Prognostic and clinicopathological value of Twist expression in breast cancer: A meta-analysis

Qiao, Weiqiang; Jia, Zhiqiang; Liu, Heyang; Liu, Qipeng; Zhang, Ting; Guo, Wanying; Li, Peng; Deng, Miao; Li, Sanqiang

doi:10.1371/journal.pone.0186191

Cited by 17 publications

(18 citation statements)

References 49 publications

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“…Still, we found that the few patients (5%) with a twist positive PT had a shorter DRFi, compared to patients with a twist negative PT. This is in line with results obtained previously, where positive expression of twist has been associated with poor outcome of breast cancer patients [44,46], though an association between positive twist expression and a superior overall survival also has been described [33]. Our results might seem paradoxical, though twist is a transcription factor involved in multiple signaling pathways and could be a more biologically relevant marker to study compared to the three EMT effector markers included in our study [47,48].…”

Section: Discussionsupporting

confidence: 91%

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Expression of epithelial-mesenchymal transition-related markers and phenotypes during breast cancer progression

Jørgensen

Forsare

Bendahl

et al. 2020

Breast Cancer Res Treat

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Purpose The study aimed to investigate expression of epithelial-to-mesenchymal transition (EMT)-related proteins and phenotypes during breast cancer progression and to relate this to patient outcome. Methods Protein expression patterns of E-cadherin, N-cadherin, twist, and vimentin were examined by immunohistochemistry on formalin-fixed paraffin-embedded samples from primary tumors (PTs) (n = 419), synchronous lymph node metastases (LNMs) (n = 131) and recurrences (n = 34) from patients included in an observational prospective primary breast cancer study. Markers were evaluated individually and combined as defined EMT phenotypes (epithelial, mesenchymal, partial EMT, and negative). EMT profiles were compared between matched tumor progression stages, and related to clinicopathological data and distant recurrence-free interval (DRFi). Results N-cadherin-positivity, vimentin-positivity, mesenchymal and partial EMT phenotypes were associated with more aggressive tumor characteristics such as triple-negative subtype. Single EMT markers and phenotype discordance rates between paired tumor samples were observed in the range of 2-35%. Non-epithelial phenotypes were more frequently identified in recurrences compared to PTs, however, no skewness of expression or phenotype was detected between PTs and matched LNMs or between PTs and matched recurrences (Exact McNemar test). Interestingly, patients with a twist positive PT had shorter DRFi, compared to patients with a twist negative PT (hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.2-5.1, P = 0.02). Essentially, the same effect was seen in multivariable analysis (HR 2.5, 95% CI 0.97-6.6, P = 0.06). Conclusion The epithelial phenotype was indicated to be lost between PTs and recurrences as a reflection of tumor progression. Twist status of the PT was related to long-term prognosis warranting further investigation in larger cohorts.

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Section: Discussionsupporting

confidence: 91%

“…Nevertheless, in this study, we did not see any difference by marker status in relation to prognosis in terms of DRFi. Expression of twist in PTs has also previously been linked to various clinical parameters [44,45]. However, we did not find a significant association with any tumor or patient characteristic analyzed in this study.…”

Section: Discussioncontrasting

confidence: 90%

Expression of epithelial-mesenchymal transition-related markers and phenotypes during breast cancer progression

Jørgensen

Forsare

Bendahl

et al. 2020

Breast Cancer Res Treat

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“…Overexpression of TWIST and SLUG has also been observed in stromal tumor cells (64). However, the association of TWIST expression with disease-free survival and overall survival has not been consistently observed throughout these studies (63)(64)(65). Moreover, in a sample of 100 breast tumors, Nodal expression was associated with VM formation and VE-cadherin expression in a subgroup of tumors.…”

