunohistochemical basal markers EGFR and CK5/6. RT-qPCR confirmed differential expression of microRNAs. To inspect the function of the selected targets we perform Gene Ontology and KEGG enrichment analysis. We identified a single miRNA signature given by miR-135b expression level, which was strictly related to TNBC with basal-like phenotype. miR-135b target analysis revealed a role in the TGF-beta, WNT and ERBB pathways. A significant positive correlation was identified between neoplastic proliferative index and miR-135b expression. These findings confirm the oncogenic roles of miR-135b in the pathogenesis of TNBC expressing basal markers. A potential negative prognostic role of miR-135b overexpression might be related to the positive correlation with high proliferative index. Our study implies potential clinical applications: miR-135b could be a potential therapeutic target in basal-like TNBCs.
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Affiliation(s)
- Paolo Uva
- CRS4, Science and Technology Park Polaris, Piscina Manna, 09010, Pula, Cagliari, Italy
| | - Paolo Cossu-Rocca
- Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy.,Department of Diagnostic Services, Pathology Unit, "Giovanni Paolo II" Hospital, ASSL Olbia - ATS Sardegna, Via Bazzoni-Sircana, 07026, Olbia, Italy
| | - Federica Loi
- Osservatorio Epidemiologico Veterinario Regionale, Via XX Settembre 9, OEVR, 09125, Cagliari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, 07100,Viale San Pietro 43b, Sassari, Italy
| | - Luciano Murgia
- Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy
| | - Sandra Orrù
- Department of Pathology, "A. Businco" Oncologic Hospital, ASL Cagliari, Via Jenner 1, 09121, Cagliari, Italy
| | - Matteo Floris
- CRS4, Science and Technology Park Polaris, Piscina Manna, 09010, Pula, Cagliari, Italy
| | - Maria Rosaria Muroni
- Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy
| | - Francesca Sanges
- Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100,Viale San Pietro 43b, Sassari, Italy
| | - Andrea Angius
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042, Monserrato (CA), Italy
| | - Maria Rosaria De Miglio
- Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 8, 07100, Sassari, Italy
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15
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Cossu-Rocca P, Muroni MR, Sanges F, Sotgiu G, Asunis A, Tanca L, Onnis D, Pira G, Manca A, Dore S, Uras MG, Ena S, De Miglio MR. EGFR kinase-dependent and kinase-independent roles in clear cell renal cell carcinoma. Am J Cancer Res 2015; 6:71-83. [PMID: 27073724 PMCID: PMC4759398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 11/03/2015] [Indexed: 06/05/2023] Open
Abstract
Epidermal growth factor receptor (EGFR) is associated with progression of many epithelial malignancies and represents a significant therapeutic target. Although clear cell renal cell carcinoma (CCRCC) has been widely investigated for EGFR molecular alterations, genetic evidences of EGFR gene activating mutations and/or gene amplification have been rarely confirmed in the literature. Therefore, until now EGFR-targeted therapies in clinical trials have been demonstrated unsuccessful. New evidence has been given about the interactions between EGFR and the sodium glucose co-transporter-1 (SGLT1) in maintaining the glucose basal intracellular level to favour cancer cell growth and survival; thus a new functional role may be attributed to EGFR, regardless of its kinase activity. To define the role of EGFR in CCRCC an extensive investigation of genetic changes and functional kinase activities was performed in a series of tumors by analyzing the EGFR mutational status and expression profile, together with the protein expression of downstream signaling pathways members. Furthermore, we investigated the co-expression of EGFR and SGLT1 proteins and their relationships with clinic-pathological features in CCRCC. EGFR protein expression was identified in 98.4% of CCRCC. Furthermore, it was described for the first time that SGLT1 is overexpressed in CCRCC (80.9%), and that co-expression with EGFR is appreciable in 79.4% of the tumours. Moreover, the activation of downstream EGFR pathways was found in about 79.4% of SGLT1-positive CCRCCs. The mutational status analysis of EGFR failed to demonstrate mutations on exons 18 to 24 and the presence of EGFR-variantIII (EGFRvIII) in all CCRCCs analyzed. FISH analysis revealed absence of EGFR amplification, and high polysomy of chromosome 7. Finally, the EGFR gene expression profile showed gene overexpression in 38.2% of CCRCCs. Our study contributes to define the complexity of EGFR role in CCRCC, identifying its bivalent kinase-dependent and kinase-independent functions, both potentially involved in CCRCC progression. These results might have important implications on therapeutic approaches to CCRCC, since the disruption of the interaction between EGFR/SGLT1, mediated by anti-EGFR antibodies and/or SGLT1 inhibitors, might constitute a novel therapeutic target for CCRCC treatment, and new clinical trials should be evaluated on the basis of this therapeutic proposal.