Section: Relationship Between Cscs Vm and The Epithelial-mesenchymalmentioning

confidence: 98%

An Overview of Vasculogenic Mimicry in Breast Cancer

et al. 2020

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Vasculogenic mimicry (VM) is the formation of vascular channels lacking endothelial cells. These channels are lined by tumor cells with cancer stem cell features, positive for periodic acid-Schiff, and negative for CD31 staining. The term VM was introduced by Maniotis et al. (1), who reported this phenomenon in highly aggressive uveal melanomas; since then, VM has been associated with poor prognosis, tumor aggressiveness, metastasis, and drug resistance in several tumors, including breast cancer. It is proposed that VM and angiogenesis (the de novo formation of blood vessels from the established vasculature by endothelial cells, which is observed in several tumors) rely on some common mechanisms. Furthermore, it is also suggested that VM could constitute a means to circumvent anti-angiogenic treatment in cancer. Therefore, it is important to determinant the factors that dictate the onset of VM. In this review, we describe the current understanding of VM formation in breast cancer, including specific signaling pathways, and cancer stem cells. In addition, we discuss the clinical significance of VM in prognosis and new opportunities of VM as a target for breast cancer therapy.

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“…Currently, the principal role of tumour markers in patients radically treated for BC and its metastases involves the early and timely diagnosis of systemic disease recurrence (13,14). Several studies have shown that elevation of serum tumour markers occurs significantly in advance of diagnosis of BC recurrence using radiodiagnostic methods (15,16).…”

Section: Discussionmentioning

confidence: 99%

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

Třeška¹,

Topolčan²,

Zoubkova³

et al. 2018

Anticancer Res

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Abstract. Background RFS (p<0.04; p<0.01; p<0.02), while CA19-9 postoperative levels were significant for OS and RFS (p<0.03; p<0.01 Breast cancer (BC) represents the most frequent cancer worldwide among women and is one of the most frequent causes of death in this population. BC metastases either develop concomitantly with the primary BC or at different time intervals in more than 50% of women with BC. Breast cancer liver metastases (BCLM) in most women are associated with concurrent BC dissemination to the lungs and bones and these represent the only site of metastatic BC in 12-15% women. Although great progress has been made in the diagnosis and effective treatment of BC, metastases develop in 30% of women despite timely diagnosis and radical treatment (1, 2).Surgical treatment of BCLM is an important component of multimodal therapeutic approaches. However, its results remain suboptimal compared, for example, to patients with colorectal cancer liver metastases. In our view, one strategy that might improve the results of surgical management of BCLM is the search for early indicators of tumour dissemination or for prognostically high-risk patients.Tumour markers are general indicators used in monitoring and follow-up of patients. The most frequently used markers to monitor treatment efficacy and diagnose BCLM recurrence include mucins, such as carbohydrate antigen CA 19-9, cytokeratins such as tissue polypeptide antigen (TPA) and tissue-specific polypeptide antigen (TPS), proliferation markers such as thymidine kinase (TK) and carcinoembryonic antigen (CEA). However, no study regarding the prognostic significance of preoperative serum tumour marker levels in patients undergoing surgery for BCLM has been published to date, as far as we are aware.The aim of our retrospective study was to determine whether perioperative levels of clinically routinely used tumour markers influence overall survival (OS) and recurrence-free survival (RFS) of patients undergoing resection or thermoablative therapy for BCLM as part of a multimodal approach. Patients and MethodsFrom January 1, 2000 until January 1, 2018, a total of 32 women underwent surgery for BCLM at the Department of Surgery, University Hospital in Pilsen, Czech Republic. Surgery was indicated in women in a general good state of health from the aspect of surgery and those who had consented to undergo the proposed surgical procedure. Surgery was indicated only if the metastases were located solely within the liver parenchyma. Every patient underwent hybrid imaging using positron-emission tomography (PET) and computed tomography (CT) or PET and magnetic resonance imaging (MRI) before surgery. Another requirement was that the future liver remnant volume exceed 30% of the total liver volume. The average age of these women was 49.5±10.7 years. The primary BC types were: ductal in 20 cases, lobular in seven, erysipeloid in four, and sarcomatoid (spindle cell) carcinoma in one. The average interval between initial breast surgery and BCLM surgery was 4.7±3.7 years.

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Prognostic and clinicopathological value of Twist expression in breast cancer: A meta-analysis

Cited by 17 publications

References 49 publications

Expression of epithelial-mesenchymal transition-related markers and phenotypes during breast cancer progression

Expression of epithelial-mesenchymal transition-related markers and phenotypes during breast cancer progression

An Overview of Vasculogenic Mimicry in Breast Cancer

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

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