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Affiliation(s)
- Paolo Cossu-Rocca
- Department of Clinical and Experimental Medicine, University of SassariSassari, Italy
- Department of Diagnostic Services, Surgical Pathology Unit, “Giovanni Paolo II” Hospital, ASL OlbiaOlbia, Italy
| | - Maria R Muroni
- Department of Clinical and Experimental Medicine, University of SassariSassari, Italy
| | - Francesca Sanges
- Department of Clinical and Experimental Medicine, University of SassariSassari, Italy
| | - Giovanni Sotgiu
- Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU SassariSassari, Italy
| | - Anna Asunis
- Department of Pathology, Azienda Ospedaliera BrotzuCagliari, Italy
| | - Luciana Tanca
- Department of Oncology, “A. Businco” Oncologic Hospital, ASL CagliariCagliari, Italy
| | - Daniela Onnis
- Department of Pathology, Azienda Ospedaliera BrotzuCagliari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of SassariSassari, Italy
| | | | - Simone Dore
- Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU SassariSassari, Italy
| | - Maria G Uras
- Department of Pathology, AOU SassariSassari, Italy
| | - Sara Ena
- Department of Biomedical Sciences, University of SassariSassari, Italy
| | - Maria R De Miglio
- Department of Clinical and Experimental Medicine, University of SassariSassari, Italy
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16
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Cossu-Rocca P, Orrù S, Muroni MR, Sanges F, Sotgiu G, Ena S, Pira G, Murgia L, Manca A, Uras MG, Sarobba MG, Urru S, De Miglio MR. Analysis of PIK3CA Mutations and Activation Pathways in Triple Negative Breast Cancer. PLoS One 2015; 10:e0141763. [PMID: 26540293 PMCID: PMC4634768 DOI: 10.1371/journal.pone.0141763] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/12/2015] [Indexed: 12/19/2022] Open
Abstract
Background Triple Negative Breast Cancer (TNBC) accounts for 12–24% of all breast carcinomas, and shows worse prognosis compared to other breast cancer subtypes. Molecular studies demonstrated that TNBCs are a heterogeneous group of tumors with different clinical and pathologic features, prognosis, genetic-molecular alterations and treatment responsivity. The PI3K/AKT is a major pathway involved in the regulation of cell survival and proliferation, and is the most frequently altered pathway in breast cancer, apparently with different biologic impact on specific cancer subtypes. The most common genetic abnormality is represented by PIK3CA gene activating mutations, with an overall frequency of 20–40%. The aims of our study were to investigate PIK3CA gene mutations on a large series of TNBC, to perform a wider analysis on genetic alterations involving PI3K/AKT and BRAF/RAS/MAPK pathways and to correlate the results with clinical-pathologic data. Materials and Methods PIK3CA mutation analysis was performed by using cobas® PIK3CA Mutation Test. EGFR, AKT1, BRAF, and KRAS genes were analyzed by sequencing. Immunohistochemistry was carried out to identify PTEN loss and to investigate for PI3K/AKT pathways components. Results PIK3CA mutations were detected in 23.7% of TNBC, whereas no mutations were identified in EGFR, AKT1, BRAF, and KRAS genes. Moreover, we observed PTEN loss in 11.3% of tumors. Deregulation of PI3K/AKT pathways was revealed by consistent activation of pAKT and p-p44/42 MAPK in all PIK3CA mutated TNBC. Conclusions Our data shows that PIK3CA mutations and PI3K/AKT pathway activation are common events in TNBC. A deeper investigation on specific TNBC genomic abnormalities might be helpful in order to select patients who would benefit from current targeted therapy strategies.
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Affiliation(s)
- Paolo Cossu-Rocca
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
- * E-mail:
| | - Sandra Orrù
- Department of Pathology, “A. Businco” Oncologic Hospital, ASL Cagliari, Cagliari, Italy
| | - Maria Rosaria Muroni
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Francesca Sanges
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Sara Ena
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Luciano Murgia
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | | | | | | | - Silvana Urru
- Biomedicine Sector, Center for Advanced Studies, Research and Development in Sardinia Technology Park Polaris, Cagliari, Italy
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